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SeniorNet - How to Search the Web
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Home  Enrichment    Health 						
How to Search the
Web									
by Michael Castleman
Introduction
Health sites rank among the
most abundant--and most visited--on the World Wide Web. As a group, they have
also become quite controversial. Various experts have warned that "some" or
"much" of the medical information on these sites is questionable, or even
possibly hazardous. Recent scandals, for example, the selling of the potentially
dangerous erection pill, Viagra, over the Web with little or no regard for the
buyer's medical history, have increased the general anxiety level about Web
health information. And while sites with "brand names," such as the American
Heart Association, or the National Cancer Institute, or the Mayo Clinic, carry
the imprimatur of credibility, you have to wonder about the quality of
information on the hundreds--thousands!--of sites that turn up when you key the
name of a medical condition into a search engine.
No guide to health information
on the Web can review all sites for content and credibility. There are simply
too many. This guide presents a step-by-step approach to finding health
information that's current, credible, and does no harm.
Fundamentally, there is
no qualitative difference between health information on and off the Web. You can
find authoritative information and inaccurate, possibly hazardous information on
the Web and everywhere else: in newspapers, magazines, books, newsletters, and
on radio and television.
The major difference between health information on and
off the Web is quantity. Go to your local library, and you might find a
half-dozen books on coping with diabetes. But key "diabetes" into any major
search engine, and you're likely to be directed to hundred of sites. As the
number of rises (100, 500, 5,000), it becomes impossible to visit them all. In
addition, you begin to suffer from that uniquely Web malady, "information glut,"
the dazed, confused feeling that there is simply no way to digest all the
information you can retrieve from cyberspace.
Another difference between health
information on and off the Web is that the Web is comparatively new and has a
"wild West" reputation that "anything goes." When other media deal with health
subjects, they generally feature experts with credible-sounding affiliations
that help consumers feel comfortable with the accuracy of the content. But many
health Web sites publish information devoid of such anchors of credibility, and
as a result, visitors might feel that they are adrift in a choppy sea of
questionable health information.
Finally, it's important to remember that
medicine is as much an art as a science. Many questions don't have definitive
answers, rather they require judgment calls. Doctors and other experts often
disagree. That's why, before consenting to surgery, or cancer treatment, or many
other procedures, it's a good idea to solicit "second opinions," to take your
situation to a number of doctors, to try to come up with a consensus view.
Medical information on the Web is similar. Sites may disagree, yet both be
"right," in the context of their own points of view, especially when one site
focuses on mainstream medicine, and another deals with alternative therapies.
As
a result, for anyone interested in health or medical information, the Web
provides both opportunities and pitfalls. Here's how to make the most of this
marvelous new medium, without getting bamboozled by unreliable information in
the process. 
Step 1: Start with Off-line Resources
It may sound odd for a guide
to health information on the Web to begin with an endorsement of off-line
resources, notably, home medical guides and books devoted to the specific
problem that interests you (cataracts, insomnia, gallstones, etc.) But off-line
resources are an easily accessible source of introductory, broad-overview
information that can help you get a handle on the subject(s) that interest
you.
Visit your local library. Talk with a reference librarian. Most libraries
contain a great deal of health and medical information that can provide basic,
ground-floor knowledge that forms an excellent foundation as you subsequently
investigate other information resources.
At a time when people increasingly
believe that any information worth having is available on the Web, some people
have turned away from the public libraries they relied on for years. This is a
mistake. Public libraries are still excellent information resources. In fact,
they're better than ever because, as a group, librarians have become extremely
Web-savvy, and can help you locate valuable information both off and on the Web.

