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A wider application than just to doctors
- Peter Murray (11 March 1999)
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Internet evaluation tools better aimed at professionals
- Michelle Gillies (7 April 1999)
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Peter Murray, Lecturer (Nursing & Informatics) The Open University
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As the co-author of one of the papers cited (no. 17)in Kim et al's review of criteria on evaluating health related web sites, I very much value their contribution to the literature. Of particular value is their recognition that a similar set of criteria are needed for use by the general public. The suite of issues around evaluation of health related information on the Web continues to attract international interest and discussion. At present, discussions are ongoing on the NURSE-UK list and the NTPDEV-L listserv discussion forum (developers of nursing theory websites). The teaching of the necessary skills (and associated knowledge) to facilitate critical evaluation of website content is currently exercising the minds of many educators in the UK and elsewhere. I am currently Course Development Chair of a team which is developing just such a set of materials for delivery by The Open University next year, but other materials are already available too (eg the CASP -Critical Appraisal Skills Programme - materials). While such educational materials can be readily made available and included in curricula for health professionals, the important issue of how to provide such education to the public, patients/clients and their carers is more problematic and may not have as ready a solution. I would conclude, though, by raising a philosophical question of whose interests are served by the development of such criteria. There is a potential danger of them becoming constraining, even acting as a form of censorship, to the free exchange of valid information if the materials are not congruent with the prevailing 'health orthodoxy' of the developers of criteria or the 'gatekeepers' of sites and portals. Quis custodiet custodes? Peter J. Murray Lecturer, School of Health & Social Welfare, The Open University Editor, ITIN: official journal of the British Computer Society Nursing Specialist Group |
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Michelle Gillies, medical student University of Glasgow
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Editor- I applaud the efforts of Kim and colleagues, in their review of published criteria for evaluating health related web sites1. However, it would appear that some confusion exists as to the likely users of such a tool. Kim et al are among a growing body of authors who advocate the development of an evaluation tool for use by the general public. I am neither convinced that there is a need for, or would be use of, such a tool by this group. In the UK the numbers with access to the Internet is still low, indeed many people have never used a computer. We can assume that this will gradually change as technical and access difficulties are overcome. Nevertheless, using simple non-medical search terms, Internet search engines will identify thousands of sites for any given medical topic2. Even experienced Internet users may have difficulty navigating through the "hits" to identify the few sites that are relevant to their query. Only the exceptionally information literate would then be prepared to invest in evaluating these sites using a validated tool, which may consist of twelve or thirteen criteria as identified by the authors. Public health initiatives would be required to persuade consumers that such evaluation tools are firstly necessary, and secondly beneficial. Such initiatives may be successful, but at an appreciable cost. Furthermore, if we consider that as yet we know very little about the epidemiology of health informatics, and are currently not able to identify which type of information has a negative effect on public health outcomes3, would such initiatives be wise? There is little doubt that the emerging consensus of evaluation criteria described is a sign of the imminent development of a validated tool for evaluating health related web sites. Health care professionals have a role to play as partners in consumer driven education by reviewing sites, and providing gateways, with commentary, on useful sites. Published criteria such as those identified by Kim et al may help to make such reviews "transparent", but such tools are better aimed at a professional rather than patient-based audience. Michelle Gillies Student in MBChB University of Glasgow References 1. Kim P, Eng TR, Deering MJ, Maxfield A. Published criteria for evaluating health related web sites: review. BMJ 1999; 318: 647-649. 2. Rose S, Bruce J, Maffulli N. Accessing the Internet for patient information about othropedics. [Letter] JAMA 1998; 280:1390 3. Coiera E. Information epidemics, economics, and immunity on the Internet. BMJ 1998; 317: 1469-1470 |
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