Prescription for Success: Consumer Health Information on the Web Bette Anton, MLS [email protected]

Prescription for Success:Consumer Health Information

on the Web

Bette Anton, MLS

[email protected]

This Workshop Is Brought to You By

National Network of Libraries of Medicine, Pacific Southwest Region, UCLA Louise M. Darling Biomedical Library.

Funded by the National Library of Medicine

Infopeople Project

Introductions

Name

Library

Position What brings you here? Are there health-related questions that you are

frequently asked?

Cheryl

Try to just ask one question during intros or else they tend to take too long. Please take off "Other comments" to reduce time.I always recommend starting the classes with a mini-needs assessment to find out a bit about them. Maybe ask "How many people answer 5 or more health reference questions a day?, 3? less than 1? think of 1 or 2 other things you'd like to know about them that they can answer by a show of hands.

Objectives

Use MedlinePlus to aid health seekers to: find reliable disease-specific information find reliable drug & supplement information find hospitals and doctors find the latest health news

Be able to identify and use: NLM and other government websites to find

answers to commonly asked health questions Websites specifically designed for California

and multi-cultural health seekers

Develop strategies for finding and evaluating health information on the Internet

Pre-Test

MedlinePlus can help you find a local consumer health library. T FReference librarians can provide advice about health information. T FName three criteria for evaluating a health website.What is the name of the largest biomedical library in the world?

The Patron’s Path to You

Physician

Patient

Friend/Relative

Librarian

Fibrocystic breast disease

Cystic Fibrosis

Cheryl

Bette, there is GREAT stuff in the notes for this slide. Should you be adding a slide or 2 on the medical reference interview?

What the Patron Says, What the Patron Means

Sick lick vomiting

Rose acre

Fireballs in the Eucharist

Sweet smiling Jesus

Cyclic vomiting

Rosacea

Fibroids in the uterus

Spinal meningitis

Cheryl

For maximum effect, I'd suggest having the stuff on hte left come in first and then the box on the right. Might even have them guess.

The Health Reference Interview

Determine who the information is for.Use dictionary, anatomy book or medical encyclopedia first.Have patron contact health care provider if sufficient information is unavailable.Never provide interpretation of the information, or advice. Always suggest that patron contact her/his health care provider.

From NLM & NIHAuthoritative & up-to-date informationEncyclopedia & dictionaryDrug & supplement informationClinical trial informationUpdated dailyNo advertising

MedlinePlus en Español

MedlinePlus is available in Spanish by clicking on the “español” link.

All materials responsive to language, dietary, and cultural needs of Hispanic population.

http://medlineplus.gov/spanish/

MedlinePlus Resources

Encyclopedia includes 4,000+ entries on diseases, tests, symptoms, injuries and surgeries, and an extensive library of photographs and illustrations.

Medical Dictionary

Health Topics

http://medlineplus.gov/

Bookmarks

Go to: bookmarks.infopeople.org

Look for the class bookmark file. [prescription_success_bk.html]

Click on it so it shows on the screen.

With the class bookmark file showing in Internet Explorer, click the Favorites menu, choose Add to Favorites…

Notice the name in the Name: box so that you can use the Favorites list to get back to the class bookmarks for the rest of the day.

Other MedlinePlus Resources

Drug & supplement information

News

Doctor/hospital finder

Interactive tutorials/surgery videos

Local libraries

NLM Resources & Collaborations

NIH Senior Health

clinicaltrials.gov

DIRLINE

Genetics Home Reference

American Indian Health

Household Products Database

Tox Town

Cheryl

can you add a sub-bullet or 2 for each of the main points. In general, it's not as useful for the learner to see the name or acronym of something as it is to know why they care to remember it. In other words, you could just put main points as to why NLM collaborations are important and who they collabrate with as opposed to the products produced by the collaboration.

Reliable Resources for Common Consumer Health Questions

Complementary & Alternative Medicine

Cancer resources

Lab Tests Online

Drug Digest

Cheryl

Put the areas you will cover, cance, complementary, drugs, etc. on this slide and maybe change title to Other Reliable Resources for Common Consumer Health Issues. Saying "other Reliable Resources" isn't so useful all on it's own ;)

Complementary & Alternative Medicine (CAM)

“Diverse medical & health care systems, practices, and products …not presently considered to be part of conventional medicine.” Source: http://nccam.nih.gov/health/whatiscam/

Less evidence of efficacy of treatments and safety.36% of adults over age 18 use some form of alternative medicine Source: CDC 2002 Nat’l Health Interview Survey

Integrative Medicine

Combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness.

