Introduction

The World Wide Web

General Search Engines and Subject Directories

Health-Specific Search Engines and Directories

Usenet Newsgroups

Listserv Mailing Lists

Real-Time Communication: Chat Rooms

Evaluating Health Information from the Internet

The Internet is a global network of computers that links together commercial online communication services with tens of thousands of university, government, and corporate networks. The Internet is composed of many parts, including World Wide Web documents, e-mail, newsgroups, mailing lists, and chat rooms. With access to the Internet, you can obtain in-depth information about hundreds of wellness topics and keep up with the latest research; you can also connect with people worldwide who share a medical problem or another challenge to wellness.

The World Wide Web is made up of computer files called Web pages or Web sites that have been created by individuals, companies, and organizations. The Web is considered a user-friendly part of the Internet because it offers easy access and navigation and has media capabilities, such as audio, video, and animation.

Each Web site is identified by an address or uniform resource locator (URL), such as http://www.healthfinder.gov. To access a site, you can type the URL into the appropriate screen of your browser or you can click on a hyperlink, a shortcut to another Web page or to a different part of the current page. When you view a Web page, hyperlinks may appear as images or as text that is a different color and/or is underlined. By clicking on links, you can jump quickly from one Web site to related sites, even if they are located at the other side of the world.

To search out information on a particular topic, you need to use a search engine or subject directory such as one of the following:

AltaVista Excite Hotbot Infoseek LookSmart Lycos

Magellan Northern Light Snap WebCrawler Yahoo!

These search engines search a unique database of Web pages and have different methods of ranking search results, so you will obtain different results from different search engines. A metasearch engine (or parallel search engine) like one of the following simultaneously submits your search to multiple search engines:

Ask Jeeves

Dogpile

Inference Find

MetaCrawler

To use a search engine or subject directory, you enter key words or navigate through a series of increasingly more specific directories; some search engines offer both key word and directory searches. Within seconds, the search engine will generate a list of sites (with hyperlinks) that match your search parameters, often with a brief description of each site.

When you are searching, it’s best to make your searches as specific as possible. Searching for key words such as "AIDS" or "cancer" will yield thousands or even millions of matches. Use more specific phrases, such as "HIV vaccine" or "cervical cancer treatment." If the search engine has a help section, take a look at it. Different search engines have different rules for how best to enter key words. For example, you may need to enclose phrases in quotation marks or put plus or minus signs between words to obtain an appropriate result. If you don’t find the information you are looking for using one search engine, try another.

The following sites have more information about search engines and tips for performing searches:

The federal government has created several consumer-oriented gateways to reliable health information:

In addition, there are many search engines and directories that specialize in health and medicine, including the following:

Newsgroups consist of archived messages, articles, and postings about a particular topic; they are similar to bulletin boards. Commercial online services maintain members-only newsgroups, but many more are available on the Internet. To locate a newsgroup on a particular topic, use a search engine or visit a site devoted to newsgroups.

You are free to browse any newsgroup’s articles. Postings on related topics are often grouped together in a "thread," consisting of an original message that began a discussion and all the replies to that message. A busy newsgroup can receive thousands of postings a day, and older articles are deleted to make room for new ones. If you find an article of interest, print it or save it to your computer—it may be deleted from the newsgroup by your next visit.

In addition to browsing, reading, and saving newsgroup postings, you can also be an active participant. You can reply to a message, either to the person who posted it or to the entire newsgroup, or you can post a new message that starts a new thread of discussion. To ensure that your postings are appropriate, it’s often a good idea to observe a newsgroup for a while or look at its "frequently asked questions" page prior to becoming an active member.

Listservs are similar to newsgroups, except that messages are delivered by e-mail to all subscribers to the mailing list rather than posted at a public site. Once you subscribe to a mailing list, you receive messages posted by other subscribers and you can post your own messages. As with newsgroups, it’s a good idea to read messages for a while before joining the discussion. You can stop subscribing to a mailing list at any time.

To locate listservs for a particular topic, do a key-word search using a search engine by entering the topic and the word "listserv." Or try the extensive mailing lists categorized by subject at Liszt: The Mailing List Directory.