Step 2: Contact Organizations and Support Groups
A librarian can also help you
find the name and contact information for the organization (or possibly more
than one) that relates to the condition that interests you.
Virtually every
condition, even rare ones, have information-support organizations. Some are
familiar, among them: The American Heart Association (heart disease and stroke),
the American Cancer Society (all cancers), the American Lung Association
(asthma, quitting smoking, emphysema, etc.), the American Diabetes Association
(diabetes and its many complications), the American Dietetic Association
(nutrition issues), and The Arthritis Foundation (joint problems of all kinds).
However, many are smaller, less widely known, and more specialized, for example:
the National Psoriasis Foundation (the skin disease), the National Organization
for Seasonal Affective Disorder (winter depression), the Association for Macular
Diseases (macular degeneration), and the American Tinnitus Association (chronic
ringing in the ears).
Condition-specific organizations and support groups are
tremendously valuable resources. They typically can provide a great deal of
background information, and can point you toward more specialized information,
experts, and news about treatment advances. Most of these organizations have Web
sites that allow easy access to their information. And some host online support
groups so you can discuss your concerns with others who have faced the same
challenges you're facing.
If you can't find an organization that relates to your
area of concern, contact the New Jersey Self-Help Clearinghouse (www.njshc.org).
Although this group focuses on New Jersey, it also functions as a national
clearinghouse of self-help and support groups. It can even help you start one.

Step 3: Visit "Brand Name" Web Sites
The brand-name sites overwhelming deal
with mainstream medicine. There are far too many of these sites to provide a
comprehensive list here, but to the left is a sampling of credible sites that
can be expected to provide authoritative information. 
Step 4: Sample Other
Widely Recommended Sites
While not exactly "brand names" on the order of the
CDC, Harvard, or The American Cancer Society, an enormous number of sites
feature credible information, that have earned kudos from physician reviewers
and consumers. An idiosyncratic listing is also to the left.
Step 5: Try a
Search Engine
It's easy to key the name of a condition into any of the major
search engines--almost too easy. You're likely to get hundreds--perhaps
thousands--of matches. Many of these sites may provide excellent information.
But be careful that you don't get misled. Here are a few suggestions:
Beware of
conflicts of interest, sites that sell products their content also endorses.
This isn't necessarily a bad thing. Many vitamin and herb sites do this. But
before you buy products touted on such sites, try to verify their effectiveness
on sites that have no commercial interest in making sales.
Beware of sites that
tout explanations or treatment regimens much different from those you've already
discovered. If you've obtained basic information at your library, contacted the
organization that deals with the condition that interests you, checked the
information on brand-name Web sites, and followed links to a few others, you can
feel reasonably assured that you're well-informed about the condition you're
researching. Now, it's possible that all these sites have overlooked some
important element that a particular site focuses on. But it's not all that
likely. At this stage of your research, it would be wise to be skeptical of
information that differs greatly from what you've already found. Consider it if
you like, but don't make major changes in your life or treatment plan before
discussing it with your physician.
Step 6: If You Want Information Direct From
the Medical Literature....
All the sites discussed so far have been created FROM
the findings in the medical research literature, but the information has been
predigested for presentation in an accessible, consumer-friendly manner. What if
you want to get behind the explanations and delve into the medical literature
itself? It's easier than you might think.
Amazing as this may sound, summaries
(known as abstracts) of the entire world medical literature going back to 1966
are available at one Web site, MEDLINE, the medical literature online at
www.igm.nlm.nih.gov (Internet Grateful Med at the National Library of Medicine
at the National Institutes of Health). These abstracts are written in medical
jargon, but if you have a good dictionary, particularly a medical dictionary,
it's not terribly difficult to search and retrieve a great deal of
state-of-the-art information.
Here's how: Go to www.igm.nlm.nih.gov. Click on
MEDLINE. When the search screen appears, simply type in a subject, for example,
osteoarthritis. MEDLINE allows up to three subjects. Suppose, for example,
you've read that glucosamine helps treat osteoarthritis (it does) and you want
to see abstracts of the studies that have investigated this issue. Then key in
two subjects: osteoarthritis and glucosamine. If you know the author of any
study or any title words, you can also search by them.
Then scroll down to the
search delimiters. It usually helps to limit the search to English-language
journals. You might also want to limit your search to human studies, as opposed
to animal and human. Unless you specify the year range, MEDLINE searches from
1966 to date. You may want to limit the search to a narrower range, say, 1985 to
date. Then scroll down and click: Perform Search.
What comes up are titles of
articles, without the abstracts. If you want just one abstract, click the box
that says View Full Citation. If your search produces multiple studies whose
abstract you would like to view, or click the box to the left of the title, then
at the bottom of the search screen, click: Fetch for Display. That command
retrieves and displays all the abstracts.
Another box, Related Articles, can
locate other articles you might be interested in.
While MEDLINE is a wonderful
resource, it can also be challenging. The language is medical jargon. And you
often find that studies disagree with one another, which is why expert
interpretation is often necessary to make sense of the findings. But for those
who want to delve deeper than most health sites allow, MEDLINE is accessible and
often very helpful. 
Step 7: If You Want An Expert to Perform a Detailed,
Personalized Search for You....
Sometimes you may not want to be bothered
researching medical conditions. Sometimes you'd rather have an expert researcher
do it for you. That's what you get at The Health Resource
(www.thehealthresource.com). This unique medical research service was launched
long before the Internet in 1984 by Jan Guthrie, of Conway, Arkansas, after she
developed ovarian cancer. Her oncologist recommended a certain treatment
program. But before submitting to it, Guthrie, who had a background in medical
research, decided to check for herself--and discovered that for her subtype of
ovarian cancer, another treatment regimen produced better longterm survival. She
presented her findings to her doctor, who opted for the treatment Guthrie had
uncovered. After she recovered, Guthrie quit her job and launched The Health
Resource to give others the benefit of her research skills. Guthrie and her
staff now research hundreds of conditions and specific health questions every
year. A basic background packet of information on any noncancer condition,
typically a few hundred pages of material, costs $275. A basic background packet
on any type of cancer costs $375. 
Search the Web 
Below are a list of Internet
resources, including "Brand Name Sites", a sampling of credible sites that can
be expected to provide authoritative information, and an idiosyncratic sampling
of others which are not exactly "brand names" on the order of the CDC, Harvard,
or The American Cancer Society, but which feature credible information, and have
earned kudos from physician reviewers and consumers.
Brand Name Sites
American
Academy of Family Physicians --Patient Information Basic medical information
about an enormous number of conditions. Includes drug, and self-care
information, and herbal medicine. 
American Cancer Society Information on
detecting and treating every major cancer. 
American Heart Association
Information about heart disease and stroke, with many links to other good sites.

