Design and Evaluation of Consumer Health Information Web Sites

Abstract

providing health information to consumers [1,2]. Even cancer patients, who are not in the typical demographic group of Internet users, often name the Internet as the second most important source for cancer information after health professionals [3,4,5], and people are more satisfied with information they receive from the Web than from other media [6]. The aim of this chapter is to give an overview of best practices for developing and providing consumer health information on the Web and to provide a framework for best practices, quality criteria, and methods for quality assurance and evaluation. Developers and health information providers are faced with “everyday” practical questions such as how to ensure, monitor, and continuously improve the quality of the information they publish. End-users (consumers) are also interested in “quality criteria” and best practices, as they wish to have “markers” (attributes of a Web site or Web page or a health information provider) that can be used to predict the “quality” in order to select “trustworthy” health information.The issue of quality criteria is also important for third-party expert evaluators working for gateways or portals, or other intermediaries such as librarians or healthcare workers putting together lists of “recommended” health Web sites, because they need to specify and apply selection criteria for the sites they endorse. Similarly, organizations that are in the business of Web site certification need to have a checklist of quality criteria to justify their decisions to certify a Web site. Finally, policy makers are interested in the subject of what makes a good (or bad) health Web site, especially in the context of making regulatory and legislative policy decisions. There has been considerable debate and research on the variable quality of health Web sites [7] and how to best evaluate health information Web sites. One reason for the controversy is that “quality” is an elusive concept and implies subjectivity. Quality can be broadly defined as the “totality of characteristics of a product or service that satisfy stated or implied needs of the user” [8,9]. This definition stresses that “quality” is determined by the concordance (or gap) between individual user needs and the actual attributes of the service or product. Perceived quality (or satisfaction) is further confounded by the users’ prior expectations, which also vary individually. In other words, certain aspects of quality seem to be in the eye of the beholder, and can be measured only by the gap between user needs and attributes of the Web site or service [10]. This apparent subjectivity has led to a pessimistic view that quality of Web sites cannot be measured or evaluated, at least not by third parties [11]. The fact that we are talking about “health information” makes the issue even more problematic, as in medicine there are often “gray” areas with no clear black-or-white 4 Design and Evaluation of Consumer Health Information Web Sites