Is What You’re Reading Junk? Evaluating the Quality of Mental Health Websites, Part 2

The internet is a minefield full of inaccurate, biased sites.

How do you tell the difference between good information and bad information? You need a guide to help you evaluate sites, to tell whether the articles presented are valid and accurate, to discover when someone is trying to sell you something, and to discern between a legitimate view and a crackpot’s rant.

This two-part series of articles is intended to be a guide for you in your search for trustworthy information. It outlines the collective wisdom of medical librarians, mental health professionals, professional associations, and other experts who surf the web every day to discover quality information in support of clinical and scientific decision making by professionals responsible for the nation’s mental health.

Today’s information, part 2 of the series, is presented under the following headings:

• How old is the information? When was it published or reviewed?
• Does the site support the doctor-patient relationship?
• Privacy, advertising, and other policies should be clearly stated
• How does the site interact with visitors?

Be sure to read yesterday’s installment, too. It discussed these topics:

• What is the purpose of the site?
• Who owns the site? How is it funded?
• Be on guard for bias and competing interests
• Authorship and affiliation are important
• Authority and cited sources

How old is the information? When was it published or reviewed?

Mental health information eventually becomes stale in light of ongoing research, so it needs to be constantly updated to reflect the most recent knowledge and understanding available. Publication and review dates allow an internet user to judge how current and relevant the information is likely to be.

Current misinformation is still misinformation, so currency is no guarantee by itself of reliable, quality mental health information. But this is one more piece of information you can look for to help you judge the overall accuracy and reliability of the article you are reading.

Web sites should be reviewed and updated on a regular basis. It is particularly important that mental health information be current. The most recent update or review date should be clearly posted. Even if the information has not changed, you want to know whether the site owners have reviewed it recently to ensure that it is still valid.

All Anxiety, Panic & Health articles are clearly dated below the title. Review dates are listed at the end of the article.

Does the site support the doctor-patient relationship?

Many sites, especially those selling “cures,” implicitly sever the doctor-patient relationship and substitute their remedies for professional mental health care solutions. They often will openly challenge the validity of professional mental health care in favor of their product. It is typical that none of the site’s claims relating to benefits and performance are backed up with anything more than customers’ testimonials. If any medical endorsement is presented at all, it will be from a single source whose authority is questionable.

Reputable sites hold the doctor-patient relationship as inviolable and recommend consulting your doctor before using (and hopefully, buying) their product.

Any mental health information on such sites should be approached with extreme caution. Be instantly suspicious if the emphasis is on selling you a product or touting a product.

Anxiety, Panic & Health holds the doctor-patient relationship in highest regard, and never seeks to violate or diminish that relationship in any way. This is stated clearly in my Disclaimer.

Privacy, advertising, and other policies should be clearly stated

Every site should have a privacy and advertising policy at a minimum, even if it’s as simple as, “We don’t collect personally identifiable information on this site, nor do we accept advertising.” That’s a policy that is clear, concise, and transparent. If you can’t glance at a site’s policy and pick up the main points, the site may not be worth spending too much time on.

For a privacy policy, the main points are what information they collect from you and what do they do with it. Frequently you are asked for your email address and name to register, subscribe, or become a member of a health-related site. In addition, web sites routinely track the path users take through their sites to determine what pages are being used through the use of “cookies.” You should know that many sites sell the information you provide to other companies, and that “cookies” can be used not only to follow you as you browse the internet, but identify you for advertising purposes.

You should look for and read the site’s privacy policy before giving them any information. If the site does not have a privacy policy, do not provide them with any personal data under any circumstances. If you suspect that the site uses cookies, either turn them off in your browser or leave immediately.

The main points for an advertising policy are whom do they allow to advertise on their site, whether the advertisers have any say over their content, and what do they do with their revenues. If you don’t agree with their answers, or their answers are hard to discern from their policies, move along to another, more transparent site.

