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Vinod Scaria
Correspondence: vinodscaria@yahoo.co.in
Abstract:
The mid 90s
witnessed a huge overhaul in the volume of Health information
available on the Net. This raised concerns about the absolute
quality of health information available to the consumers and the
potential implications of accessing controversial, substandard,
or fraudulent information on the Net. To solve this problem,
many rating and trust marking organizations evolved and continue
to do so.
The Internet is an
anarchic and chaotic volume of information. With a somewhat
exponential growth of Health information on the net, the problem
rises to huge proportions
There is a wide
range of conceptual disparity among different rating
organizations. While some organizations prescribe ethical
guidelines/principles for self-imposition, others actually rate
the contents. The problem of trust marking /rating health
information continues to be a problem not just for consumers,
but also for health care workers and providers
Keywords:
Internet, Health, Quality, Rating, Evaluating, Trust marking.
Introduction:
The Internet has
evolved into a huge storehouse of information. The boom that
occurred in the 90s, both in terms of the volume of content and
the number of users had its impact on Health related activities
too.
The mid 90s
witnessed a huge overhaul in the volume of Health information
available on the Net. This raised concerns about the absolute
quality of health information available to the consumers and the
potential implications of accessing controversial, substandard,
or fraudulent information on the Net. To solve this problem,
many rating and trust marking organizations evolved and continue
to do so[1],[2]. Despite the fact that Rating organizations
continue to evolve to meet the challenges, the anarchic
structure of the Internet, which is the prime source of concern,
continues to operate unabated, with profound influences on trust
marking organizations too[2],[3]. The present paper deals with
the potential problems with trust marking health information on
the Net.
Problems
inherent to Net Structure:
The Internet is an
anarchic and chaotic volume of information. The basic
characteristic of Internet being transparency and openness is
the most prone to abuse. Anybody could post virtually anything
on the Net, maintaining his anonymity. Though many countries
have brought legal frameworks to tackle this problem, there is
no uniform framework universally applicable. This makes these
laws toothless tigers.
Another major
problem is the absolute volume of health information on the net.
With a somewhat exponential growth of Health content on the net,
no single trust marking organizations will be able to trust mark
all the Health related information on the net.
Search engines
evolved to categorise the chaotic volumes of information on the
Net. Though many search engines have developed their own
technologies to categorise and present information to the
consumers, these technologies work on analytical logic rather
than commonsense. Anyone could fool crawlers and ranking[4]
technologies and have their contents top the list.
Another
characteristic of the Net is the ability to hyperlink. Unlike
bound volumes of books which are discrete entities, information
on the net is a continuous and endless. This could mean one
could be taken away from an apparently rated source of
information to an apparently fraudulent or controversial source
without perhaps the consumer being aware of it.
The anarchic
structure of the net, which is the major source of concern,
continues to operate unabated. A recent study[2] demonstrated
that many of the trust marking organizations that evolved in the
earlier years either have disappeared or were incompletely
developed to meet the challenges. This poses a major problem:
who would rate these raters?[6]
Problems
Inherent to page design and/or presentation
HTML (Hypertext
Markup Language) which was the lingua franca of the world wide
web, which provided static contents have now given way to
dynamic Languages like DHTML, XML and ASP. Moreover,
technologies like Java have come to the picture. This extreme
level of dynamism makes it difficult to trust mark the absolute
content posted on a particular website. Moreover, many
conventional search engine robots do not recognize contents
posted using technologies like java.
Many of the Health
websites support interactive technologies like Chat, E-mail etc
to interact with consumers and offer Health advice . The major
problem as far as Interactive communication is concerned is the
absence of any published guideline to directly assess the
quality of information provided.
Problems with
disparity in the criteria for rating/trust marking
There is a wide
range of conceptual disparity among different rating
organizations. While some organizations like Health On the Net
(HON)[1] prescribe ethical guidelines/principles for self
imposition without actually rating these websites, others like
HealthAtoZ[7] actually rate the contents. There is also a wide
range of disparity among organizations that actually rate
websites. While some actually rate the content, some resort to
indirect parameters[8] for judging the quality of information.
The present state
of affairs is that there is no hard and fast rule that is
universally applicable for trust marking Health information on
the net. Though both these conceptual frameworks have its own
advantages, the lack of a uniform guideline makes comparisons
impossible.
Another problem is
perhaps the illegal use of trust marks on apparently fraud
websites[9]. The rating organizations do not have the adequate
capabilities to find out and impose restrictions to their use.
However, new generation trust marking organizations like
MedCERTAIN[10] have plans to provide dynamic trust marks, which
are loaded from a third party server. Time has always taught us
that there is absolutely no technology on earth that can be free
from abuse.
Conclusions:
The problem of
trust marking /rating health information continues to be a
problem not just for consumers, but also for health care workers
and information providers. Though there are many designs based
on varying concepts, there is no single guideline for rating
health information on the net. New generation rating techniques
are emerging to meet the challenges, but it is for time to prove
their worth.
References:
[1]Health On the
Net foundation available at: http://www.hon.ch HON code of
conduct: available at http://www.hon.ch/HONcode/Conduct.html
[both accessed on 28 Feb 2002]
[2]Gagliardi.A,Jadad
A.R.Examination of Instruments used to rate Quality of Health
Information on Internet: Chronicle of a voyage with unclear
destination BMJ 2002 Mar9: 324(7337): 569-573
[3]Risk.A,
Dzenowagis.J Review of Health Information Quality Initiatives J
Med Internet Research 2002 Oct-Dec; 3(4): E28
[4]Google Page
Rank available at : http://www.google.com/technology/index.html
[accessed on 28 feb 2002]
[5]Craigie M,
Loader B, Burrow R, Muncer s Reliability of Health Information
on the Internet: An Examination of Experts' ratings J Med
Internet Research 2002 Jan-Mar; 4(1): E2
[6]Terry N.P
Rating the "Raters": Legal exposure of Trustmark
Authorities in the context of Consumer Health information. J Med
Internet research 200; 2(3): E18
[7]HealthAtoZ
available at: http://www.healthatoz.com [accessed on 28 Feb
2002]
[8]Don Fallis,
Martin Fricke Indicators of accuracy of Consumer health
Information on the Internet Journal of Am Med Informatics Asso
9:73-79 (2002)
[9]Nater T, Boyer
C, Eysenbach G, Debate about Evaluation and Monitoring of sites
Containing HON Logo J Med Internet Research 2000 ; 2(12): E13
[10]MedCERTAIN
available at http://www.medcertain.com [accessed on 28 Feb 2002]
Acknowledgements:
I express my
gratitude to all my colleagues and friends for guiding and
'suffering' me throughout the period of this study.
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