RATING HEALTH INFORMATION ON THE INTERNET - NAVIGATING TO KNOWLEDGE OR TO BABEL

Context.-The rapid growth of the Internet has triggered an information revolution of unprecedented magnitude. Despite its obvious benefits, the increase in the availability of information could also result in m any potentially harmful effects on both consumers and health professio nals who do not use it appropriately. Objectives.-To identify instrume nts used to rate Web sites providing health information on the Interne t, rate criteria used by them, establish the degree of validation of t he instruments, and provide future directions for research in this are a. Data Sources.-MEDLINE (1966-1997), CINHAL (1982-1997), HEALTH (1975 -1997), Information Science Abstracts (1966 to September 1995), Librar y and Information Science Abstracts (1969-1995), and Library Literatur e (1984-1996);the search engines Lycos, Excite, Open Text, Yahoo, HotB ot, Infoseek, and Magellan; Internet discussion lists; meeting proceed ings; multiple Web pages; and reference lists. Instrument Selection.-I nstruments used at least once to rate the quality of Web sites providi ng health information with their rating criteria available on the Inte rnet. Data Extraction.-The name of the developing organization, Intern et address, rating criteria, information on the development of the ins trument, number and background of people generating the assessments, a nd data on the validity and reliability of the measurements. Data Synt hesis.-A total of 47 rating instruments were identified. Fourteen prov ided a description of the criteria used to produce the ratings, and 5 of these provided instructions for their use. None of the instruments identified provided information on the interobserver reliability and c onstruct validity of the measurements. Conclusions.-Many incompletely developed instruments to evaluate health information exist on the Inte rnet. It is unclear, however, whether they should exist in the first p lace, whether they measure what they claim to measure, or whether they lead to more good than harm.