Criteria for quality control of medical Web sites

Amsterdam 22 April 1998 Internet provides access to large amounts of uncontrolled medical information. As a health consumer, you can roam for hours on the Web without finding the right solution to your problem and even get misled by commercial propaganda or pseudo-scientific news. At the Central University Hospital in Rouen, Dr. Stefan Darmoni is coordinator of an international research partnership between Europe and the USA in order to establish a methodology for the scoring and evaluation of the quality displayed by medical sites on the Web. At the ITIS'98 Conference, Dr. Denis Mrejen, member of the board of the French National Health Information Technology Industrial Association, presented seven categories of criteria, used by the international co-operation, to assess the value and validity of the numerous internet health resources.

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Internet provides access to large amounts of uncontrolled medical information. As a health consumer, you can roam for hours on the Web without finding the right solution to your problem and even get misled by commercial propaganda or pseudo-scientific news. At the Central University Hospital in Rouen, Dr. Stefan Darmoni is coordinator of an international research partnership between Europe and the USA in order to establish a methodology for the scoring and evaluation of the quality displayed by medical sites on the Web. At the ITIS'98 Conference, Dr. Denis Mrejen, member of the board of the French National Health Information Technology Industrial Association, presented seven categories of criteria, used by the international co-operation, to assess the value and validity of the numerous internet health resources.

The establishment of the seven categories permits the webmaster of an internet health site to optimise the news quality for the benefit of the consumer, and to avoid detrimental consequences due to the distribution of wrong or inexact information. The first standard implies all criteria which enhance the credibility of the Web site. Indispensable data such as the institution name, logo, references, and author name should always be mentioned, as well as the last update and current date. Background revelation and disclosure offer important clues to the user with regard to the information context, influence and possible conflicts of interest. The source of financing or commercial dependence equally fit into this criterion. For marketing reasons, the quality, relevance and utility of the medical information should be obvious.

Web master identification and the existence of an editorial team, controlled by a scientific committee inspire confidence to the readers. The site visitors have to be distinctly targeted: for instance, is the information aimed at health professionals or at the general public? Contents constitutes the second category, as explained by Dr. Mrejen. Here, exactitude and accuracy are taken into consideration as well as the hierarchy of evidence, so that the user can form his own opinion. News at second hand should refer to the original source indication. The denegation or disclaimer function warns the reader against the danger of implicit trust in the external links' reliability. A clear mention of possible omissions and exclusions is absolutely necessary. Further items include a general index, a "what's new" rubric, a help page and a site map.

The choice and selection of links has to be performed with utmost care in order to build a consistent architecture throughout the site. Both back/forward links and ways of escape should be present on every page. The use of different colours for internal and external links is highly recommended, while the webmaster should create a nice balance between text and images. Of course, a regular check-up with regard to the validity of the links prevents unpleasant surprises. Preferably, the general design has to display a logical organisation, whereas an internal search engine considerably facilitates the effective use of the site.

The site visitor highly appreciates the invitation to send his reactions on the presented information. A feed back mechanism for optional comments turns the site into a vivid place of interactivity. If a chat room is installed, the moderator has to be clearly identified. A sixth category determines the quantitative aspects, involving the site's traffic statistics, such as the number of visiting machines with their geographical dispersion, the number of press mentions, and the number of scientific productions issued by the site. The ethical aspects form a last criterion, relating to responsibility, independence and confidentiality. If personal information, submitted to the site by the reader, is going to be used, the visitor has to know in advance. In addition, the European point of view allows no personal promotion on the site on behalf of health professionals.

Dr. Mrejen strains the fact that both consumer and provider need education with regard to site assessment for the sake of their common interest. For this purpose, questionnaires have been drafted for evaluation by a third independent party. The established categories of criteria certainly will allow a large improvement to the health news quality on the internet, in order to transform it into a means of hopeful opportunities, without imposing the impelling threat of constantly being watched. You can consult a full account of the set criteria at the Central University Hospital site of Rouen.


Leslie Versweyveld

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