1. Nancy Calabretta, MS, MEd
Assistant Library Director
Cooper Medical School of Rowan University

2. Pretest
he web is accurate and reliable True or False
ormation online is by using Google True or False
health web sites
ave ads
True or False
urce of health information True or False
y ability to find quality True or False

3. – 72% of internet users have looked
online for health information within
the past year
– 35% of American adults report having
gone online to “figure out” a medical
condition
– 77% of online health seekers start at a
search engine like Google, Bing or
Yahoo
Why This Session Now?
Pew Internet & American Life Project findings

4. Why This Session Now?
The amount of information available on health
topics is staggering. A search on “Heart
Failure”
retrieves:
20,200,000 on Google
9,540,000 on Bing
9,550,000 on Yahoo

5. IF we agree that…
“…nurses are in a unique position to
recommend Web sites to patients that provide
accurate and current information and can be
used to answer their health-related questions.”
Plast Surg Nurs. 2007 Oct-Dec;27(4):192-6.
Oermann MH, McInerney SM.

6. Then we can conclude that…
“…nurses need to be taught how to identify
websites that contain quality information, are
reader-friendly, and are credible.”
Adv Emerg Nurs J. 2013; 35(3):245
Orlowski JL, Oermann MH, Shaw-Kokot J.

7. Nurse-led Evaluation Of Web Sites
Evaluation of heart failure websites for patient education. Adv Emerg Nurs J. 2013 Jul-Sep;35(3):240-6
Orlowski JL, Oermann MH, Shaw-Kokot J.
An evaluation of sepsis Web sites for patient and family education. Plast Surg Nurs. 2007 Oct-
Dec;27(4):192-6. Oermann MH, McInerney SM.
Evaluation of breastfeeding Web sites for patient education. MCN Am J Matern Child Nurs. 2006 Jan-
Feb;31(1):18-23. Dornan BA, Oermann MH.
An evaluation of bariatric Web sites for patient education and guidance. Gastroenterol Nurs. 2005
Mar-Apr;28(2):112-7. Nichols C, Oermann MH.
Evaluation of asthma websites for patient and parent education. J Pediatr Nurs. 2003 Dec;18(6):389-
96O Oermann MH, Gerich J, Ostosh L, Zaleski S.
Evaluation of Web sites on management of pain in children. Pain Manag Nurs. 2003 Sep;4(3):99-105.
Oermann MH, Lowery NF, Thornley J.
Using health web sites for patient education. J Wound Ostomy Continence Nurs. 2003 Jul;30(4):217-23. Oermann
MH.
HRT & the World Wide Web. Helping patients find good information on the web. AWHONN
Lifelines. 2002 Dec;6(6):526-32 Oermann MH, DiBartolomeo RA, Mahfet SA.

8. • Identify key points of knowledge and assess
site for their presence
• Assess quality using HONcode principles
• Check readability of text using FKGL and FRES
in Microsoft Word
• Search for topic on top search engines
(Google, Yahoo, Bing)
• Evaluate first 5 web sites on each search
engine after eliminating duplicates
The Oermann Method
HONcode principles
readability FKG
L
FRES

9. • On March 20, 1996, www.hon.ch became one
of the very first URLs to guide both lay users
and medical professionals to reliable sources
of healthcare information
• Web publishers can apply and, if website
qualifies, may display the HONcode symbol
• Regular monitoring begins one year after
initial certification or following complaints or
technical malfunction
Health on the Net Foundation

10. HONcode Principles
Authoritative Indicates qualifications of authors
Complementarity Information supports, not replaces, doctor-patient
relationship
Privacy Respects privacy and confidentiality of personal data
submitted to site by visitor
Attribution Cites source(s) of published information, including date
of last modification
Justifiability
Supports claims relating to benefits and performance
Transparency
Accessible presentation with accurate e-mail contact
Financial Disclosure
Identifies funding resources
Advertising Policy
Clearly distinguishes advertising from editorial content

11. Making the most of HONcode
HONcode Search
HONcode Toolbar
Sample HONcode search
HONcode Status can be checked using the HONcode Toolbar

12. Issues to Consider
be aware of HONcode
applied unsuccessfully
perceive HONcode as important
a voluntary program
• They may have
• Website publishers may not
• HONcode IS
• They may not

13. Uses length of sentences and number of
polysyllabic words to determine scores from 0
– 100, the higher the score the easier the read
Readability Tools
Flesch Reading Ease

14. Uses mean sentence and word length to
calculate reading level corresponding to
grade in school
Readability Tools
Flesch-Kincaid Grade Level

