Health on the Net Special: The Web way to good health

Want to know more about your body? Forget the library; go for the Internet. But user beware.

One of the many dramatic effects of the Internet is that it is changing for ever the relationship between doctor and patient. Even five years ago, when you were diagnosed with something chronic, or learnt that your child had a life-threatening disease, there was little you could do except follow doctor's orders. The medical profession had control of all the information. If you wanted to know more, a couple of out-of- date textbooks in the local library was about the best you could hope for.

Now all that has changed. The Internet is bursting with health information. In February just one directory - Yahoo - had links to 4,563 sites devoted to diseases and medical conditions, 1,101 for mental health and 307 for dentistry. Today there are certainly more - it is estimated that the total number of web pages doubles every nine months. Anyone with a PC and a modem sitting at home can have access to mountains of new research, as well as a host of alternative and often controversial remedies. Not only that, but there are support groups where you can swap experiences and information with others suffering the same problem. It is not uncommon for patients to appear in their GP's surgery clutching computer print- outs and demanding new and exotic treatments for their condition.

Inevitably, the medical profession is in two minds about all this. On the one hand, the informed patient fits the current rhetoric that makes us all consumers. We shop around for the best value when buying a car or a kitchen, so why shouldn't we do the same with our health? But the old habit of being an infallible source of wisdom dies hard, and there are genuine fears about the quality of information available on the Net.

A good example of this contradiction appears in the current issue of the British Medical Journal, in an exchange of letters about the controversial link between the MMR vaccine and autism.

"As a parent of young children," writes J Selway, senior registrar in public health, Edensor, Tunbridge Wells "I have become aware of the website "The Informed Parent": /aphillip/WNW/ vaccine/dvm.txt). Although it is written by a non-physician it is written in the style of a medical journal which lends it more authority than it may merit ... it argues that vaccination is dangerous and unnecessary."

Selway goes on to suggest that it is no longer enough for doctors to give the simple reassurance they would have done in the old days. "The challenge is to produce information for parents that is accessible (including on the Internet) that addresses concerns that websites like this engender."

Not only does the letter highlight the theoretical issue, it nicely illustrates the practical problems involved. When I tried to find "The Informed Parent" web site, I couldn't. Wrong address? Temporary glitch? Who knows.

Someone who has been trying to build bridges between the medical profession and all the new resources on the web is Robert Kiley of the Wellcome Trust in London. His bi-monthly newsletter "He@lth Information on the Internet" is an invaluable source for tracking new developments.

"Doctors are worried about the Internet," he says, "and there have been studies in the journals showing that much of the information, even in specialised newsgroups dedicated to a disease, is inaccurate."

He describes some recent scams and idiocies, such as the sites that sprang up in the wake of the Viagra frenzy, using copies of the proper research by its makers, Pfizer, to sell something called Viagro that turned out to be a herbal stimulant. And there are other stories about people selling DIY sterilisation kits on the Net, not to mention a site where you can select donors you fancy and buy their sperm.

But this is part of the age-old battle between freedom and censorship. The anarchic, non-hierarchical nature of the Web does allow porn, Diana death conspiracy and sperm donor sites to flourish, but it also makes available an unbelievable wealth of information.

So how to separate the good stuff from the rubbish? Let's suppose that your child has been diagnosed as having asthma. Where can you go to find out what's new and what works? First step might be one of the major search engines, such as Alta Vista, Excite or Hot Bot (I'm assuming a basic familiarity with the Internet). The trouble is that putting in the word "asthma" will yield thousands of results.

These engines are much more useful if you are looking for something specific, such as the possible side-effects of a new drug or a particular controversial treatment. There is valuable information on the most obscure topics out there. For instance, a search for "amyotrophic lateral sclerosis" on one search engine yielded a dozen sites; another threw up a further 3,067 hits. But how do you know what is reliable?

"These four points are useful to bear in mind when judging how seriously to take the information a site gives," says Kiley. "First: does it say who the author is? Second: does it give references for its claims? Three: does it clearly state any vested interests? Four: does it show when it was last updated?"

The sites - gateways - listed below are all likely to throw up more reliable information than most. Many of the sites have a link to the massive medical database, Medline. This contains 9 million records, abstracts (mostly) from articles in thousands of journals. Any bit of serious research in the world will be referenced in Medline, and that is part of the problem. Put a search for asthma in there and you will get thousands of detailed results, many of them impenetrable accounts of biomolecular interactions. On the other hand, if you have a specific query, such as "Has anyone tested the effects of glucosamine on rheumatism?", you may well get something useful.

