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Review of online breast cancer information encourages healthy skepticism for consumers

February 11, 2008

Quality criteria does not determine accuracy of Web sites

HOUSTON - In an extended analysis of Web pages dedicated to disseminating breast cancer information, researchers at two University of Texas institutions in the Houston have determined that while most breast cancer data found online was accurate, one in 20 breast cancer Web pages featured inaccuracies and sites displaying complementary and alternative medicine were 15 times more likely to contain false or misleading health information.

Published in the March 15 issue of Cancer and online today, the study was conducted by The University of Texas M. D. Anderson Cancer Center in collaboration with researchers at The University of Texas School of Health Information Sciences at Houston (SHIS) as one of a series of studies to determine whether existing quality assessment tools can identify false or inaccurate breast cancer information available online.

The Pew Internet and American Life Project estimates that more patients seek health information online rather than visit a physician.

According to Funda Meric-Bernstam, M.D., associate professor of surgery at M. D. Anderson, many of her patients have gone on the Internet for education and are savvy in their breast cancer knowledge even before their first appointment with her.

"Often it's clearly a benefit. For example, I've had patients who were recommended mastectomies that were really breast conservation candidates. They actually figured this out by going online and then seeking out surgeons capable of performing the surgery," says Meric-Bernstam, the study's senior and corresponding author. "In contrast, there are times patients read about treatments that clearly do not apply to them, which can increase their level of anxiety or expectations for a treatment that they are not a candidate for. Of course, one also worries about patients who go online and then ultimately do not seek out any treatment despite it being necessary."

In total, 343 Web pages, retrieved using search engines that consumers are likely to use, were analyzed. Each was reviewed for 15 quality criteria, including display of authorship, date of creation and last modification. It was important that the quality criteria be "reproducible," says the study's first author Elmer Bernstam, M.D., an associate professor at both SHIS and The University of Texas Medical School at Houston. Forty-one inaccurate statements were found on 18 of the different Web sites, or 5.2 percent.

"Consumers are taught to look for Web sites where the author's credentials are identified, his or her affiliations are disclosed and other information is listed," said Bernstam, an internist. "But none of this ensures accuracy."

A more positive finding is that the breast cancer information available on the Internet is more accurate than other fields of health information, says Meric-Bernstam.

The authors recognize that while much has changed in terms of the wealth of information about health available on the Internet since the data was collected in 2004, the issue regarding specific quality criteria is timely.

"The question that we really tried to answer was if we could separate Web sites that have misinformation from Sites that have more accurate content. No combination of the criteria allowed us to differentiate the Web sites with accurate information versus those that did not," Bernstam said.

Using such quality criteria, the researchers ultimately hope to develop a screening or automated tool to help consumers eliminate sites with misinformation.

"However, our current recommendation to patients is to be skeptical, make sure what patients read is applicable to their specific medical well-being and not to take action without consulting a clinician," says Meric-Bernstram.

University of Texas M. D. Anderson Cancer Center