Friday, March 18, 2011

Assessing web-based healthcare content


Remember that you cannot believe all you read. Below is a guide.
When look for internet-based resources there are a number of things to look out for to ensure that the links are reliable, based in fact not fiction, myths or rumours, and that you can depend upon what you are reading. Unfortunately, some studies do not research enough of a population to come to conclusions. Other studies, many paid for by pharmaceuticals, do not report the truth. All studies do not include seniors over a certain age (65?) in their studies, or those with comorbidities. Most seniors have multiple issues and each patient is different. Journals do not publish studies that do not prove a hypothesis. There is a fight over journal space.

What irks me about the Internet are the bloggers and lobbyists who continue to listen the media. They fearmonger, exaggerate facts, create dire predictions, and put down all of us who are in or approaching our senior years. Ageism exists in this country. Watch for it! Those who broadcast misinformation and crappy research as facts, e.g., CARP's Elder Abuse 'research', based on their middle/upper middle class reader survey, want your attention.

Those who broadcast misinformation and crappy research as facts, e.g., CARP's Elder Abuse 'research', based on their middle/upper middle class reader survey, want your attention. 'CARP received saturation coverage and successfully made elder abuse a front-page issue. ' Even the provincial government doesn't know how many elders are abused, and while we focus on this issue, sending money there, direct services are lacking. Media coverage, which is what they base their research on, is not evidence-based decision-making. [ Click here to see a full pdf copy of the compendium.] Blatant pseudo research: 'Did you know that almost 1 in 10 elder Canadians have suffered ? Click here for our infographic
Below the infographic (when I did research we called it data), if you scroll down, they explain that this is based on contacting 2000 of their members. Hardly reliable or valid research practices! Good for a political party, but not for 'evidence-based' research!

You can tell the frauds who do not display their credentials. They litter their webpages with the ubiquitous Google ads, designed to make money for them every time you click on them. Some blatantly take advertising revenue from sponsors. Click away from them like the plague.
I checked my sitemeter the other day, and found a direct link, including a few sentences of my discussion of Mom's lymphedema on a page littered in this way. With Fair Practice (Fair Use) legislation in Canada and the US, this is legal, if disingenuous.

Impatient for Change, who use stock images, or stolen images, with which to brighten their webpage. This is a lobby group, who bases their actions and reactions on individual cases, not research. Bad doctors exist, mistakes occur, we must not base healthcare policy on their lobby efforts. We must do the research, and obtain facts, not fear. Base healthcare investment of tax dollars on reliable data.

Another pet peeve, are those who blame seniors for health care costs. They predict the downfall of Canadian healthcare, due to the boomer generation. My research shows that this is crap. Check out Dr. Michael Rachlis for more information about the good news in healthcare.

1. Check the source of the information. Often a webpage will have a button, "All About Us".  Universities are the most reputable, as well as  'Institute, Society, Association' and .net or .org. 
 e.g., Alzheimer Society, Cancer Society. Especially those who depend upon funding, with a responsible Board of Directors to manage the group.  I would avoid a union piece of research, as they have their own biases: their funding is based on membership, and position papers have hidden agendas for the members. CUPE, for example. Even CARP/AARP Canadian/American Associations for Retired Persons, are motivated by members who fit specific demographics, they do not legally represent all of us. They are lobby groups. Avoid About.com, as there is no way we can determine if the authors wrote the piece, or hold the credentials they purport to hold.

2. Check the credentials of the writer, if it is an individual. Ensure that writers are experienced professionals, who write from expertise. Look for M.Sc.N, in a nurse, as well as doctors credentials. Obviously, registered accredited professional groups, Canadian Medical Association, Nurses Associations, often publish excellent reference-based journals. A refereed journal is your guarantee that peers have reviewed the information, and several people have read it for content, accuracy, sources. (I used to do this for AACE.org)

3. Check for the date of publication. Anything older than ten years needs to be reviewed. We do more research in the world, and we ignore much of it, as well. 

4. Determine if the site is selling something. Many have a vested interest in particular products, and are selling something. You can spot these, in that the author recommends a particular product to solve the problem, a certain drug to make your disease go away! 

People, like myself, who have done research for a book, have had editors check for accuracy. Check a site for their qualifications and resume. I have an M.Ed., and this means that I know something specific about doing research. It also means that I have been trained to weed myths, and have discipline in my writing. Weeding facts from fiction, for civilians is a tricky prospect on the web. Many volunteers write blogs, but have only personal experiences to show for credentials. This is not to say that autobiographies are to be discounted, but carefully perused. The recent research on the Autism/innoculation scandal illustrates this. Actor/comedian Jenny McCarthy wrote a whole book on this topic.
    5. Who is paying for the site? Is there someone checking sources? Nothing is free, and most have an agenda of some sort.
    Some sites are simply reposting information, with nothing new to add. They may not have ensured that the information is credible. You can spot these by the Google Ads, intended to make them a buck to two.
    On the other hand, some sites are 'self-help', and this can be dangerous. Many of us, as caregivers as well as care recipients, need professional help and should not avoid those who have been trained to help.

    6. If the site has spelling mistakes, grammatical errors, avoid it! There is no excuse for this.

    7. Check references for specific articles and issues. No one should be publishing without including support for the topic from credible sources. 

    8. Ensure that content represents your healthcare system; Canadian healthcare is vastly different than USA, and variances exist from province-to-province. For example, 500+ out of 640 or so long-term care (LTC) homes in Ontario are for-profit. It means that you must watch how you use the information you find. Ontario LTC are governed by the Ministry of Health and LTC, and have reporting rules, and rules, requirements and legislation that supports the healthcare recipient.

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