Telemedicine - Internet and Medicine, Study notes of Telemedicine

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Internet and Medicine

Medicine on the Internet

• (^) Consumers
• (^) Providers
• (^) Companies

Consumers

• (^) Disease info
  • (^) 2/3 don’t receive info about their or their child’s disease(s) when in the MD’s office
• (^) Medications
  • (^) Most don’t receive info about medications they are prescribed
• (^) Alternative medicine
  • (^) Increased interest in alternative medicine (45%)
  • (^) Many consider alternative medicine to be equal to traditional medicine

Providers

• (^) Provider education
  • (^) Literature,
• (^) Provider-provider communication
  • (^) Provider groups
  • (^) Teleconsultation
• (^) Patient information
  • (^) Lab and radiology results
• (^) Provider-patient communication

Healthcare info on the net

• (^) Provider sites
  • (^) MayoClinic Home - MayoClinic.com
• (^) Special interest sites
  • (^) JAMA Migraine Information Center
  • (^) The Migraine Relief Center
  • (^) Migraine Awareness Group MAGNUM
  • (^) Natural Migraine Treatment FAQ

Healthcare info on net

• (^) Procedure information
  • (^) Liposuction
  • (^) Lipoinfo
• (^) Usenet
• (^) Medical search engine
  • (^) Achoo Gateway to Healthcare

Healthcare info quality

• (^) JAMA study
  • (^) Study of accessibility, quality, readability
  • (^) 14 search engines
  • (^) 25 web sites
  • (^) Evaluated by MD’s

Accessibility or relevant content

• (^) 10 English language and 4 Spanish language search engines - (^) Ranking methods used: location and frequency of key words, cross-linking, payment from sites, human editing
• (^) Search terms
  • (^) Breast cancer
  • (^) Childhood asthma
  • (^) Depression
  • (^) Obesity

Accessibility

• (^) 34% of discovered links were relevant with

significant variation by search engine

• (^) 74% of relevant links led to relevant content

within ten clicks

• (^) English: 56% contained explicit content and

44% contained promotional material

• (^) Spanish: 36% explicit ads and 21%

promotional material

Quality of content

• (^) Web sites selected for ranking, reputation and the absence of a need for subscription or payment (open sites)
• (^) Panel developed condition-related questions that one would expect to be answered by a site - (^) “When should I start having regular mammograms?”
• (^) Panel developed clinical elements (recommendations/statements that should be included) - (^) “most breast cancers occur in women without a family history of the disease”

Percentage of “required clinical elements not covered”

• (^) English
  • (^) Breast 16%
  • (^) Asthma 27%
  • (^) Depression 20%
  • (^) Obesity 35%
• (^) Spanish
  • (^) Breast 49%
  • (^) Asthma 33%
  • (^) Depression 61%
  • (^) Obesity 69%

Quality

• (^) Material not covered
  • (^) Alternatives to medical and surgical rx for breast Ca
  • (^) Evaluation of depression
  • (^) Safety and effectiveness of dietary supplements

Inaccurate info

• (^) Omega-3 fatty acid deficiencies causes major

depression

• (^) Cockroaches are the leading cause of

childhood asthma

Conflicting info

• (^) About half of English language sites had one or more conflicts re: - (^) Treatment 35% - (^) Diagnosis 13% - (^) Definitions 7% - (^) Adverse effects 5% - (^) Etiology/Risk factors 5% - (^) Incidence/Prevalence 4%
• (^) Example
  • (^) One point in web site says inhaled steroids do and another don’t stunt growth