How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews

doi:10.1136/bmj.324.7337.573

BMJ 2002;324:573-577 ( 9 March )

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How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews

Gunther Eysenbach, senior researcher, Christian Köhler, researcher.

Unit for Cybermedicine and eHealth, Department of Clinical Social Medicine, University of Heidelberg, Bergheimer Str 58, 69115 Heidelberg, Germany

Correspondence to: G Eysenbach ey{at}yi.com

Objectives: To describe techniques for retrieval and appraisalused by consumers when they search for health information on theinternet.
Design: Qualitative study using focus groups, naturalisticobservation of consumers searching the world wide web in a usabilitylaboratory, and in-depthinterviews.
Participants: A total of 21 users of the internet participatedin three focus group sessions. 17 participants were given a seriesof health questions and observed in a usability laboratory settingwhile retrieving health information from the web; this was followedby in-depthinterviews.
Setting: Heidelberg,Germany.
Results: Although their search technique was oftensuboptimal, internet users successfully found health informationto answer questions in an average of 5 minutes 42 seconds (median4 minutes 18 seconds) per question. Participants in focus groupssaid that when assessing the credibility of a website they primarilylooked for the source, a professional design, a scientific orofficial touch, language, and ease of use. However, in the observationalstudy, no participants checked any "about us" sections of websites,disclaimers, or disclosure statements. In the post-search interviews,it emerged that very few participants had noticed and rememberedwhich websites they had retrieved informationfrom.
Conclusions: Further observational studies are needed todesign and evaluate educational and technological innovationsfor guiding consumers to high quality health information on theweb.

What is already known on this topic
Little is known about how consumers retrieve and assess the quality of health information on the internet

Qualitative data are needed to design educational and technological innovations to guide consumers to high quality health information

What this study adds
Users of the internet explore only the first few links on general search engines when seeking health information

Consumers say that when assessing the credibility of a site they primarily look for the source, a professional design, and a variety of other criteria

In practice, internet users do not check the "about us" sections of websites, try to find out who authors or owners of the site are, or read disclaimers or disclosure statements

Very few internet users later remember from which websites they retrieved information or who stood behind the sites

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Rapid Responses:

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Focus on quality of website information neglects issue of internet usage: John R Petrie, et al.
bmj.com, 12 Apr 2002 [Full text]
A more democratic approach to information: Robert C Hsiung
bmj.com, 30 May 2002 [Full text]
Re: A more democratic approach to information: Gunther Eysenbach
bmj.com, 1 Jun 2002 [Full text]
Re: A more democratic approach to information: Robert C Hsiung
bmj.com, 11 Jun 2002 [Full text]
starting from basics: Vinod Scaria
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An Expertise Not Utilized: Elizabeth M. La Rue
bmj.com, 31 Jan 2003 [Full text]