How to improve health information online for our patients
Recommending trustworthy sites can help address problems with quality, quantity of information
Health literacy’s import in web searches
Low health literacy is associated with poor outcomes, including increased mortality and re-hospitalizations (Clin Nephrol 2014; 8:30-7; Cancer 2012; 118:3842-51). More specific to urology, research has shown low health literacy can impact the quality of life of those with newly diagnosed, localized prostate cancer (J Health Commun 2010; 15:3-17).
Moreover, patients with low health literacy can’t evaluate and discern trustworthy information. Often, inaccurate sites will be linked to others that are equally problematic, reinforcing mistaken, wrong, or even erroneous information (N Engl J Med 2010; 362:1063-6). Web searches can become chronic for those with anxiety. “Cyberchondria” is a condition resulting from searching the web—unfounded anxiety based on looking up symptoms (J Bone Joint Surg Am 2010; 92:1612-18).
Too often, patients defer actual diagnosis and treatment and do themselves harm with random research. To address this, the following four findings were gleaned from what’s out there on “Dr. Google” from the perspective of a urologist and urology patient.
First, it’s important to understand that online researchers are both patients and their caregivers. Thirty-nine percent of U.S. adults are caregivers and 84% of caregivers with Internet access said in a 2013 survey they went online within the past year to research health topics such as medical procedures, health insurance, and drug safety.
Second, these online researchers (77%, according to Pew’s research) usually start with typing into a search engine, rather than consulting a specific website.
Third, website variability is documented in research, yet as Hartzband and Groopman state, “Material is perceived as factual merely because it is on a computer screen (N Engl J Med 2010; 362:1063-66).” For example, in a review of 154 websites for content quality of orthopedic sports medicine diagnoses, reviewers used a 100-point scale to rate the content. The average score for quality of the content was 55 (Urology 2010; 75:619-22). A review of YouTube video content on prostate cancer appeared in 2010 in Urology. The reviewers concluded that much of the information was “inadequate” and “unbalanced.”
Fourth, when a patient gets over 33 million Google search results on “prostate cancer” (March 9, 2016 search numbers), he is overwhelmed. Spinning through just the first page of those results is daunting.
These four insights make it clear that health care professionals can make a huge difference in what our patients and their caregivers see online by actually prescribing websites that are trustworthy.