Intended for healthcare professionals


Information epidemics, economics, and immunity on the internet

BMJ 1998; 317 doi: (Published 28 November 1998) Cite this as: BMJ 1998;317:1469

We still know so little about the effect of information on public health

  1. Enrico Coiera (, Senior project manager
  1. School of Computer Science and Engineering, University of New South Wales, Sydney, Australia

    Information in practice p 1496

    For several years we have been warned of the internet's rapid growth and potential to spread poor information to the public.1 Now there are anecdotes of patients coming to harm because of information obtained on the internet.2 Are we witnessing the beginning of an epidemic of misinformation or nothing more than a variation of what is endemic? Patients have always obtained information outside the formal healthcare system. Perhaps now there is simply a new carrier called the internet, and nothing else has changed?

    The truth is we know very little about epidemiology in medical informatics, so it is hard to identify which information processes lead to unfavourable health outcomes. Encouragingly, new studies show surprising regularities when we look at population behaviour on the internet.3 Perhaps we will soon inject information “tracers” into our information and communication systems and observe their effect as they course though the social decision making apparatus.

    In the meantime we should do what we know best and focus on the public's health. Though there is poor quality health information on the internet, 4 5 no one has yet shown it has a positive or negative impact on public health outcomes. …

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