Quality and safety of health information on the Internet: Who decides and how? Role of standards, consumer education and media literacy by Dr.Gunther Eysenbach

1. Associate Professor Department of Health Policy, Management and Evaluation, University of Toronto; Canada Senior Scientist , Centre for Global eHealth Innovation, Division of Medical Decision Making and Health Care Research; Toronto General Research Institute of the UHN, Toronto General Hospital, Canada Visiting Professor, Faculty of Behavioural Sciences University of Twente, The Netherlands Editor & Publisher, Journal of Medical Internet Research (www.JMIR.org) Chair, Medicine 2.0 Conference Series (www.medicine20congress.com) Quality and safety of health information on the Internet: Who decides and how? Role of standards, consumer education and media literacy Gunther Eysenbach MD MPH Gunther Eysenbach MD MPH

5. The ethnic theory of plane crashes (Chapter in “Outliers” by Malcolm Gladwell)

6. “ The single most important variable in determining whether a plane crashes is not the plane, it's not the maintenance, it's not the weather, it's the culture the pilot comes from. Planes are flown safely when the pilot and co-pilot are in open and honest communication. And in cultures where it is difficult for a junior person to speak openly to a superior, you have lots of plane crashes.” (Source: Gladwell)

7. Power Distance Index (P.D.I.) [Geert Hofstede] = measurement of how much a particular culture values and respects authority. Countries with a high P.D.I. generally value being more deferential towards authority, and thus not contradicting a superior.

9. Eysenbach. Random Research Rants (Blog) http://www.webcitation.org/5h5jkooUX

11. Eysenbach G, Jadad AR Evidence-based Patient Choice and Consumer health informatics in the Internet age J Med Internet Res 2001;3(2):e19 <URL: http://www.jmir.org/2001/2/e19/>

12. Quality

13. Eysenbach G, Powell J, Kuss O, Sa ER. Empirical studies assessing the quality of health information for consumers on the World Wide Web: A systematic review. JAMA 2002; 287: 2691-2700 Meta-analysis of information quality on the web

14. 100% 0% Inaccurate / non-evidence based information on the web Systematic review of studies evaluating health information on the web (Eysenbach et al., 2002. JAMA 2002; 287: 2691-2700 ) n=1781 websites 27 studies

15. 100% 0% Inaccurate / non-evidence based information on the web n=1781 websites 27 studies Cancer ~5% inaccurate Systematic review of studies evaluating health information on the web (Eysenbach et al., 2002. JAMA 2002; 287: 2691-2700 )

16. 100% 0% Inaccurate / non-evidence based information on the web n=1781 websites 27 studies Nutrition ~45% inaccurate Diet ~89% inaccurate Systematic review of studies evaluating health information on the web (Eysenbach et al., 2002. JAMA 2002; 287: 2691-2700 )

21. Challenge: Access URL:http://www.internetworldstats.com/stats1.htm. Accessed: 2009-06-09. (Archived by WebCite® at http://www.webcitation.org/5hOqCogVB)

22. Challenge: Access

23. Physical accessibility Skills / Education / Computer literacy / Health literacy (external) findability Reading level Design + Usability privacy convenience site developers Search engine developers content developers At home School Kiosk/Library User factors Lore ipsum dolor sit amet consectetuer Policy makers Level 1 Level 2 Level 3 Level 4 “ accessible” content Accessibility barriers Eysenbach, In: Lewis, D; Eysenbach, G; Kukafka, R; Jimison, H; Stavri, Z (eds.) (2005). Consumer Health Informatics. New York: Springer. ISBN 9780387239910.

24. Challenge: Literacy

25. Challenge: eHealth Literacy Norman CD, Skinner HA eHealth Literacy: Essential Skills for Consumer Health in a Networked World J Med Internet Res 2006;8(2):e9 <URL: http://www.jmir.org/2006/2/e9/>

26. Challenge: Language >2,000 languages in Africa (Source: UNESCO)

29. URL:http://ross.typepad.com/blog/2008/07/twitter-for-afr.html. Accessed: 2009-06-09. (Archived by WebCite® at http://www.webcitation.org/5hOiOf6uR)

30. Thank you!