American Pain Foundation Original information and links to other sites that
deal with pain--everything from arthritis and burns to cancer pain and chronic
pain. 
Intelihealth Developed by Harvard University, this site provides
up-to-date information in nonmedical language on the diagnosis and treatment of
hundreds of ailments. Includes a special section on Senior Health. 
Mayo Clinic
Health Oasis Updated daily, this site presents a vast collection of information
developed by professionals at the Mayo Clinic. 
The Centers for Disease Control
Full-text CDC publications on 250 subjects that impact public health. 
The Merck
Manual is a medical textbook, but one that's reasonably accessible to nonmedical
folks. Just have a dictionary handy, preferably a medical dictionary.

Traveler's Health Issues This CDC site provides information on health
recommendations--vaccinations and precautions--for travel anywhere in the world.

Other Reputable Sites
Health in the Headlines Want more information about
something you caught on the news? The University of Connecticut's Lyman Maynard
Stowe Library developed this site to provide information on medical information
in the news. It draws from the New York Times and Reuters. 
Healthworld Online A
good introductory site to the alternative therapies. 
Medical Answers An
extensive collection of consumer health information, drawn from major
organizations, for example CDC and the American Academy of Family Physicians.

National Center for Complementary and Alternative Medicine The National
Institutes of Health's branch that deals with alternative medicine. Good
introductions to a broad range of topics. 
Reuters Health Information A
health-oriented wire service. 
RxList Developed by a research pharmacist, this
site lists an enormous amount of information about more than 4,000 drugs and
herbs: trade and generic names, how the drug is used, and possible side effects
and interactions. 
The Daily Apple In addition to a great deal of health
information, this site offers free membership, which allows members secure
access to lab test results. 
The Natural Pharmacist Developed by a team of
doctors, this site provides science-based information on herbal medicines and
nutritional supplements. 
WebMD Contains a great deal of information about
mainstream and alternative medicine. 
 
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