Intended for healthcare professionals


Quality of health information about depression on internet

BMJ 2001; 322 doi: (Published 02 June 2001) Cite this as: BMJ 2001;322:1366

Study's shortcomings may have affected findings

  1. André Tomlin, director of knowledge services (,
  2. Karin Lee Dearness, knowledge officer,
  3. John Geddes, consultant psychiatrist
  1. Centre for Evidence Based Mental Health, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX
  2. Computing and Networks Department, Rouen University Hospital, F-76031 Rouen Cedex, France
  3. Centre Cochrane Français, Centre Léon Bérard, F-69373 Lyons, Cedex 8, France
  4. Department of Medical Information, Tenon Hospital, Assistance Publique de Paris, F-75020 Paris, France
  5. EA 643/ Service de Pharmacologie Clinique, Faculté RTH Lannec, F-69376 Lyons
  6. Centre for Mental Health Research, Australian National University, Canberra, ACT 0200, Australia

    EDITOR—Griffiths and Christensen evaluated the quality of web based information on the treatment of depression.1 Although they have tried to scrutinise the quality of a select group of websites, there are shortcomings in their methods that may have affected their findings.

    Griffiths and Christensen used just one search engine (DirectHit) and one meta-search engine (MetaCrawler), which limited the comprehensiveness of their search. Although the popularity of search engines changes rapidly, we question the choice of DirectHit over more often used engines such as AltaVista or Google.2 Therefore, it is difficult to justify the assumption of Griffiths and Christensen that their search method provided the best available approximation to a list of depression sites.

    We also question the strategy of using the single search term of “depression,” given that over 44% of internet users search using multiple keywords.3 The extreme narrowness of using a single keyword search was summed up eloquently by Brian Pinkerton, the founder of MetaCrawler, when he said: “Imagine walking up to a librarian and saying, ‘travel.’ They're going to look at you with a blank face.”4

    Griffiths and Christensen attempt to assess the quality of information found by comparison with a guideline of the Agency for Health Care Policy and Research (AHCPR) guideline. Readers should be aware that tools, such as DISCERN (, are readily available for appraising the quality of patient information. Furthermore, although the AHCPR guidelines were developed using an evidence based method, they were published in 1993 and may not necessarily reflect recent …

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