Using the Internet has absurdly been called "surfing"; in fact it is much more like being a librarian. You need to be patient, careful, precise and organised in order to find something useful. Gateways and other useful sites are all free, but for many you have to register, which just means providing name, address and other details. For some you may have to pay - via credit card - for articles downloaded. They all have their own search engines that may take a bit of getting used to.


Biomednet http://BioMed A bright, busy site with user-friendly articles on all sorts of medical and biological science topics, plus a search engine that will find a range of serious and often pretty dense journal articles.

Medical matrix http://www. A site with a mix of results including articles from research journals, extensive chapters from online text books and patient care guidelines, and a link to asthma articles in the New York Times.

Medical World Search http:// Has a search engine that will yield lots of proper research papers from high-quality journals, but it does take a bit of getting used to. There are all sorts of settings that you can change, so it can be bewildering at first, but it's worth persevering.

Medicine Net http://www. A rather more chatty and consumer- oriented site. Short entries; non-technical.

Medscape A heavyweight professional site where a search for asthma throws up detailed articles such as: "Alpha1-Antitrypsin Deficiency in COPD", as well as those that sound more accessible, like: "A Pediatric Asthma Self-Management Program That Gets Results".

Medexplorer Not a source of documents and research papers, but gives leads to useful resources. A number of them involve alternative and complementary medicine as well as self-help and support groups.

Healthworks http://www. A useful site and one of the few general UK ones. Has several e-mailed newsletters on subscription, such as "Health on the Internet", with regular lists of new medical and support sites, and "Women's health on the Internet". Also a database of 300-plus journals and links to many other sites.

Mining Co http://www.mining This site has sections on computers and hobbies but is useful for two health sections with clear, untechnical information. One covers general health; the other deals specifically with women's health. Links to alternative medicine sites and links to support groups.

Health on the Net http:// Here a panel of experts evaluates sites and divides your hits into "recommended" and "not checked". Gives lots of information on each to tell you whether it is worth visiting. Asthma yielded 64 approved and 1,600 unchecked.

Omni A UK attempt to bring quality control to online information, funded by, among others, the Welcome Trust and the Institute of Medical Research. Not as comprehensive as Health on the Net. It produced only 23 hits on asthma, but is clearly set out, easy to use and authoritative.

Arts and Entertainment
'The Archers' has an audience of about five million
radioA growing number of listeners are voicing their discontent; so loudly that even the BBC's director-general seems worried
Arts and Entertainment
Ready to open the Baftas, rockers Kasabian are also ‘great film fans’
musicExclusive: Rockers promise an explosive opening to the evening
Arts and Entertainment
Henry VIII played by Damien Lewis
tvReview: Scheming queens-in-waiting, tangled lines of succession and men of lowly birth rising to power – sound familiar?
Arts and Entertainment
Arts and Entertainment
Hell, yeah: members of the 369th Infantry arrive back in New York
booksWorld War Z author Max Brooks honours WW1's Harlem Hellfighters in new graphic novel
Arts and Entertainment
Taylor Swift is heading to Norwich for Radio 1's Big Weekend

Arts and Entertainment
Beer as folk: Vincent Franklin and Cyril Nri (centre) in ‘Cucumber’
tvReview: This slice of gay life in Manchester has universal appeal
Have you tried new the Independent Digital Edition apps?
Arts and Entertainment

ebooksNow available in paperback
Arts and Entertainment

Arts and Entertainment
‘A Day at the Races’ still stands up well today
Arts and Entertainment
‘The Royals’ – a ‘twisted, soapy take on England’s first family’
tvAnd its producers have already announced a second season...
Arts and Entertainment
Kraftwerk performing at the Neue Nationalgalerie (New National Gallery) museum in Berlin earlier this month
musicWhy a bunch of academics consider German electropoppers Kraftwerk worthy of their own symposium
Arts and Entertainment
Icelandic singer Bjork has been forced to release her album early after an online leak

Arts and Entertainment
Colin Firth as Harry Hart in Kingsman: The Secret Service

Arts and Entertainment
Brian Blessed as King Lear in the Guildford Shakespeare Company's performance of the play

