Surviving the Internet Jungle

The Internet. It's a worldwide repository of medical information larger than any physical library ever imagined. It's searchable. It's open any time of the day or night. And it's a jungle, filled with misinformation, traps, and predators.

"There are a lot of malicious sites and programs out there, but you can explore the jungle safely and come home with some real gems that may not exist anywhere else," said Peter Ziemkowski, M.D., assistant professor at the Michigan State University/Kalamazoo Center for Medical Studies Family Practice Residency Program. "The Internet can be a gold mine of information for any clinical practice. Every practitioner can use it in everyday care as long as you know how."

There is another reason to use the Internet. That's where your patients are getting their information?and misinformation. As long ago as mid-2003, 80% of adult Internet users reported searching for health information, Dr. Ziemkowski said. Half were looking for drug information, although few actually bought Rx or OTC products online.

There are two keys to using the Internet effectively and efficiently, Dr. Ziemkowski told the American Academy of Family Physicians Scientific Assembly: Learning how and where to find information and learning how to assess the validity of individual Websites.

But using the Internet is not quite like using the familiar medical school library. Unlike traditional media such as printed journals and textbooks, the Internet is dynamic. Using the Internet is also a dynamic process.

"The Internet is a constantly changing resource," Dr. Ziemkowski explained. "What is here today may not be there tomorrow, or may be in a different place. Your information search has to be just as dynamic."

Instead of memorizing Website addresses that are subject to change, physicians should get comfortable with search engines such as Google (www.google.com). Searching for a subject such as National Institutes of Health will bring up the NIH Website (www.nih.gov) even if the address changes.

Looking for specific terms such as hypertension or high blood pressure leads to sites such as the American Heart Association (www.heart.org), the American Society of Hypertension (www.ash-us.org), and MedLine Plus (www.nlm.nih.gov/medlineplus).

But searching online is as much miss as hit. Searching Google for "hypertension" returned more than 20 million possible locations. "High blood pressure" produced nearly 12 million potential Websites. The most likely locations, or "hits" will be among the first few pages of results, Dr. Ziemkowski noted. But once a Website has been found, it is up to the user to evaluate the content.

"Just because it is on line does not mean it is authoritative," Dr. Ziemkowski cautioned. "You have to evaluate a Website as carefully as you would evaluate any other unknown information source."

He suggested five tests to evaluate a Website:

• does the information appear to be accurate?

• are the authors qualified and credible?

• does the information appear to be objective, or are there questions of funding or product recommendation that raise questions?

• is the information timely?

• is the information complete?

"Einstein is reputed to have said ?Never remember what you can look up,'" Dr. Ziemkowski said. "With the number of potential Internet information sources reaching into the billions, that advice has never been more true than it is today."