National Center for Complementary & Alternative

Medicine http://nccam.nih.gov

My daughter, who is on Zoloft, is taking St. John’s Wort for depression. Does it really work?

Reliable Cancer Information

National Cancer Institutehttp://www.cancer.gov/

American Cancer Societyhttp://www.cancer.org

University of Pennsylvania’s Oncolinkhttp://www.oncolink.org

My mother was diagnosed with cervical cancer. I think they called it stage IIA. What can you tell me about it? Is she going to have chemo or radiation?”

Cheryl

Maybe put this one after the complimentary medicine slide? It feels a little awkward that what's coming next is reliable resources (from what's on previous slide) and then this has resources but the next 2 slides are descriptions of complementary medicine. It would be ideal to smooth this out so that there is consistency. We can discuss by phone if my comment isn't clear.

Drug Web Sites

Many drug sites are commercial ones.

Many are simply advertising for pharmaceutical companies or particular drugs.

Direct-to-consumer advertising of prescription drugs can be misleading.

Drug Digest

Drug Library

Interactions

Comparisons

Conditions & Treatments

Interactive Tools

http://www.drugdigest.org/

Are there interactions between St. John’s Wort and Zoloft?

Cheryl

Consider having overview slide of why they care about drug library or interactions or tools and then this slide? I'm still looking for that consistency in the presentation that gives an overview of something - why is it important, why should I care and then goes to the specifics.

Lab Tests Online

My doctor says my cholesterol is 210. What does that mean?

http://www.labtestsonline.org/

Why is evaluation of health websites important?

How is evaluation of health web sites different from evaluation on non-health websites?

Cheryl

I'd take off the 2nd bullet point. In Anne Lipow fashion, the answer to question 2 is either Yes or NO but doesn't get you what you want ;) You can ask for examples when you bring up the question along with the question in your notes about how is it different from evulating non-health web sites. Actually, I would put that on the slide to help them stay on task with you but have it come up when you click the mouse to start that part of the conversation. Great question to discuss - even if it's obvious to some.

Evaluation Issues

Increasing number of :patients accessing information on the

Internethealth-related websitesPatients believe that the web is a reliable source of information

Cheryl

Change title to "Evaluation Issues"

What Do We KnowAbout Consumer Behavior?

Consumers use search engines rather than medical portals or sites of medical societies or libraries.

When assessing the credibility, they claim to primarily look for the source, professional design, scientific or official touch, language, and ease of use.

Under observation, none checked “about us” sections, disclaimers, or disclosure statements.

Source: Eysenbach, G, Köhler, C. How do consumers search for and appraise health information on the world wide Web? BMJ. 2002 March 9; 324 (7337): 573–577.

Cheryl

change "looked" to "look" in second bullet.

Five Criteria for Evaluation

Accuracy

Authority

Bias

Currency

Coverage

Each of these alone is meaningless, but together they

create solid guidelines for evaluation.

Read URL Carefully

Is it someone’s personal page? ~ or % geocities or aol.com

What type of domain does it come from? .gov or .edu or .org

Who is the “publisher”? http://publisher/

Cheryl

Change title to Read URL carefully - then you can take it off the slide and promote all the points.

¡¡Evaluate, Evaluate, Evaluate!!

Scan the perimeter of the page and think about these questions: Why did the person create the page? What’s in it for them? Are they trying to sell something?

Contact informationAbout us

Now apply the five criteria

Cheryl

Since you say "five criteria" here, please change title of your basic criteria page to "Five Criteria for Evaluating" Instead of giving extra space to separate out your last point, maybe put it in it's own box

Accuracy

Is the information accurate? Remember:

Anyone can publish on the web Many web pages are not reviewed or verified

by editors or peers Web standards to ensure accuracy do not exist

Accuracy Example

http://www.malepregnancy.com/

Cheryl

Consider doing a mini-exercise here where they go to the site themselves before you talk about it and let them tell you what they figured out and how.

