Assessing the quality of newspaper medical advice columns for elderly readers

Background: Medical advice columns in newspapers can provide a valuable ser vice by educating the general public about important health-related issues. However, these columns may be harmful if the advice or information given i n them is incomplete, inappropriate or misleading. The objective of this st udy was to assess the safety and appropriateness of advice given to elderly readers of newspapers in medical advice columns. Methods: Medical advice columns published in Canadian newspapers in 1995 we re identified from a CD-ROM database. The articles that were selected were published in English and contained medical advice pertinent to elderly peop le about topics that could be found in a textbook of geriatric medicine. Fi fty articles, randomly selected from the 109 articles that met these criter ia, were independently assessed by 5 geriatricians. A scoring system was us ed to rate the ability to determine to which population the article applied , how well fact was distinguished from opinion, the degree to which critica l issues were addressed, the safety and the appropriateness of the advice. When the kappa statistic for inter-rater agreement was 0.74 or less, a 2-st age Delphi process was used in an attempt to reach consensus. Results: Agreement (kappa > 0.74) was eventually achieved for 232 (92.8%) o f the 250 ratings. In 4 (8%) of the articles there was a high probability t hat the advice given could be applied to the wrong patient population; in 7 (14%) there was a high probability that opinion might be interpreted as fa ct; and in 11 (22%) the major critical issues were not identified. Of great est concern, however, the advice in 25 (50%) of the articles was judged to be inappropriate, and in 7 4 (28%) advice may have been dangerous and poten tially life-threatening. Interpretation: Although medical advice columns have the potential to impro ve the health of elderly readers, a significant percentage of these article s contain inappropriate or even potentially dangerous advice.