Anxiety, Panic & Health’s policies are grouped under the “Policies” tab in the menu. There you will find:

• A “Disclaimer” stating my qualifications for writing and editing articles
• A Comment Policy” that describes the do’s and don’ts of commenting on articles
• A “Funding and Advertising Policy” that lays out ownership, funding, and advertising on this site
• A “Privacy Statement” that describes the data collected from visitors to this site, and what is done with that information

How does the site interact with visitors?

There should always be a way for you to contact the site owner if you run across problems, have questions, or want to send feedback. Somewhere on the screen should be a “Contact” or similarly worded link that will allow you to interact with the site owner or their representative. If the site provides no contact information, or if you can’t easily find out who runs the site, use caution. If you do contact the site, another gauge of their credibility is the promptness of their reply and whether it is a form letter or a personal note.

If the site hosts chat rooms or other online discussion areas, it should tell visitors what the terms of using this service are. Is it moderated? If so, by whom, and why? It is always a good idea to spend time reading the discussion without joining in, so that you feel comfortable with the environment before becoming a participant.

Anxiety, Panic & Health has a “Contact” tab in the menu on every screen. It sends an email directly to me. I answer all emails promptly. Users can interact with other readers and me by writing comments at the end of articles. I reply to all comments quickly, and if necessary will send an email to the commenter.

Be sure to read yesterday’s installment

It discussed important topics that you should be aware of under the headings:

• What is the purpose of the site?
• Who owns the site? How is it funded?
• Be on guard for bias and competing interests
• Authorship and affiliation are important
• Authority and cited sources

What do you think?

I have a specialized browser optimized for search, DEVONagent. I can enter a search query and get sites from many sources on the internet that a Google search alone would miss. Sometimes it produces hundreds of hits that are closely related to my search terms. It never ceases to amaze and surprise me how many sites are invalidated based on the criteria outlined in this guide — at least half of them, and according to the search keywords, sometimes more.

This is disturbing to me, since many people innocently put in a search term, and pick only the first two or three at the top of Google’s list for their information. Often these are the most inaccurate they could find!

• What has been your experience searching for information?
• Have you found the information available to be accurate, or biased and unreliable?
• What do you think of this series? Has it helped you in any way?

©2009 Michael L Nichols. All rights reserved.

Resources used in this post:
Grohol, John M. (2007, January 11). Reliability and Validity in a Web 2.0 World. Retrieved June 25, 2008 from Psych Central web site.
Grohol, John M. (2007, December 4). Evaluating the Quality of Mental Health Websites. Retrieved June 25, 2008 from Psych Central web site.
Kroski, Ellyssa. (2006, February 20). Authority in the Age of the Amateur. Retrieved October 21, 2008 from Infotangle web site.
Medical Library Association. (2008, July 25). A User’s Guide to Finding and Evaluating Health Information on the Web. Retrieved October 27, 2008 from Medical Library Association web site.
Medline Plus. (2006, February 13). Medline Plus Guide to Healthy Web Surfing. Retrieved October 27, 2008 from Medline Plus web site.
National Cancer Institute. (2005, September 1). How to Evaluate Health Information on the Internet: Questions and Answers. Retrieved October 27, 2008 from National Cancer Institute web site.
National Center for Complementary and Alternative Medicine. (2008, August 27). 10 Things to Know About Evaluating Medical Resources on the Web. Retrieved October 27, 2008 from National Center for Complementary and Alternative Medicine web site.
National Institute on Aging. (2005, August). Health Quackery: Spotting Health Scams. Retrieved October 27, 2008 from National Institute on Aging web site.
Schloman, Barbara F. (2002, December 16). Information Resources: Quality of Health Information on the Web: Where Are We Now? Retrieved October 27, 2008 from The Online Journal of Issues in Nursing web site.
Winker, Margaret; Flanagin, Annette; Chi-Lum, Bonnie; White, John; Andrews, Karen; Kennett, Robert; DeAngelis, Catherine; Musacchio, Robert. (2008, August 1). Guidelines for medical and health information sites on the Internet. Retrieved October 22, 2008 from American Medical Association web site.