Which Health Websites Can I Trust? The Devil is In the Details

You wake up with a splitting headache and numb hands and feet. Your first move  —  assuming these symptoms aren’t tequila-related  —  is probably to consult Dr. Google.

Here’s a sample of the top ten pages for “headache numb hands feet”: You could have vitamin B12 deficiency, migraines, nerve damage, meningitis, Guillain-Barre syndrome, Bell’s palsy, fibromyalgia, brain cancer, or are going through menopause.

Let’s hope not all at the same time!

If you’re a regular patient of Dr. Google, you aren’t alone. Over 70% of internet users go online to learn about their health. Medical research that a few decades ago only doctors would be familiar with can now be accessed by anyone with a WiFi connection. And because the average doctor’s appointment lasts 13–16 minutes, the internet is the most convenient source for answers.

But convenience doesn’t come without costs. Instant access to health information has lead to the rise of “cyberchondria,” or anxiety related to diagnosing health problems using the internet.

The example above shows how crucial it is for today’s web user to learn how to navigate a tangle of conflicting, irrelevant, difficult, misleading, or downright false information. Otherwise you could wind up relying on bad advice or needless (and possibly dangerous and costly) tests and treatments.

How do you know your symptoms don’t signal brain tumors instead of the likely cause —  such as low blood pressure? Below we’ll look at a simple test to help you find online resources that are both high quality and relevant to your specific health situation. Best of all, you don’t need a medical degree to use it.

The T.R.A.A.P. Test, or Five Dimensions of Trustworthy Sources

Digital activist and entrepreneur Mitch Kapor compared getting information on the internet to “taking a drink from a fire hydrant.” That’s why we recommend all internet users practice the T.R.A.A.P. test. This simple tool can help you manage your browsing experience by filtering out low quality resources.

The T.R.A.A.P. test asks you to evaluate five dimensions of any information source:

“T” for Timeliness. In 1950 it was estimated that medical knowledge doubled every 50 years. In 1980, it doubled every 7 years. In 2010, doubling occurred in half that time, or every 3.5 years. Researchers now believe that by 2020, medical knowledge will double every 73 days.

High quality sources will convey stable scientific agreement. But because major medical breakthroughs occur every day, they should also incorporate significant developments in the field or promising alternatives based on sound evidence.

How can you determine a source’s timeliness? Websites publish a copyright date at the bottom of the page, though this can only tell you whether or not the website is still operating.

Instead, look for the age of the materials themselves — publication dates, when (or if) they’ve been updated, and how recent the research references are. Trustworthy websites review and update their content as needed and publish those dates for readers.

A good measure of timeliness is 2–3 years. Anything older than that is likely due for an update.

Questions to ask: How current is the information I’m reading? When was it published? Has it been updated in light of recent breakthroughs? How old are the sources it references? Are the links still functional?

Red flags: No dates of publication or revision, dates that are more than 2–3 years old, research that doesn’t incorporate medical developments, citations that go nowhere

“R” for Relevance. Most health-related Google searches return thousands of results. You may not struggle to find reading material, but chances are much of it won’t be relevant.

In 2012 a group of researchers studied the quality of infant sleep safety information  on the internet. They found that an alarming 28% of 1,300 websites contained irrelevant information. Those are terrible odds for parents researching how to keep their infants safe.

Just because a treatment worked for one person doesn’t mean it will help someone else. Despite this, studies show that “consumers tend to give more credibility to testimonials coming from people with whom they have something in common,” even if those similarities aren’t related to the health issue at hand.

Context and medical history matter. Be wary of recommendations that don’t apply to you or your loved ones. It always helps to have a trusted primary care doctor available who can put the information you find into the context of your own life. You should also prepare a research checklist beforehand to help you stay on track while you browse.

Finally, when reading information online, make sure you’re among the author’s intended audience. Knowing that much will prevent you from taking irrelevant advice that sounds appealing but doesn’t address the topic of interest.

Questions to ask: Is this information relevant to what I’m looking for? Am I the right audience for this? Can I find more appropriate information elsewhere?

Red flags: Information unrelated to the topic(s) you’re researching, materials that are either too simplistic or advanced for your needs, personal testimonies based on someone else’s health history

“A” for Authority. You probably don’t take financial advice from your teenager. But how many of us would brush off investment tips from Warren Buffet?

That’s because experience still counts for something. We tend to respect people and organizations whose perspective is reputable, experienced, and insightful. Yet when it comes to health content, we fall for headlines that grab our attention with exciting, sensationalized claims — even if there’s no substance behind them.

The good news is we can assess a website’s authority using basic web browsing skills. First take note of the website’s domain extension. Common ones include:

●   .com (commercial)

●   .gov (government)

●   .org (organization)

●   .edu (education)

●   .mil (military)

Government websites like the National Institutes of Health are considered the most credible resources, followed by educational websites. These institutions can access cutting-edge research, and their content is almost always reviewed by authorities in the field. Such websites commonly recommend other resources they trust, too.

You can learn even more about a website’s authority by reading their “About Us” page. Try to locate an editorial policy or background on who’s responsible for writing the content. Websites sponsored by nonprofit or research institutions may have your interests in mind more than those funded by a pharmaceutical or marketing company. Always be skeptical of websites where the sponsorship information is vague or hard to find.

Bottom line: Don’t risk your health on the word of somebody who isn’t qualified to give medical guidance.

Questions to ask: Who wrote this? Do they have the proper background? Who sponsors the website, and what’s their reputation? Is their editorial policy transparent? Can I easily contact the owners?

Red flags: Conflicts of interest, poor reputation in the field, non-expert writers, no authorial attribution, difficult-to-find contact information, vague or profit-seeking mission

“A” for Accuracy. Ever hear of confirmation bias? It’s a cognitive phenomenon that makes you more likely to find and retain information that fits in line with your current beliefs and behaviors. Whatever contradicts your view of the world is conveniently overlooked or discredited.

Confirmation bias is dangerous when researching health topics. If you think you have  (or don’t have)  a specific diagnosis, odds are you will drift toward content that supports your expectations. An example is how people who drink alcohol are more receptive to studies that conclude moderate drinking is good for your brain compared to research that suggests the opposite.

To prevent the effects of bias, compare several resources on the same topic to see how they stand up against one another, even if they offer conflicting advice. Accurate health information will aim to provide complete coverage of a topic including both the pros and cons of treatment, associated medical costs, long-term outcomes, and admissions of the unknown.

If one website’s content is strikingly different than what you find elsewhere, look hard at the quality of evidence it uses. Is it too good to be true? Are the conclusions opinion-based rather than evidence-based? Does the content say something different than the evidence it’s based on?

Keep in mind that most health information online is summarized from complex scholarly literature. It’s possible the author may not have the experience to interpret the materials accurately, especially if they’re not an expert in the field.

Above all, try not to let your personal assumptions steer you away from quality materials just because you don’t agree with the conclusions.

Questions to ask: Does the website favor one side of the debate? How does this website compare to other websites covering the same topic? What’s the value of its supporting evidence? Are my expectations guiding my research?

Red flags: Blatantly false information, no references or data sources, information that isn’t or can’t be verified, reliance on personal testimonies, opinions masquerading as evidence, numerous typographical errors

“P” for Purpose. If this era of fake news has taught us anything, it’s that many “neutral” websites have their own vested interests. Sometimes the product being sold is a worldview, like websites that falsely link vaccines with autism. More commonly, health websites sell literal products like vitamins and supplements, wonder cures, VIP content, etc.

Help yourself by sticking to websites that promote an educational mission over a commercial one. Articles filled with sales pitches may reveal ulterior motives, whereas government, educational, and nonprofit websites generally want to keep their readers informed more than anything else.

Again, you can learn about a website’s purpose on the “About Us” page or through its mission statement. Both should be easy to locate and provide an obvious purpose so that you know what to expect from the site’s content.

Another way to evaluate purpose is by looking at a website’s advertisements. Most websites rely on advertising to cover operation costs, so the presence of advertising or sponsored content isn’t a credibility-killer. Be wary, though, if you can’t distinguish between paid advertisements and health content, or if the advertisements promote pseudo-scientific products.

Questions to ask: Why did the person or group create this page? What is the author’s tone or angle, and how might they benefit? Is there bias at play? Am I being pushed to buy something? Are the advertisements labeled as such?

Red flags: Excessive promotion of a product or service, claiming there’s a “cure all,” persuading readers to adopt the writer’s personal biases, advertisements that mimic impartial content or promote pseudo-science

Don’t Let Health Websites Substitute for Medical Care

Even the most trusted health websites, like doctors, make mistakes. But talking to an experienced doctor about the information you find online allows you to exert control over your health while also staying grounded.

That’s why HealthWeb Navigator publishes reviews of health-related websites written by medical professionals. On our website, you can see which resources healthcare providers trust the most — and which ones they avoid.

Want to learn more strategies for finding high quality health websites on the internet? Watch our recorded webinar:

And lastly, if you’re worried about your health after reading something on the web, here’s a little parting advice from NeedyMeds President Dr. Rich Sagall: “When you hear hoofbeats, it’s probably horses, not zebras.”

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