Reviews

NETLINES

• A quarter of all the material on the internet is health related (www.ama-assn.org/sci-pubs/journals/archive/jama/vol_281/no_4/cv80008x.htm). About a third of web surfers are searching for health information (www.rcsed.ac.uk/journal/vol44_4/4440040.htm). Much of this material is not technical but of interest to consumers.
• A comprehensive starting point is the Hardin Meta directory at http://www.lib.uiowa.edu/hardin/md/index.html, which is effectively a gateway to other directories. This site is catalogued by specialty, but it is more than just a simple (and extensive) collection. The webmaster has gone to the trouble of checking that the links within the target directories are functioning, and Hardin is quite choosy about whom it includes (see www.lib.uiowa.edu/hardin/md/submit.html). If you cannot find what you are looking for in Hardin, there is a list of other similar collections. This site allows the user to locate specific good quality information quickly.
• Another guide to appraising health information is an instrument called DISCERN (www.discern.org.uk). A questionnaire prompts assessment of the quality of health information materials. The instrument has been widely validated for written leaflets and for use by designers of new information as well as people assessing existing material.
• A site that caters for both doctors and patients is at www.cancerbacup.org.uk. This UK based resource on cancer information and support is aimed primarily at people with cancer and their families or carers; the home page proudly proclaims that there are about 1500 pages of data. It is a content-rich site, with the main button bar sporting separate sections for health professionals and patients. The division between the information needs of the health professional and those of the lay person becomes blurred when the information is presented well, as is the case with this website. But the addition of a site map would greatly help navigation.
• www.betterhealth.com/virtualcheckup/noplugin/heart/index.html, as the URL suggests, is a "virtual check up" and relies on consumers inputting data relating to their cardiovascular health, such as blood pressure and cholesterol concentration. The site then gives an assessment coupled with a diagram of the coronary arteries. "Bad" news from the self assessment may cause alarmbut others may feel that they must do something to improve their health. At least it is thought provoking and may promote a better lifestyle. As internet technology improves, we will certainly see more (and more sophisticated) variations on this kind of interactive consultation.
• To see some of the best design in a health website, visit Cancer Help UK (http://medweb.bham.ac.uk/Cancerhelp/indexg.html). Based at the University of Birmingham in the Cancer Research Campaign's Institute of Cancer Research, this site is unusual for its consideration of novice users. There are several ways of accessing information, which allows readers to choose how they drill down to the desired information. A glossary of terms can be left permanently on in a separate window, for looking up unfamiliar words. None of these touches is unique, but the combination is unusually friendly.
• Information on the web (or in newspapers and magazines) may not be all that it seemshence the importance of critical appraisal skills. A site to teach this to children is Quick (www.quick.org.uk/), a quality information checklist for health. It is a crisp, speedy, entertaining, and well illustrated resource. Guidance for teachers is also available at www.quick.org.uk/teachers.htm.
• Currently being developed is the "building site" of the National Electronic Library for Health (www.nelh.nhs.uk/buildng.htm). The site takes its architectural theme a long way: when the library is built there will be a floor for patients (branded as NHS Direct online) and the whole enterprise will revolutionise information flows. Check the blueprints yourself.
• A branch of the US based National Institutes of Health has produced a publication on impotence for doctors and patients (www.niddk.nih.gov/health/urolog/pubs/impotnce/impotnce.htm). It is simply and clearly laid out. There are no links to other external impotence websites, but a major plus is the lack of copyright, allowing unlimited copying and dissemination of the contents of the page.
• After being diagnosed with a condition, patients may want to join a self help group or a support group, but often the problem is finding a suitable one. Two good UK sites that can help are www.cafamily.org.uk/home.html and http://www.patient.co.uk. A useful place to start hunting for US based self help groups is to look at www.healthy.net/home/index.html. This can lead to a massive archive of contacts within a few mouse clicks.
• And finally, point your browser at http://pbcn.findhere.com and read the welcome page from the Philippine Breast Cancer Network, a patient pressure group. The site contains moving stories of women and their battle with breast cancer; equally it emphasises the point that the internet is the number one global publishing medium.

Harry Brown general practitioner and trainer, Leeds UK

DrHarry{at}dial.pipex.com

David Dickinson consumer information designer, UK

david.dickinson{at}consumation.com

We welcome suggestions for websites to be included in future Netlines. Readers should contact Harry Brown at the above email.