ContextThe Internet has attracted considerable attention as a means to improve
health and health care delivery, but it is not clear how prevalent Internet
use for health care really is or what impact it has on health care utilization
Available estimates of use and impact vary widely Without accurate estimates
of use and effects, it is difficult to focus policy discussions or design
appropriate policy activitiesObjectivesTo measure the extent of Internet use for health care among a representative
sample of the US population, to examine the prevalence of e-mail use for health
care, and to examine the effects that Internet and e-mail use has on users'
knowledge about health care matters and their use of the health care systemDesign, Setting, and ParticipantsSurvey conducted in December 2001 and January 2002 among a sample drawn
from a research panel of more than 60 000 US households developed and
maintained by Knowledge Networks Responses were analyzed from 4764 individuals
aged 21 years or older who were self-reported Internet usersMain Outcome MeasuresSelf-reported rates in the past year of Internet and e-mail use to obtain
information related to health, contact health care professionals, and obtain
prescriptions; perceived effects of Internet and e-mail use on health care
useResultsApproximately 40% of respondents with Internet access reported using
the Internet to look for advice or information about health or health care
in 2001 Six percent reported using e-mail to contact a physician or other
health care professional About one third of those using the Internet for
health reported that using the Internet affected a decision about health or
their health care, but very few reported impacts on measurable health care
utilization; 94% said that Internet use had no effect on the number of physician
visits they had and 93% said it had no effect on the number of telephone contacts
Five percent or less reported use of the Internet to obtain prescriptions
or purchase pharmaceutical productsConclusionsAlthough many people use the Internet for health information, use is
not as common as is sometimes reported Effects on actual health care utilization
are also less substantial than some have claimed Discussions of the role
of the Internet in health care and the development of policies that might
influence this role should not presume that use of the Internet for health
information is universal or that the Internet strongly influences health care
utilization

https://jamanetwork.com/journals/jama/articlepdf/196536/joc21898.pdf

Use of the Internet and e-mail for health care information: results from a national survey.

Objective: To review published criteria for specifically evaluating health related information on the world wide web, and to identify areas of consensus. Design: Search of world wide web sites and peer reviewed medical journals for explicit criteria for evaluating health related information on the web, using Medline and Lexis-Nexis databases, and the following internet search engines: Yahoo!, Excite, Altavista, Webcrawler, HotBot, Infoseek, Magellan Internet Guide, and Lycos. Criteria were extracted and grouped into categories. Results: 29 published rating tools and journal articles were identified that had explicit criteria for assessing health related web sites. Of the 165 criteria extracted from these tools and articles, 132 (80%) were grouped under one of 12 specific categories and 33 (20%) were grouped as miscellaneous because they lacked specificity or were unique. The most frequently cited criteria were those dealing with content, design and aesthetics of site, disclosure of authors, sponsors, or developers, currency of information (includes frequency of update, freshness, maintenance of site), authority of source, ease of use, and accessibility and availability. Conclusions: Results suggest that many authors agree on key criteria for evaluating health related web sites, and that efforts to develop consensus criteria may be helpful. The next step is to identify and assess a clear, simple set of consensus criteria that the general public can understand and use. Key messages Many organisations and individuals have published criteria to evaluate health related information on the world wide web A literature and world wide web search found that the most frequently cited criteria were those dealing with content, design and aesthetics of site, disclosure of authors, sponsors, or developers, currency of information, authority of source, and ease of use Criteria related to confidentiality and privacy were only cited by one author Consensus regarding critical criteria for evaluation of web based health information seems to be emerging Our results indicate that many authors agree on key criteria for evaluating health related web sites, and that efforts to develop a set of key criteria may be helpful

https://www.bmj.com/content/bmj/318/7184/647.1.full.pdf

Published criteria for evaluating health related web sites: review

The Internet is a massively expanding body of information, with an estimated 320 million Web pages available. In 1997 an estimated 24 million North Americans used the Internet, and Internet use has been estimated to double each year. Even prior to the advent of the Internet as a source of medical information, patients have become more informed regarding their care, seeking increased amounts of information regarding their diagnoses and primarily wanting more information regarding their treatment options. In the past, these patients would rely heavily on health professionals for this information, through conversations or from pamphlets, videos, or books available to physicians for office distribution. Some resourceful patients may have ventured into medical libraries and some may have navigated through Index Medicus. Even the accessibility of MEDLINE searches in libraries and public institutions provided patients chiefly with peer-reviewed medical articles. We are living in a time of exponential expansion in accessibility to medical information. Data that previously would have required hours of research in a medical library now can be found easily by anyone with access to the Internet. This has enhanced the medical professional’s ability to gain extensive knowledge of research findings from many different medical specialties. However, medical professionals are not the only ones searching the Internet for such information. Our patients have the same capability that we have to research a medical topic thoroughly via the Internet. However, of concern is the quality of this newly gained knowledge. The free flow of information on the Internet permits anyone with good computer skills and a modem to establish a Web site with whatever information they wish to share. In this respect, the Internet becomes the great equalizer: experts, specialists, authorities, professionals, alternative therapy promoters, interested lay people, charlatans, and hucksters all may set up sites containing information regarding specific topics of interest. As physicians, we are concerned whether medical information 381