With access to the Internet, you may also have the opportunity to participate in real-time communication with people from around the world. You can sign on to a particular chat group and communicate with others who are signed on to the same group at that time. You can have a "public" conversation, in which everyone in the chat room is included, or a "private" conversation between you and one other person. Many chat groups have a moderator who can kick people off and/or refuse them further access if they don’t behave appropriately. For reasons of privacy and security, many people suggest that chat room participants avoid divulging too much personal information. (The U.S. Department of Education publishes an online  Parent’s Guide to the Internet that includes safety tips for children who interact with others online.)

Anyone can post information and advice on the Internet—true or false, good or bad. When evaluating information from the Internet, ask the following questions:

What is the source of the information? Who is the author or sponsor of the Web page? Web sites maintained by government agencies, professional associations, or established academic or medical institutions are likely to present trustworthy information. Many other groups and individuals post accurate information, but it’s important to stay alert and watch your sources carefully. Many sites will describe their sponsor on the home page; alternatively, they may have an "about us" or "who we are" link that provides this information. Take a look at the backgrounds, qualifications, and credentials of the people who are behind the information at the site. Beware of sites that don’t indicate the source of the information they post; if you don’t know where it comes from, you can’t assess its validity.

As you click on links and move from page to page, also pay attention to where you are. Even if you start out at a trustworthy site, the click of a button can catapult you into a completely different site. Learn how to read your current Web address so you know when you’ve left one site and entered another. A URL can be broken down into the following parts:

protocol://server and domain name/directory and file name

Examples:

http://helping.apa.org/warningsigns

http://www.nalusda.gov/fnic/dga/dguide95.html

http://www.hsph.harvard.edu/cas/JACH1999-5.htm

You can learn something about many Web sites by looking at their URLs.

• The protocol, which is always following by a colon and two slashes, indicates the type of file that is being accessed. Many Web sites utilize the hypertext transfer protocol, or http; others include file transfer protocol (ftp) and gopher (gopher).
  
  
• The next part of the address, the server and domain names, refers to the particular computer that is the host for the Web page. Take a look at the abbreviation in the server name, which will change according to the host’s purpose. This can give you more information about the sponsor of a particular page, such as in the following examples:

• The final part of the address gives the directory and file name for the particular file on the server that you are accessing. Not all URLs include a file name; many "home pages" consist of only a protocol and server and domain name. At such sites, you can navigate deeper into the site to look at specific files. (Note: The inclusion of the tilde symbol[~] in a file name usually indicates a personal page.)

The three URLs listed as examples above are addresses for the following Web documents:

• A guide to recognizing warning signs of violence and dealing with anger created by the American Psychological Association (APA).
  
  
• The Dietary Guidelines for Americans, located at the Web site sponsored by the National Agricultural Library of the U.S. Department of Agriculture.
  
  
• Results of a recent study of college alcohol use, located at the Web site of the study’s authors at the Harvard School of Public Health.

How often is the site updated? Most Web pages will indicate the date of their most recent modifications. Major organizations may update their Web sites on a daily or weekly basis. Look for sites that are updated frequently.

What is the purpose of the page? Does the site promote particular products or procedures? Are there obvious reasons for bias? The same common sense you’d use to evaluate any factual claim applies to the Internet. Be wary of sites that advertise specific products, use testimonials as evidence, appear to have a social or political agenda, or ask you to send money. Many sites sponsored by commercial companies and lay organizations do provide sound, useful information; however, it is a good idea to consider possible sources of bias in the information they present.

What do other sources say about the topic? To get a broad perspective on a piece of information, check out other online sources or ask a professional. You are more likely to obtain and recognize quality information if you use several different sources. Be wary of claims that appear at only one site.

Does the site conform to any set of guidelines or criteria for quality and accuracy? A number of organizations, including the American Medical Association and the Health on the Net Foundation, have developed codes of conduct for health-related sites; these codes include criteria such as use of information from respected sources and disclosure of the site’s sponsors. Look for sites that identify themselves as conforming to some code or set of principles. (A recent article in the British Medical Journal reviewed many of these sets of criteria:  Kim, P., et al. 1999. Published criteria for evaluating health related web sites: Review. British Medical Journal 318: 647-649.)

Is the site easy to use? Does it have links to other sites? In addition to strong content, good Web pages should be easy to use, clearly organized, and have a good search capability.

For more on finding and evaluating online wellness-related information, check out the following Web pages: