Intended for healthcare professionals

Rapid response to:


The quality of health information on the internet

BMJ 2002; 324 doi: (Published 09 March 2002) Cite this as: BMJ 2002;324:557

Rapid Response:

A significant number of users are confused by medical information provided over the internet.


Purcell et al argue against the regulation of medical information
provided over the internet.(1) However, they state that in the final
analysis, it is the users views that are paramount. Our questionnaire
study of patients attending an orthopaedic outpatient clinic in a district
general hospital addressed use of the Internet and the perception of
quality of information obtained.

From 369 respondents (response rate 91%), 55.3% of patients had
accessed the Internet. Of these, 52.0% had obtained medical information
from this source. Access was linearly correlated with age (r2=0.975,
p<_0.01 and="and" was="was" also="also" related="related" to="to" social="social" status.="status." a="a" total="total" of="of" _25="_25" those="those" who="who" had="had" visited="visited" medical="medical" website="website" reported="reported" that="that" they="they" been="been" left="left" confused="confused" by="by" the="the" information="information" provided.="provided." _12.3="_12.3" patients="patients" researched="researched" their="their" particular="particular" orthopaedic="orthopaedic" condition="condition" _20="_20" advice="advice" received="received" from="from" surgeon="surgeon" in="in" clinic="clinic" contradicted="contradicted" obtained="obtained" internet.="internet." _35.7="_35.7" would="would" undergo="undergo" an="an" internet="internet" _-based="_-based" consultation="consultation" whilst="whilst" further="further" _25.5="_25.5" consider="consider" this="this" depending="depending" on="on" question.="question." p="p"/> This study suggests that the a significant proportion of “users” of
medical websites will enter our clinics more confused than those who have
not endeavoured to surf the internet. Moreover, the rate of perceived
discrepancy between advice provided over the Internet as compared to that
provided by the doctor in the clinic is worryingly high. However, the use
of the Internet for this purpose looks set to increase.

In the United States the American Medical Association has issued
guidelines to govern aspects of its medical websites and has identified
four major areas in which quality standards are required: content,
advertising and sponsorship, privacy and confidentiality,and e-

On the basis of “users” views we suggest that the British medical
establishment, and its individual specialities, set up similar guidelines
for approved websites. At the very least, we agree with those who have
suggested that patients require education in the rudiments of critical
review when confronted with the wealth of information available over the

1 Purcell GP, Wilson P, Delamothe T. The quality of health
information on the internet. BMJ 2002:324;557-558

2 Winker MA, Flanagin A, Chi LB, White J, Andrews K, Kennett RL et al.
Guidelines for medical and health information sites on the internet:
principles governing AMA web sites. JAMA 2000:283;1600-6.

3 Ling CA. Guiding patients through the maze of drug information on the
Internet. Am J Health Syst Pharm 1999:56;212-4.

Chinmay M Gupte, specialist registrar

Cynthia Datta, senior house officer

Abdel NA Hassan, specialist registrar

Ian D McDermott, specialist registrar

Department of Musculoskeletal Surgery, Imperial College, Charing
Cross Hospital, London W6 8RF.
Competing interests: none.

Competing interests: No competing interests

11 March 2002
Chinmay M Gupte
Specialist registrar
Cynthia Datta, Abdel NA Hassan, Ian D McDermott
Musculoskeletal surgery and biomechanics,Imperial College, London W6 8RF