Predictors Of Inaccurate Online Breast Cancer Information

Published in the March 15 issue of Cancer, 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.

Article: "Commonly Cited Website Quality Criteria Are Not Effective at Identifying Inaccurate Online Information About Breast Cancer." Elmer V. Bernstam, Muhammad F. Walji, Smitha Sagaram, Deepak Sagaram, Craig W. Johnson, and Funda Meric-Bernstam. Cancer; Published Online: February 11, 2008 (DOI: 10.1002/cncr.23308); Print Issue Date: March 15, 2008.

The study was supported by grants from the Robert Wood Johnson Foundation, National Library of Medicine, National Center for Research Resources and a training fellowship from the W. M. Keck Center for Interdisciplinary Biosciences Training.