Use of the Internet and Ratings of Information Sources for Medical Decisions: Results from the DECISIONS Survey
ABSTRACT The rise in Internet use for seeking health information raises questions about the role the Internet may play in how patients make medical decisions.
To examine Internet use and perceived importance of different sources of information by patients making 9 specific medical decisions covering prescription medication initiation, cancer screening, and elective surgery.
National sample of US adults identified by random-digit dialing.
Cross-sectional survey conducted between November 2006 and May 2007.
The final sample comprised 2575 English-speaking US adults aged 40 y and older who had either undergone 1 of 9 medical procedures or tests or talked with a health care provider about doing so during the previous 2 y.
Participants indicated if they or other family members used the Internet to seek information related to each of the specific medical decisions and rated how important the health care provider, the Internet (if used), family and friends, and the media (newspapers, magazines, and television) were in providing information to help make the medical decision.
Use of the Internet for information related to specific decisions among adults 40 y and older was generally low (28%) but varied across decisions, from 17% for breast cancer screening to 48% for hip/knee replacement. Internet use was higher at younger ages, rising from 14% among those aged 70 y and older to 38% for those aged 40 to 49 y. Internet users consistently rated health care providers as the most influential source of information for medical decisions, followed by the Internet, family and friends, and media.
Telephone surveys are limited by coverage and nonresponse. The authors excluded health-related Internet use not associated with the 9 target decisions.
A minority of patients reported using the Internet to make specific common medical decisions, but use varied widely by type of decision. Perhaps reflecting perceived risk and uncertainty, use was lowest for screening decisions and highest for surgical decisions.
- SourceAvailable from: Colleen M GallagherThe American Journal of Bioethics 10/2012; 12(10):47-9. DOI:10.1080/15265161.2012.708093 · 2.45 Impact Factor
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ABSTRACT: Exponential growth in genomics has led to public and private initiatives worldwide that have dramatically increased the number of procreative couples who are aware of their ability to transmit genetic disorders to their future children. Understanding how couples process the meaning of being genetically at-risk for their procreative life lags far behind the advances in genomic and reproductive sciences. Moreover, society, policy makers, and clinicians are not aware of the experiences and nuances involved when modern couples are faced with using Preimplantation Genetic Diagnosis (PGD). The purpose of this study was to discover the decision-making process of genetically at-risk couples as they decide whether to use PGD to prevent the transmission of known single-gene or sex-linked genetic disorders to their children. A qualitative, grounded theory design guided the study in which 22 couples (44 individual partners) from the USA, who were actively considering PGD, participated. Couples were recruited from June 2009 to May 2010 from the Internet and from a large PGD center and a patient newsletter. In-depth semi-structured interviews were completed with each individual partner within the couple dyad, separate from their respective partner. We discovered that couples move through four phases (Identify, Contemplate, Resolve, Engage) of a complex, dynamic, and iterative decision-making process where multiple, sequential decisions are made. In the Identify phase, couples acknowledge the meaning of their at-risk status. Parenthood and reproductive options are explored in the Contemplate phase, where 41% of couples remained for up to 36 months before moving into the Resolve phase. In Resolve, one of three decisions about PGD use is reached, including: Accepting, Declining, or Oscillating. Actualizing decisions occur in the Engage phase. Awareness of the decision-making process among genetically at-risk couples provides foundational work for understanding critical processes and aids in identifying important gaps for intervention and future research.Social Science [?] Medicine 03/2012; 74(10):1536-43. DOI:10.1016/j.socscimed.2012.02.003 · 2.56 Impact Factor
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ABSTRACT: To examine the scope, completeness, credibility, and readability of health, medical and nutritional information found on Wikipedia, WebMD, and Mayo Clinic websites.A total of ninety-two statements, across nine health categories, were formulated and used to assess the selected websites. Trained raters used a standardized search protocol, electronic logs and the nine-item tool to assess for scope, completeness, credibility, and readability of online material across the three websites. In terms of the scope, answers for 91.3% of the 92 general health statements were available on Wikipedia. WebMD (89.1%), and the Mayo Clinic (81.5%) followed respectively. The Flesch Reading Ease Score (FRES) was significantly higher for Wikipedia compared to WebMD and the Mayo Clinic websites (p<0.001). The Flesch-Kincaid Grade Level (FKGL) scores were also significantly higher for Wikipedia compared to those for WebMD and the Mayo Clinic websites (p<0.001). Sources supporting the general health statements were present for 96.0% of webpages on the Mayo Clinic site, 95.1% of webpages for Wikipedia, and 94.9% of webpages for WebMD. he study findings demonstrate the importance of aligning information and services for health with the skills and abilities of its recipients. As a result, these findings may be used to improve patient health literacy and consequently reduce health disparities. s a growing number of people use online sources to obtain health, medical, and nutritional information, it is important that this information be complete, comprehensive in scope, and available at a literacy level that is accessible to the general population.