WEBSITE OF THE WEEKBMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7195.1427a (Published 22 May 1999) Cite this as: BMJ 1999;318:1427
www.healthanswers.com/ This week's subject illustrates the classic problem of medical information on the internet: a surfeit of sites of varying quality. On page 1375 we publish details of a systematic review of trials of treatment of the premenstrual syndrome with vitamin B-6 (pyridoxine) that suggests that, although existing trials are of low quality, the vitamin may be useful in relieving premenstrual symptoms, especially depression.
The need for rigorous evaluation is clear: premenstrual syndrome is as much a lay diagnosis as a medical one, which will tend to increase the quantity of information directed at a lay audience. It is also a condition for which there are many treatments, usually a fair sign that nothing works particularly well. Worse still, some of these are vitamins, a certain way to (how can I be polite?) attract practitioners with unusual health beliefs. And behind every treatment is a company with something to sell (see, for example, www.mothernature.com/ency/Concern/pms.asp). Add in the variability that a prefixed word can cause in a digital search, and the result is entanglement.
The Cochrane Library would be a good place to start; abstracts of its systematic reviews are free on the web (at www.update-software.com/cochrane.htm), as are protocols in progress (including the one of the research reported this week), but subject coverage remains limited. Omni (www.omni.ac.uk) wasn't much help: two links, one dead, and one a brief summary. You could pick hundreds of sites with information about the syndrome from a raw search on any search engine. The best that I came across was HealthAnswers, which has good quality, well organised information aimed at consumers.
However, the problems of the medical encyclopaedia persist into the virtual world: you have to know what you've got before you can look it up.