15. Readability Tools
The 7 Steps to Using
a Readability Tool
(MS Word 2007)
76
54321

16. Top 5 Websites on Heart Failure

17. What Else is There?
Portals & Gateways provide collections of
prescreened web sites determined to be of
high quality by a governing organization.
HealthFinderMedlinePlus Mayo Clinic Health Information
Translations

18. MedlinePlus Quality Guidelines
Quality, authority and accuracy of content
Primary purpose is educational
Consistent availability & maintenance of web page
Special features (unique information,
graphics/diagrams, accessible to persons with
disabilities)

19. MedlinePlus Features

20. Medline Plus Guide to Health Web Surfing
• Consider the source – use recognized authorities
• Focus on quality – all sites are not created equal
• Be a “cyberskeptic” – quackery abounds on the web
• Look for the evidence – research NOT opinion
• Check for currency – look for the latest
• Beware of bias – What is the purpose? Who funds?
• Protect your privacy – Health info should be confidential
• Consult with your health professional

21. MedlinePlus Topical Pages
Heart Failure
Back to Menu

22. HealthFinder
Back to Menu

23. Mayo Clinic
Back to Menu

24. Health Information Translations
Back to Menu

25. What Do You Think?
The Facts About
Tourette’s Syndrome
The Doctor’s
Medical Library
Drugs.comLearning About Dercum Disease
Dercum’s Disease

26. The Doctor’s Medical Library
Back to Menu

27. The Facts About Tourette’s Syndrome
Back to Menu

28. Dercum’s
Disease
What Do You Think?
Back to Menu

29. What Do You Think?
Learning
About
Dercum
Disease

30. What Do You Think?
Back to Menu

31. Drugs.com
Back to Menu

33. Post Test
he web is accurate and reliable True or False
ormation online is by using Google True or False
health web sites
ave ads
True or False
urce of health information True or False
y ability to find quality True or False

34. 1) To research and write an “Oermann style”
article;
2) To research and compile a short list of reliable
sites for your patients;
3) To search with confidence using HONcode,
readability scores and favorite gateway sites.
Use what you learned today…

35. References
• Ahmed, O.H., Sullivan, S.J., Schneiders, A.G., McCrory, P.R. (2012) Concussion information online: evaluation of information
quality, content and readability of concussion-related websites. British Journal of Sports Medicine, 46, 675-683.
• Akerkar, S.M., Bichile, L.S. (2004). Doctor patient relationship: changing dynamics in the information age. Journal of Postgraduate
Medicine, 50, 120-122.
• Bradley, S.M. (2008). The Internet: Can patients link to credible resources? MEDSURG Nursing, 17, 229-236.
• Golterman, L., Banasiak, N.C. (2011). Evaluating web sites: Reliable child health resources for parents. Pediatric Nursing, 37, 81-83.
• Oermann, M.H., McInerney, S.M. (2007). An evaluation of sepsis web sites for patient and family education. Plastic Surgical
Nursing, 27, 192-196.
• Orlowski, J.L., Oermann, M. H., Shaw-Kokot, J. (2013). Evaluation of heart failure websites for patient education. Advanced
Emergency Nursing Journal, 35, 240-246.
• Wald, H.S., Dube, C.E., Anthony, D.C. (2007). Untangling the Web – The impact of Internet use on health care and the physician-
patient relationship. Patient Education and Counseling, 68, 218-224.
• Websites:
• Fox, S., Duggan, M. (January 15, 2013). Pew Internet & American Life Project. Health online 2013 summary of findings. Retrieved
9/27/13 from http:// www.pewinternet.org/Reports/2013/Health-online/Summary-of-Findings.aspx.
• Health on the Net Foundation. (Last updated February 2012). Advice to patients on the safe use of the internet. Retrieved 9/27/13
from http://www.hon.ch/HONcode/Pro/visitor_safeUse.html.
• Health on the Net Foundation. (Last updated September 2013). The HON Code of conduct for medical and health web sites
(HONcode). Retrieved 9/27/13 from: http://www.hon.ch/HONcode/Pro/Conduct.html.
• Medical Library Association. (Last updated April 2013). A User’s guide to finding and evaluation health information on the web.
Retrieved 9/27/13 from: http://www.mlanet.org/resources/userguide.html
• MedlinePlus. (Last updated May 2013). MedlinePlus quality guidelines. Retrieved 9/27/13 from:
http://www.nlm.nih.gov/medlineplus/criteria.html.
• MedlinePlus. (Last updated April 2012). MedlinePlus Guide to healthy web surfing. Retrieved 9/27/13 from:
http://www.nlm.nih.gov/medlineplus/healthywebsurfing.html.
• MedlinePlus. (Last updated September 2013). Evaluating health information. Retrieved 9/27/13 from:
http://www.nlm.nih.gov/medlineplus/evaluatinghealthinformation.html.