Authority

Is the author an authority on the subject? Remember: It is often difficult to determine the authorship

of web pages If a name is listed, the author’s qualifications

are frequently absent Check if the web page has the backing of a

well-established organization, institution, or agency

Authority Example

http://members.tripod.com/~tourette13/

Cheryl

maybe do another mini-exercise here and have them go to the site themselves

Bias

Does the author bring any biases in posting the information? Remember: Web pages often are “soapboxes” Check that the author’s goals are clearly stated Watch out for the emotional “kick”…

photographs, exclamation points, huge fonts

Cheryl

2nd sub point on goals needs to be reworded to be consistent. Maybe need to say - check that the author's goals are clearly stated OR Check to see that the authors goals are clearly stated

Bias Example

http://bseinfo.org/

Currency

Is the information current and timely? Remember: Dates are not always included If dates are included it may not be clear if it is:

Date created Date revised Date page was placed on Web

Currency Example

http://www.nytimes.com/specials/women/whome/hrt.html

Coverage

Many health sites are not comprehensive. The information may be accurate but important information may be left out. Remember: How does the information compare with other

sources on the same topic? Is a better source available? Does the site have a disclaimer?

Coverage Example

http://www.medical-library.net/

http://servers.medlib.hscbklyn.edu/ebm/2100.htm

¡¡Evaluate, Evaluate, Evaluate!!

“Contributes to”, “is linked to”, “associated with” is not the same as “causes”

“Doubles the risk” is meaningful depending upon what risk was in the first place

“Significant” is not the same as “statistically significant”

More Evaluation Tips

“May” v. “will”

“Proves” - one study alone infrequently proves something.

“Breakthroughs” rarely happen.

Beware of miraculous cures.

Cheryl

Chagne title to "More Evaluation tips" so it is different from previos slide

MedlinePlus Evaluation Resources

Evaluating health Internet information: a Tutorial http://www.nlm.nih.gov/medlineplus/webeval/webeval.html

Health fraud resourcehttp://www.nlm.nih.gov/medlineplus/healthfraud.html

Cheryl

Can you make the title more specific?

Health Literacy

Health literacy is the ability to read, understand, and act on health care

information.

Source: Center for Healthcare Strategies, http://www.chcs.org/usr_doc/FS1.pdf

Who Has Health Literacy Problems?

People of all backgrounds, especially those with chronic health problems

Most adults in U.S. read at 6th grade level, 45% below 6th grade level.

Older people, immigrants & those with low incomes are disproportionately more likely to have trouble reading & understanding health-related information.

According to the latest U.S. census data, 41% of Californians over the age of 5 speak a language other than English at home.

Cheryl

Change title or take it off. It is not correct with the text on the slide.

Multilingual Resources

What language group(s) does your library serve?

The NN/LM provides links to many multilingual resources

http://nnlm.gov/train/chi/multi.html

Cheryl

Take off point on slide as it's redundant to title of slide. Are there some overview/big picture points you can make on this slide? Is it just info translated? Is it culturally specific? Different ways to find or evaluate? Biggest language areas to be sure to know about?

California-Specific Web Sites

California Department of Health Services

California Healthcare Foundation What Patients Think of California Hospitals California Nursing Home Search Online Enrollment for Public Health Insurance

NN/LM/PSR http://nnlm.gov/psr/about/region/california.html

Action Plan: Next Steps

Post-Test

MedlinePlus can help you find a local consumer health library. T FReference librarians can provide advice about health information. T FName three criteria for evaluating a health Web site.What is the name of the largest biomedical library in the world?

In Summary

The National Library of Medicine provides many important and reliable consumer health resources.Evaluation of unknown sites is essential.Health seekers frequently have difficulty finding, understanding and using health information.NEVER provide medical advice. Send patrons to their health care providers for advice and interpretation of health information.

Wrap-Up

How to reach NNLM/PSR:http://nnlm.gov/psr/ or 1.800.338.7657

Funding opportunities:http://nnlm.gov/psr/funding/

Other classes:http://nnlm.gov/psr/training/

Member Serviceshttp://nnlm.gov/psr/members/

Documents

Prescription for Success: Consumer Health Information on the Web Bette Anton, MLS [email protected]