Nancy Calabretta, MS, MEdAssistant Library Director

Cooper Medical School of Rowan University

PretestAll health information on the web

is accurate and reliableTrue or False

The best way to find health information online is by using Google

True or False

It’s okay for a health web sites to have ads

True or False

Wikipedia is a good source of health information

True or False

I am confident in my ability to find quality

True or False

– 72% of internet users have looked online for health information within the past year

– 35% of American adults report having gone online to “figure out” a medical condition

– 77% of online health seekers start at a search engine like Google, Bing or Yahoo

Why This Session Now?Pew Internet & American Life Project findings

Why This Session Now?

The amount of information available on healthtopics is staggering. A search on “Heart Failure”retrieves:

20,200,000 on Google 9,540,000 on Bing 9,550,000 on Yahoo

IF we agree that…

“…nurses are in a unique position to recommend Web sites to patients that provide accurate and current information and can be used to answer their health-related questions.”

Plast Surg Nurs. 2007 Oct-Dec;27(4):192-6. Oermann MH, McInerney SM.

Then we can conclude that…

“…nurses need to be taught how to identify websites that contain quality information, are reader-friendly, and are credible.”

Adv Emerg Nurs J. 2013; 35(3):245 Orlowski JL, Oermann MH, Shaw-Kokot J.

Nurse-led Evaluation Of Web SitesEvaluation of heart failure websites for patient education. Adv Emerg Nurs J. 2013 Jul-Sep;35(3):240-6 Orlowski JL, Oermann MH, Shaw-Kokot J.

An evaluation of sepsis Web sites for patient and family education. Plast Surg Nurs. 2007 Oct-Dec;27(4):192-6. Oermann MH, McInerney SM.

Evaluation of breastfeeding Web sites for patient education. MCN Am J Matern Child Nurs. 2006 Jan-Feb;31(1):18-23. Dornan BA, Oermann MH.

An evaluation of bariatric Web sites for patient education and guidance. Gastroenterol Nurs. 2005 Mar-Apr;28(2):112-7. Nichols C, Oermann MH.

Evaluation of asthma websites for patient and parent education. J Pediatr Nurs. 2003 Dec;18(6):389-96O Oermann MH, Gerich J, Ostosh L, Zaleski S.

Evaluation of Web sites on management of pain in children. Pain Manag Nurs. 2003 Sep;4(3):99-105. Oermann MH, Lowery NF, Thornley J.

Using health web sites for patient education. J Wound Ostomy Continence Nurs. 2003 Jul;30(4):217-23. Oermann MH.

HRT & the World Wide Web. Helping patients find good information on the web. AWHONN Lifelines. 2002 Dec;6(6):526-32 Oermann MH, DiBartolomeo RA, Mahfet SA.

• Identify key points of knowledge and assess site for their presence

• Assess quality using HONcode principles• Check readability of text using FKGL and FRES

in Microsoft Word

• Search for topic on top search engines (Google, Yahoo, Bing)

• Evaluate first 5 web sites on each search engine after eliminating duplicates

The Oermann Method

HONcode principlesreadability FKGL FRES

• On March 20, 1996, www.hon.ch became one of the very first URLs to guide both lay users and medical professionals to reliable sources of healthcare information

• Web publishers can apply and, if website qualifies, may display the HONcode symbol

• Regular monitoring begins one year after initial certification or following complaints or technical malfunction

Health on the Net Foundation

HONcode PrinciplesAuthoritative Indicates qualifications of authors

ComplementarityInformation supports, not replaces, doctor-patient relationship

Privacy Respects privacy and confidentiality of personal data submitted to site by visitor

Attribution Cites source(s) of published information, including date of last modification

Justifiability Supports claims relating to benefits and performance

Transparency Accessible presentation with accurate e-mail contact

Financial Disclosure Identifies funding resources

Advertising Policy Clearly distinguishes advertising from editorial content

Making the most of HONcode

HONcode Search

HONcode Toolbar

Sample HONcode search

HONcode Status can be checked using the HONcode Toolbar

Issues to Consider

be aware of HONcode

applied unsuccessfully

perceive HONcode as important

a voluntary program

• They may have

• Website publishers may not

• HONcode IS

• They may not

Uses length of sentences and number of polysyllabic words to determine scores from 0 – 100, the higher the score the easier the read

Readability Tools

Flesch Reading Ease

Uses mean sentence and word length to calculate reading level corresponding to grade in school

Readability Tools

Flesch-Kincaid Grade Level

Readability ToolsThe 7 Steps to Using a Readability Tool (MS Word 2007)

7654321

Top 5 Websites on Heart Failure

What Else is There?Portals & Gateways provide collections ofprescreened web sites determined to be ofhigh quality by a governing organization.

