BY SUE MacDONALD
The Cincinnati Enquirer
When regular searches through library books turned up little information on the antidepressant herb St. John's wort, Launa Murdock turned to the Internet.
"I've only used it a little bit, and I was scared of it until I tried it," says Ms. Murdock, who found enough information online to write a paper for her dietetics internship program at University Hospital. "It was good because I couldn't find anything anywhere else."
More than ever, people are browsing thousands of Web sites in search of health and medical information that just a decade ago was available only to physicians and only in books or medical journals -- or not widely available at all.
Though much of it is good information, some Web sites aren't always up to date. A few have strictly commercial goals.
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LOCAL SITE ACTIVE
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One of the most active local health Web sites is http://www.netwellness.org, a collaboration of the University of Cincinnati Medical Center, Ohio State University Health Sciences Center and Case Western Reserve University School of Medicine.
It averages 1 million hits a month, and its "Ask an Expert" interactive feature is the most popular spot on the site.
Visitors can pose a question that's answered within a day or two by one of more than 100 doctors, nurses, pharmacists or other health specialists. Other Web visitors then have access to a backlog of previously asked questions.
Common topics revolve around children's health and development, drugs - drug reactions and women's health.
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The Internet may hold as many as 10,000 health-related sites, says Bruce Maxwell, a Virginia author who turned to the Internet when he doubted his doctor's diagnosis of a chronic health problem. (He doesn't disclose the problem.) But what Mr. Maxwell learned online matched what his doctor was telling him, and he decided to pursue the treatment his doctor had recommended -- a treatment he previously had rejected.
"The health information that I found on the Internet saved my life," says Mr. Maxwell, whose book How to Find Health Information on the Internet (Congressional Quarterly Books; $35.95) was published in August. "The point of writing the book was to give people some starting points for their research on the Internet."
Starting out, however, can be "daunting," Mr. Maxwell says. Call up the Yahoo Web page, for example, type "breast cancer" in the search field, and you'll get 408,719 references. The same search on the federal government's healthfinder.gov site brings up 33 Web resources and links to 15 breast cancer organizations.
Where does an average consumer start?
A new way to learn
There's a vast difference between walking into a traditional library and surfing on the Internet, says Roger Guard, director of information technology and libraries for the University of Cincinnati Medical Center.
In a library, all the books, magazines and journals are preselected and approved by librarians, most of them holding master's degrees in library science.
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RECOMMENDED WEB SITES
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Six health-related Web sites recommended by the Chicago-based Medical Library Association are:
http://www.healthfinder.gov is the Web site of the Department of Health and Human Services.
http://www.healthweb.org is a Web site sponsored by the Greater Midwest region of the National Network of Libraries of Medicine and by the Committee for Institutional Cooperation.
http://www.kidshealth.org is a site about child and teen health, sponsored by Alfred I. duPont Hospital for Children and the Nemours Children's Centers, Wilmington, Del.
http://www.nlm.nih.gov is a Medline site of the National Institutes of Health's medical library, with access to more than 9 million references from worldwide medical journals.
http://www.mayohealth.org is updated daily by physicians at the Mayo Clinic in Rochester, Minn.
http://cancer.med.upenn.edu is a multimedia cancer information resource sponsored by the University of Pennsylvania.
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On the Internet, everybody's information gets thrown into the pot, and it's job of surfers to stir the pot as much and wisely as possible to dredge up what they need.
Mr. Guard, in fact, calls the Internet the "ultimate vanity press because almost anybody of any age can put up a Web site. You retrieve great (information) and you retrieve garbage, and they're all filed the same way. You can't tell the difference unless you're a pretty sophisticated person."
The question to ask, says Leslie Schick, associate library director at UC, is "are people really getting the best information off the Internet, or are they getting whatever comes easiest?"
Mr. Maxwell often found himself pursuing useless information about his health problem until he learned to narrow his searches and find launching sites that made searching easier.
