Information In Practice

Commentary: measuring quality and impact of the world wide web

BMJ 1997; 314 doi: (Published 28 June 1997) Cite this as: BMJ 1997;314:1879
  1. Jeremy C Wyatt, senior research fellowa
  1. a ICRF Centre for Statistics in Medicine Institute for Health Sciences PO Box 777 Oxford OX3 7LF


    The world wide web gives patients and professionals access to thousands of pages of clinical information, some of which are assessed by Impicciatore et al above.1 However, although the web makes it absurdly easy to disseminate information, by allowing anonymous authors to conceal commercial or other conflicts of interest2 it does not help readers to discriminate between genuine insight and deliberate invention.3 Thus, recent proposals for improving the accountability of medical information on the internet2 will enhance its value. Sometimes, though, checking whether a web site passes the criteria of Silberg et al for explicit authorship and sponsorship, attribution of sources, and dating of material2 is not enough, as Impicciatore et al show.1 For example, most doctors would recommend to patients or junior colleagues only those web sites whose content seemed of adequate quality. Some clinicians might go further and have to satisfy themselves that a site was well constructed, easy to use, and had a beneficial impact on doctors and patients.

    Thus, for many purposes, evaluation of web sites needs to go beyond mere accountability to assessing the quality of their content, functions, and likely impact (see table 1)–similar to the assessment of electronic textbooks, telemedicine, and decision support systems,4 5 6 where the same issues arise.

    View this table:
    Table 1

    Aspects of a web site which need to be considered when evaluating its reliability

    Evaluating the content and structure of a web site

    Since internet philosophy declares that anyone can set up a web site7 there is a risk that, through ignorance or bias, the content of the site may not be correct even if the original information sources were reliable. Impicciatore et al showed that parents searching for information about treating a feverish child could either receive good advice or be advised to administer aspirin, putting their child at risk of Reye's …

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