/pdf/evaluation-of-cancer-information-on-the-internet-3ux5hivfsm.pdf

Evaluation of cancer information on the Internet.

Background
Rule violations among elite-level sports competitors and tragedies among adolescents have largely defined the issue of non-medical anabolic-androgenic steroid (NMAAS) use for the public and policy makers. However, the predominant and oft-ignored segment of the NMAAS community exists in the general population that is neither participating in competitive sports nor adolescent. A clearer profile of NMAAS users within the general population is an initial step in developing a full understanding of NMAAS use and devising appropriate policy and interventions. This survey sought to provide a more comprehensive profile of NMAAS users by accessing a large sample of user respondents from around the United States.

https://link.springer.com/content/pdf/10.1186%2F1550-2783-4-12.pdf

A league of their own: demographics, motivations and patterns of use of 1,955 male adult non-medical anabolic steroid users in the United States

Context.—Despite the common use of e-mail, little beyond anecdote or impressions
has been published on patient-clinician e-mail consultation.Objective.—To report our experiences with free-of-charge e-mail consultations.Design.—Retrospective review of all e-mail consultation requests received between
November 1, 1995, and June 31, 1998.Setting and Participants.—Consecutive e-mail consultation requests sent to the Division of Pediatric
Gastroenterology at the Children's Medical Center of the University of Virginia
in Charlottesville.Main Outcome Measures.—Number of consultation requests per month, time required to respond,
who initiated the request and their geographic origin, and the kind of information
requested in the consultation.Results.—During the 33-month period studied, we received 1239 requests, an average
(SD) of 37.6 (15.9) each month. A total of 1001 consultation requests (81%)
were initiated by parents, relatives, or guardians, 126 (10%) by physicians,
and 112 (9%) by other health care professionals. Consultation requests were
received from 39 states and 37 other countries. In 855 requests (69%), there
was a specific question about the cause of a particular child's symptoms,
diagnostic tests, and/or therapeutic interventions. In 112 (9%), the requester
sought a second opinion about diagnosis or treatment for a particular child,
and 272 consultations (22%) requested general information concerning a disorder,
treatment, or medication without reference to a particular child. A total
of 1078 requests (87%) were answered within 48 hours of the initial request.
On average, reading and responding to each e-mail took slightly less than
4 minutes.Conclusion.—E-mail provides a means for parents, guardians, and health care professionals
to obtain patient and disease-specific information from selected medical consultants
in a timely manner.

https://jamanetwork.com/journals/jama/articlepdf/188075/joc80479.pdf

The origin, content, and workload of e-mail consultations.

a growing concern has emerged for the quality of health-related documents contained on the World Wide Web. Increased use of the World Wide Web by consumers and health education professionals, as well as ease of Web page publication, has heightened the need for criteria in Web page construction and evaluation. This article reviews and discusses elements to consider in Web page construction and evaluation, and provides a form to assist in assessment.

Evaluating health-related Web sites.

Collecting health-risk behavior data from college students is a Web survey research application with extraordinary potential that has implications for individual schools and for the next National College Health Risk Behavior Survey. Recent evidence suggests that it is now feasible to collect health-risk behavior data from college students using the Web. This article describes the eight steps used in the 1999 University of Florida Health Behavior Survey that demonstrated the feasibility of the Web to collect health-risk behavior data from undergraduates. Practical issues researchers should consider when conducting Web-delivered survey research also are presented. Information in this article can be used by college and university health survey researchers and student health service administrators to plan and conduct their own health-risk behavior Web-delivered survey, and to develop an electronic college health-risk behavior surveillance system for their schools.

L.N. Pealer

Papers

Evaluating health-related Web sites.

Guidelines for designing a Web-delivered college health risk behavior survey: lessons learned from the University of Florida Health Behavior Survey.

Video display terminals: safe use guidelines.

Early initiation of alcohol or marijuana use and nonmedical use of prescription drugs