HealthFinderMedlinePlus Mayo Clinic Health InformationTranslations

MedlinePlus Quality Guidelines

Quality, authority and accuracy of contentPrimary purpose is educationalConsistent availability & maintenance of web pageSpecial features (unique information,

graphics/diagrams, accessible to persons with disabilities)

MedlinePlus Features

Medline Plus Guide to Health Web Surfing• Consider the source – use recognized authorities• Focus on quality – all sites are not created equal• Be a “cyberskeptic” – quackery abounds on the web• Look for the evidence – research NOT opinion• Check for currency – look for the latest• Beware of bias – What is the purpose? Who funds?• Protect your privacy – Health info should be confidential• Consult with your health professional

MedlinePlus Topical PagesHeart Failure

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HealthFinder

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Mayo Clinic

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Health Information Translations

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What Do You Think?

The Facts About Tourette’s Syndrome

The Doctor’s Medical Library

Drugs.comLearning About Dercum Disease

Dercum’s Disease

The Doctor’s Medical Library

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The Facts About Tourette’s Syndrome

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Dercum’s Disease

What Do You Think?

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What Do You Think?

Learning About Dercum Disease

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Drugs.com

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Post TestAll health information on the web

is accurate and reliableTrue or False

The best way to find health information online is by using Google

True or False

It’s okay for a health web sites to have ads

True or False

Wikipedia is a good source of health information

True or False

I am confident in my ability to find quality

True or False

1) To research and write an “Oermann style” article;

2) To research and compile a short list of reliable sites for your patients;

3) To search with confidence using HONcode, readability scores and favorite gateway sites.

Use what you learned today…

References• Ahmed, O.H., Sullivan, S.J., Schneiders, A.G., McCrory, P.R. (2012) Concussion information online: evaluation of information quality,

content and readability of concussion-related websites. British Journal of Sports Medicine, 46, 675-683.• Akerkar, S.M., Bichile, L.S. (2004). Doctor patient relationship: changing dynamics in the information age. Journal of Postgraduate

Medicine, 50, 120-122.• Bradley, S.M. (2008). The Internet: Can patients link to credible resources? MEDSURG Nursing, 17, 229-236.• Golterman, L., Banasiak, N.C. (2011). Evaluating web sites: Reliable child health resources for parents. Pediatric Nursing, 37, 81-83.• Oermann, M.H., McInerney, S.M. (2007). An evaluation of sepsis web sites for patient and family education. Plastic Surgical

Nursing, 27, 192-196.• Orlowski, J.L., Oermann, M. H., Shaw-Kokot, J. (2013). Evaluation of heart failure websites for patient education. Advanced

Emergency Nursing Journal, 35, 240-246.• Wald, H.S., Dube, C.E., Anthony, D.C. (2007). Untangling the Web – The impact of Internet use on health care and the physician-

patient relationship. Patient Education and Counseling, 68, 218-224.• Websites:• Fox, S., Duggan, M. (January 15, 2013). Pew Internet & American Life Project. Health online 2013 summary of findings. Retrieved

9/27/13 from http:// www.pewinternet.org/Reports/2013/Health-online/Summary-of-Findings.aspx.• Health on the Net Foundation. (Last updated February 2012). Advice to patients on the safe use of the internet. Retrieved 9/27/13

from http://www.hon.ch/HONcode/Pro/visitor_safeUse.html.• Health on the Net Foundation. (Last updated September 2013). The HON Code of conduct for medical and health web sites

(HONcode). Retrieved 9/27/13 from: http://www.hon.ch/HONcode/Pro/Conduct.html.• Medical Library Association. (Last updated April 2013). A User’s guide to finding and evaluation health information on the web.

Retrieved 9/27/13 from: http://www.mlanet.org/resources/userguide.html• MedlinePlus. (Last updated May 2013). MedlinePlus quality guidelines. Retrieved 9/27/13 from:

http://www.nlm.nih.gov/medlineplus/criteria.html.• MedlinePlus. (Last updated April 2012). MedlinePlus Guide to healthy web surfing. Retrieved 9/27/13 from:

http://www.nlm.nih.gov/medlineplus/healthywebsurfing.html.• MedlinePlus. (Last updated September 2013). Evaluating health information. Retrieved 9/27/13 from:

http://www.nlm.nih.gov/medlineplus/evaluatinghealthinformation.html.