His book starts with a list of recommended search engines -- sites from which to start searching, such as www.yahoo.com -- as well as disease-specific Web sites on a variety of topics, from pesticide poisoning to diabetes to leukemia.
"One of the joys of the Internet," he says, "is that once you find one good site, there are usually links to other good sites. You can branch out from there in a kind of spider-web-like link to other sites and information."
Many people, Mr. Maxwell says, begin searching the Internet in a frantic frame of mind -- scared, stressed, fatigued and grasping for a quick answer.
"Under these circumstances, you may be tempted to suspend your normal good judgment and latch onto anything that promises hope, no matter how outlandish it seems," he says in the book's introduction. "You must resist that temptation, as hard as it is, and carefully assess any information that you find."
People who use the Internet regularly, he says, will find "an incredible amount of very good information."
Some sites outdated
Some sites sell products only and do not disseminate information. Of those that provide information, not all of it is reliable. Some is outdated or downright dangerous.
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HOW TO EVAULATE A WEB SITE
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How can you tell if a Web site is a legitimate source of health information? Bruce Maxwell, author of Health Information on the Internet (Congressional Quarterly Books; $35.95) offers these tips when evaluating Internet sites.
Make sure the sponsor is identified. Addresses ending in "edu" are educational institutions, "gov" are government agencies, "org" are organizations (often non-profit) and "com" are commercial firms.
Does the site provide addresses, phone numbers and e-mail contacts if you want more information? If no contacts are provided, be wary.
Be mindful that sites selling health-care products, drugs or devices may be pushing a particular product without offering competing information. Some sites by non-profit organizations are funded by drug companies or businesses, which may indicate a conflict of interest.
Is information complete? If it's controversial, are sources identified? Are credentials supplied?
How often is the site updated? Reliable ones are upgraded regularly and indicate when they were last revised.
Is the information full of opinions? If opinions dominate the site, are sources of opinions readily apparent? Are they substantiated? Be wary of sites that give partial or one-sided information.
The Medical Library Association offers a free brochure, Deciphering Medspeak, on evaluating the credibility of health care information and providing lay definitions for medical jargon found on Web sites. For a copy, write to Medical Library Association, 6 North Michigan Ave., Suite 300, Dept. BR, Chicago, Ill. 60602-4805; (312) 419-9094.
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Ohio State University researchers recently analyzed 60 traditional medical sources for information on childhood diarrhea and found that only 20 percent of the sites presented accurate information.
Updating Web sites regularly is critical to their credibility, says Mr. Guard, who helps oversee UC Medical Center's NetWellness site (http://www.netwellness.org), which averages 1 million hits a month. In August, NetWellness received a Links2Go Key Resource Award, placing it in the top 50 Web sites of all U.S. medical schools.
But sites require daily updating and regular monitoring so that information is current, he says.
"Things are changing so fast, you can't possibly keep up," Ms. Schick says. "Nobody can."
The Internet is also a place where people with the same medical problems can trade ideas, offer advice, and network with people who've shared similar experiences.
Finneytown resident Barb Wehmann, who has a rare, debilitating metabolic condition called Fabry's disease, checks a Fabry Support and Information Group Web site daily to monitor a discussion page where other people from around the world with the disease pose and ask questions and form an online support group.
"The amount of caring and sharing that has taken place on this page has been immense," says Ms. Wehmann, who notes that 80 people now check the discussion page regularly. Such sites are especially helpful, she says, for people whose doctors are not familiar with rare diseases or disorders.
"There is some junk out there, but there's not as much as critics would have you believe," Mr. Maxwell says. "Especially in the health area, there are a lot of very sincere people who are telling about their personal experiences and doing research on their own to tell others about an illness that struck them or their families."
But the Internet is also a place in which "surfer beware" is important to remember, the author says.
"There are also fly-by-night artists and scam artists who want to sell you miracle cures and diet aids, but they're not unique to the Internet," he says.
"You have to approach it with a certain degree of caution.
"And don't try to self-diagnose yourself off the Internet," he adds. "If you find something, take it to your doctor and say, "Hey, does this make sense?' "
