March 2019 – De-Mystifying the Medical Web

There are many, many sources of medical and health information online, but not all of them are reliable. Today, we attempt to sort the wheat from the chaff.

Disclaimer: I am married to an allopathic (M.D.) physician, and am mother of two more. I have strong ties to Big Health Care, which may mean that I am possibly more aware than most of the considerable problems which plague the U.S. health care system, because I hear regularly the complaints of insiders who seek to make things better. I have a bias towards approaches which have their basis in scientific evidence, and appreciate that allopathic and osteopathic (D.O.) medical traditions place science at the center of their practice. This means I harbor an abject terror of what “Fake News” in this realm can mean in terms of putting people’s health at risk.

In her recent book, Hype: A Doctor’s Guide to Medical Myths, Exaggerated Claims and Bad Advice – How to Tell What’s Real and What’s Not, Nina Shapiro, M.D., a pediatric otolarygologist, attempts to sort through the information and disinformation on subjects as diverse as vaccinations and how many glasses of water to drink. In an interview with ZDogg M.D, a physician who advocates for improving U.S, healthcare, she talked about how as a specialist, she herself wasn’t sure about the correct answers to some of the questions her patients and their parents ask her about more general health matters. So she spent the time between surgeries researching the answers and writing her book. I recommend this book as an excellent jumping off place to get a broad view on medical media literacy.

Where to Start?

If you enjoy browsing health news sites, the University of Vermont Medical Center recommends these:

I surprised myself with this recommendation, but really, the National Center for Complementary and Integrative Health , which is focused not on “mainstream” medicine but on alternative health resources, has a really nice list of reliable sites to start from. They suggest:

  • To search for accurate health information, start with one of these organized collections of high-quality resources:
    • MedlinePlus, sponsored by the National Library of Medicine, which is part of the National Institutes of Health (NIH) 
    •, sponsored by the Office of Disease Prevention and Health Promotion in the U.S. Department of Health and Human Services.
  • If you’re looking for information about complementary and integrative health approaches:

Avoid Like the Plague

No, really. There are some maliciously inaccurate health-oriented sites out there, where they trade on conspiracy theory and outrageous too-good (or bad!) -to-be-true “news” stories. The U.K. newspaper, the Independent published a useful story on this subject entitled

A site I find useful for a second opinion on how dicey I think a site might be is Media Bias/Fact Check. They offer some blistering critique on such popular sites as

Not everybody loves Media Bias / Fact Check. The Columbia Journalism Review points out that this site is run by a guy named Dave Van Zandt who with his team, can’t likely be completely unbiased in rendering their judgments. They make the same observation about Vanessa Otero’s Media Bias Chart, calling Otero and Van Zandt “arm chair academics.” This may be true, and yet REAL academics at the University of Michigan consult Media Bias / Fact Check in constructing their Iffy Quotient , a measure of the proportion of reliable vs. unreliable news being published on Twitter and Facebook.

Consider the Source

As with any research you might do, it’s terribly important to consider the source of your information. “Dr. Google” is very popular with medical and lay people alike, but it’s important to remember that the top positions in Google’s pages are based on an algorithm that is proprietary, and that organizations purchase advertising on this site. The most popular sites may not be the most reliable. It’s good to ask yourself:

  1. What’s the domain? .gov is a government source. .org is likely not-for-profit. .com means to sell you something
  2. Are the words “miraculous,” “ground-breaking,” or “remarkable” used? These are not the words of scientific inquiry!
  3. Are the phrases “clinically proven,” “scientifically proven,’ “studies show,” or “doctors recommend” used? These phrases do not actually establish anything meaningful. “Clinically Proven” means that for at least one person, the thing worked in the clinical setting. The other phrases are not regulated at all.
  4. Is there a link to the original study?
  5. How many people were studied, over how long a time?
  6. Are they selling something? Is there an ad on the page for the very thing being hailed as useful?
  7. What are the credentials of the authors?
  8. How old is this article?

There’s a really nice rundown on how to evaluate a medical site on MedlinePlus: MedlinePlus Guide to Healthy Web Surfing

Medical Sites come in various flavors:

What to look for in a Scientific Journal Article

Most of the time, I’m happy enough with an article written by a lay person. I don’t have medical training, and I’m pretty easily intimidated by medical jargon. But because headlines in consumer pieces tend to be hyped, I sometimes like to follow the link to the original journal to get a feel for the study itself. Often, there’s a paywall, but you can read the abstract, which is a summary of the study, its methodology, and its findings.

  • Beware the predatory journal! Not all scientific journals are reputable. Some actually invite authors to PAY to have their stuff published. The reputable ones review the articles for scientific validity and publish only 5% of the articles submitted to them. So make sure that the article you are reading was not published in one of the journals on this list!
  • Look for the word “randomized”. It is only when the sample of population is large and randomly selected that results of that sample can reliably be expected to mirror the results of a population at large
  • Look for how long the study was conducted. Results that stand up over time are more impressive than results over 2 days or 2 weeks!

Ask Your Health Care Provider!

Most of us do not have years of experience with thousands of patients. Our doctors, physician assistants, and nurse practitioners do. They understand subtleties about the way things work that we do not, and they are able to weigh our individual situation against statistical findings for larger populations. Unfortunately they will never be able to fully explain what took them years to learn to those of us who just do not have that training. At some point, you need to believe that they are competent in their field, that they do have your welfare at heart, and are telling you what you need to know to make an informed decision. If you are not confident that this is the case, then you should seek out a provider who does inspire this confidence!

It’s good to research, and to become as expert as we can be about our own health. And yes, doctors are human and can overlook things, so the more we know to ask about, the better our communications can be. Here’s a handy little guide to bringing up your research with your health care provider.

It’s also always good to bring a second set of ears with you when you go to the doctor. Most of us tend to be a little nervous and we don’t always remember clearly what we hear, especially if the news is upsetting. Having a trusted person there to take notes can calm us and free us to speak plainly of our concerns and really listen to what we are hearing.

It’s harder than it should be to be a well-informed user of medical information. I hope this page helps in that quest!