Arts and Entertainment
In the picture: Anthony LaPaglia and Martin Freeman in 'The Eichmann Show'

Arts and Entertainment
Anne Kirkbride and Bill Roache as Deirdre and Ken Barlow in Coronation Street

tvThe actress has died aged 60
Arts and Entertainment
Marianne Jean-Baptiste defends Joe Miller in Broadchurch series two

Arts and Entertainment
The frill of it all: Hattie Morahan in 'The Changeling'

Arts and Entertainment
Gillian Anderson and David Duchovny may reunite for The X Files

Arts and Entertainment
Jeremy Clarkson, left, and Richard Hammond upset the locals in South America
A young woman punched a police officer after attending a gig by US rapper Snoop Dogg
Arts and Entertainment
Reese Witherspoon starring in 'Wild'

It's hard not to warm to Reese Witherspoon's heroismfilm
Arts and Entertainment
Word up: Robbie Coltrane as dictionary guru Doctor Johnson in the classic sitcom Blackadder the Third

Arts and Entertainment
The Oscar nominations are due to be announced today

Oscars 2015
Arts and Entertainment
Hacked off: Maisie Williams in ‘Cyberbully’

Maisie Williams single-handedly rises to the challenge

Arts and Entertainment
Eddie Redmayne in The Theory of Everything and Benedict Cumberbatch in The Imitation Game are both nominated at the Bafta Film Awards
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    Isis hostage crisis: The prisoner swap has only one purpose for the militants - recognition its Islamic State exists and that foreign nations acknowledge its power

    Isis hostage crisis

    The prisoner swap has only one purpose for the militants - recognition its Islamic State exists and that foreign nations acknowledge its power, says Robert Fisk
    Missing salvage expert who found $50m of sunken treasure before disappearing, tracked down at last

    The runaway buccaneers and the ship full of gold

    Salvage expert Tommy Thompson found sunken treasure worth millions. Then he vanished... until now
    Homeless Veterans appeal: ‘If you’re hard on the world you are hard on yourself’

    Homeless Veterans appeal: ‘If you’re hard on the world you are hard on yourself’

    Maverick artist Grayson Perry backs our campaign
    Assisted Dying Bill: I want to be able to decide about my own death - I want to have control of my life

    Assisted Dying Bill: 'I want control of my life'

    This week the Assisted Dying Bill is debated in the Lords. Virginia Ironside, who has already made plans for her own self-deliverance, argues that it's time we allowed people a humane, compassionate death
    Move over, kale - cabbage is the new rising star

    Cabbage is king again

    Sophie Morris banishes thoughts of soggy school dinners and turns over a new leaf
    11 best winter skin treats

    Give your moisturiser a helping hand: 11 best winter skin treats

    Get an extra boost of nourishment from one of these hard-working products
    Paul Scholes column: The more Jose Mourinho attempts to influence match officials, the more they are likely to ignore him

    Paul Scholes column

    The more Jose Mourinho attempts to influence match officials, the more they are likely to ignore him
    Frank Warren column: No cigar, but pots of money: here come the Cubans

    Frank Warren's Ringside

    No cigar, but pots of money: here come the Cubans
    Isis hostage crisis: Militant group stands strong as its numerous enemies fail to find a common plan to defeat it

    Isis stands strong as its numerous enemies fail to find a common plan to defeat it

    The jihadis are being squeezed militarily and economically, but there is no sign of an implosion, says Patrick Cockburn
    Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action

    Virtual reality: Seeing is believing

    Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action
    Homeless Veterans appeal: MP says Coalition ‘not doing enough’

    Homeless Veterans appeal

    MP says Coalition ‘not doing enough’ to help
    Larry David, Steve Coogan and other comedians share stories of depression in new documentary

    Comedians share stories of depression

    The director of the new documentary, Kevin Pollak, tells Jessica Barrett how he got them to talk
    Has The Archers lost the plot with it's spicy storylines?

    Has The Archers lost the plot?

    A growing number of listeners are voicing their discontent over the rural soap's spicy storylines; so loudly that even the BBC's director-general seems worried, says Simon Kelner
    English Heritage adds 14 post-war office buildings to its protected lists

    14 office buildings added to protected lists

    Christopher Beanland explores the underrated appeal of these palaces of pen-pushing
    Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

    Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

    Scientists unearthed the cranial fragments from Manot Cave in West Galilee