Health resources come home with a savvy Webside manner

The Internet can be a big, scary place to find health information. One wrong click and you could be inundated with bogus miracle cures, or scams to diagnose what ails you, for a fee, of course. As a Web browser, be smart, savvy, skeptical, and always check for indicators of credibility.

It's easy to wonder how much health information is really out there on the Internet, especially when you search for a particular topic and get a dizzying array of choices to wade through.

Health On the Net Foundation at — a not-for-profit international organization based in Geneva, Switzerland — estimated in 1999 an approximate 10,000 to 20,000 health-related Web sites. And in its October-to-November 1999 user survey, 71 percent of respondents said the quality of medical-health information on the Internet needs to improve.

"The problem is therefore no longer finding information but assessing the credibility of the publisher as well as the relevance and accuracy of a document retrieved from the Net," HON explains on its Web site.

In 1996 HON first established "code of conduct" guidelines for health Web sites to adhere to, and revised them in 1997.

The HON code addresses the following:

*Authority: Information should be provided by qualified personnel only.

*Complementarity: Information should be designed to support, not replace, recommendations by personal physicians.

*Confidentiality: Privacy should be honored by Web site owners.

*Attribution: Information should be supported by references.

*Justifiability: Claims should be supported by evidence.

*Transparency of authorship: E-mail addresses of Web masters should be displayed prominently.

*Transparency of sponsorship: Names of contributors to the site should be displayed prominently.

*Honesty in advertising and editorial policy: Advertisers should be listed; editorial policy should be outlined.

If a Web site clearly displays the square "HON code" seal on its homepage and it links directly to, it has followed guidelines for presenting credible and reliable health information.

Some Web health sites act only as portals to other sites, others give health information. Know which is which.

If Web health sites don't display the HON code seal, don't panic. Look for other signs that indicate a site contains reliable information.

For example, a site should clearly differentiate between health content and advertising. Links to the site's standards for editorial content, disclaimers or professional ethics codes should be prominently displayed. And health sites should be updated regularly to keep pace with changing information. Look for a current date or the words "updated on" to be displayed.

You should be able to click on an "about us" or similarly worded link for an explanation of who created the site and why.

Karma Castleberry, a nursing professor at Radford University in Radford, Va., says, "In general, I would say to consider the source — every source has its own philosophical, scientific and economic stance. Using several sources can help a person sift through the tremendous amounts of information."

Even if an e-mail address is provided, look for a company name, physical address and phone number to be provided. Also, check that the site links to other reputable health sources, so that, as a consumer, you can compare information.

Finally, be aware that commercial health sites that require you to "register" can market the information. Make sure the site explains what it does with your information up front.

Orvin Gelber, chief executive officer of Nevada-based Inc., suggests using common sense.

"Someone can pull the wool over your eyes very easily. Go to multiple sources; don't take the first site you see as gospel."

Gelber, a computer-Internet consultant for international Hitachi Data Systems, got his start in the health Web game while he presented introductory Internet seminars to health care professionals through the Institute for Natural Resources in Berkeley.

He spent so much time "hopping around" the Internet, he created — a directory service that links to other Web sites with health content, about four years ago, as a resource for seminar attendees.

Today, Gelber says, with the help of three other partners and on-site advertising, has the "largest number of health care links on the Internet in one place." He says the objective is to provide a qualified site for both consumers and health care professionals. Gelber personally approves every health link posted, and the site adheres to the HON code of conduct.

Sometimes, large health Web sites can be intimidating, and you can get bogged down with extraneous information that doesn't meet your needs. Be specific about the health information you seek.

Do you want to pinpoint prevention? Get a disease explanation? Check clinical trials? Find groups or others with your same health interest? Keep abreast of the latest scientific articles and research?

Remember to always communicate with your physician or health care provider about information you might find on Web health sites that relates to your condition.

Dr. Donald A.B. Lindberg, director of the U.S. National Library of Medicine in Bethesda, Md., says that doctors welcome well-informed patients.

"Doctors nowadays are quite delighted when patients have taken the time to try to understand the nature of the problem," he says.

Lindberg also says patients are better-educated and more motivated and willing than they were in the past to participate in medical decisions for themselves and their families.

Castleberry, a registered nurse and certified clinical nurse specialist who teaches a Web-based undergraduate nursing research course, recommends gathering information from many sites, and says to "learn what you can from various health care disciplines."

Or, like 69-year-old Longmont, Colo., resident Frances Larson, you can get lucky. She wanted to find out more about a family condition, "malignant hyperthermia." She typed it into her America Online search and got information right away, more than she did at the local library. "This was a rather rare thing, so it was pretty specific," she says.

Here are some general Web health sites, both public and private, to get you out of the starting gate and help you avoid dead-end searches and questionable health information. (Many of them adhere to the HON code.)

Each site is easy to navigate, offers access to quality health information, directly links to other reputable sites, clearly states standards and provides information about its purpose:

*Health on the Net Foundation at

*U.S. National Library of Medicine at

*National Institutes of Health at

*Healthfinder at

*National Center for Complementary and Alternative Medicine at

*Centers for Disease Control and Prevention at

*Agency for Healthcare Research and Quality at

*American Medical Association at

*Medscape at

*WebMD at

*Dr. Everett Koop at

*Health A to Z at

*HealthWorld Online at

* at