Lecture 4: Website Evaluation

Internet has increased the availability of knowledge, but has not given consumers the education and training they need to interpret the meaning of the information.

consumer internet usage:

no

do open access journals have strict copyright and license restrictions?

evidence based practice

integration of the best available research with clinical expertise in the context of client characteristics, culture, and preferences

c. Is the information current? Because research information changes rapidly, this is the most important factor for determining the validity, currency, and quality of a website's health information. d. Is the information peer reviewed or verified by a qualified editor? e. Is the site free from content and typing errors? (punctuation, spelling, grammar) · A sloppy website is less credible. Editors review high-quality websites. Is the reading level appropriate for the intended audience? Layman's Terms? or Medical Jargon?

other qualities to check for validity and quality

clinical expertise

the ability to use clinical skills and past experience to rapidly identify each patient's unique health state and diagnosis

Sigma Theta Tau International

what is the name of the national honor society for nursing

It is a standard used today to investigate evidence-based care in medicine and nursing. Patient, problem, or population Intervention Comparison of interventions Outcome

Explain the PICO process for asking an evidence-based practice question and identify the meaning of each letter.

patient values

Unique preferences, concerns, and expectations each patient brings to a clinical encounter and which must be integrated into clinical decisions if they are to serve the patient

Lists author's credentials Has an abstract Is peer-reviewed

Which of the following criteria indicate a scholarly online article?

Named editor Adheres to HONcode Recently updated Same menu for each page

Which of the following website criteria indicate credible health information?

1. Recognize need 2. Use information gathering strategies 3. Locate information 4. Analyze quality info 5. Use IT tools 6. Share info

cycle of information literacy:

i. An opinion article should be clearly stated or obviously implied as opinion. "When I was a critical care nurse, I learned this . . ." ii. Do not use a source if author is attempting to put forth his opinion as fact. iii. Blogs are usually pure opinion or un-substantiated data - don't use blogs to gain facts or to educate your patients.

opinion vs fact

i. Primary Source · First-Hand Information: The person who actually wrote the information · Not citing somebody else's work. · Examples: A research article written by the person who actually did the research; A pharmacology textbook written by a pharmacist ii. Secondary Source · Information that is cited from somewhere else · Using someone else's information · Examples: Wikipedia: anyone can write; Class Notes (Believe it or not, teachers do not come up with all this stuff on their own J -- we look in different textbooks and research articles to determine the best information to share with our students.)

primary source vs secondary source

iii. Problems with Secondary Sources · Information can be easily misquoted or taken out of context. · Author of a secondary source is less likely to be an expert in the field. · If using a secondary source, look for citations that will take you to the original source of the information. iv. Conclusion: Primary sources are better than secondary! ** Always try to use primary sources if at all possible. **

problems with secondary sources

A. There are various reasons for a website appearing first on a search engine list. It does not mean the website is a good/accurate source. B. What influences the list? 1. Wording in the Website - experts will be hired to change the wording on the website to make it appear higher on the search engine list. 2. Payment to the search engine company. 3. Prior searches from the same IP address d/t web cookies bringing up prior searches.

search engine results (google, bing)

1. No training for consumers 2. Public is turning to Internet, healthcare should lead! a. We need to be the leader in what is good and what is bad websites 3. Health Literacy - ability to obtain, evaluate and comprehend health information to be able to make an informed, appropriate decision a. Understanding the literacy of our patient and thinking about a method to teach them b. Get around barriers! 4. Only 15% of 85 million users say they check the source and date of information; so they are using it, but they need assistance to evaluate and effectively use information. 5. Health information should be held to a higher standard of review and evaluation than general websites. 6. You can help your patients choose websites wisely as they research their own diagnoses/procedures.

understanding consumer internet usage:

information literacy

The ability to know when one needs information, how to locate, evaluate, and effectively use it (National Forum on Information Literacy 2011).

HON code

Use of this specific standard is an indication that a website takes seriously the importance of accurate and relevant health information.

computer literacy

ability to perform tasks on a computer (temporary)

E. Privacy & Disclosure 1. Look for privacy statements and nondisclosure agreements a. Recognized privacy standard? 2. Does the website have a privacy policy that is clearly understood? o Look for a "Privacy" link at the bottom or top of the page. 1. Does the website include an easy to understand nondisclosure agreement? a. A credible website will not collect any personally identifiable information. b. A credible website will most likely collect anonymous analytical data to assist the website sponsors make improvements to the website.

assessing privacy and disclosure

B. Authority 1. Who is the author? a. Identify? 2. Is the author qualified? an expert on that topic? - Anyone can pen a website, but does that author have established qualifications? a. College Degree - BSN, MSN, PhD b. Credentials - certification in that particular field (critical care, pediatrics, oncology) c. Teaching Position - professor at a university; accountability to keep information current d. Documented Experience - especially in that particular field (ex: "working on a med-surg floor for 40 years") 3. What are the author's affiliations? a. Does the author belong to any state or national organizations in his field? b. Is the website author a recognized health information resource? (e.g. American Heart Association, American Cancer Society, American Diabetes Association, Centers for Disease Prevention and Control, National Library of Medicine) 4. Is there any contact information? a. Contact info is preferable, at least a place of employment. b. There should be a way to contact the author to make corrections or comments about the posted health information. c. Lets us know they are willing to be critiqued

assessing the authority:

C. Funding 1. Is the site nonprofit? a. Generally, websites with nonprofit support have less bias. b. ".org" usually refers to nonprofit status. 2. Is there any commercial funding? (Are there any advertisements on the site?) a. If so, are the advertisements clearly labeled? b. Do the advertisements interfere with viewing the content? c. Do the advertisements present any conflicts of interest? d. Does the website sponsor gain profit from the advertisements? 3. Example of Conflict of Interest: Jeanne Sewell (author of our textbook) creating a website about nursing informatics, and then posting an advertisement encouraging viewers to buy her book. 4. Conclusion: Many advertisements usually indicate a non-scholarly source that you should not use.

assessing the funding:

D. Validity & Quality: the most important aspect of analyzing 1. What is the date of the website? When was the website last update? a. Is the information still relevant? b. Does the date matter to the content? c. Look at the copyright date to see if the website has been abandoned for years. 2. Who is the website's target audience? (healthcare professionals or a layperson) 3. What is the intent of the website? a. Information? Entertainment? Sales? Personal? b. Many websites will have a purpose or mission statement. 4. Are accurate scholarly references provided? a. Statistics without a reference are useless ("if it's not documented, it's not done"). b. Be careful of unsubstantiated "facts" c. Ex: An article states that latex exam gloves are more comfortable than plastic ones. (Says who? What tests were done to determine this?) 5. How is the website organized? a. Is it easy to navigate? How easily can the lay person find the information they are looking for? b. Is the menu the same for each page of the website? c. Does the website take a long time to load? d. Are all the links to quality reputable resources? Do the links actually work or are they broken links? e. Difficult navigation may = poor content OR trying to hide something OR just unskilled in website design. 6. Content

assessing validity and quality

A. Source 1. Who is the owner or sponsor of a webpage? a. Look at the bottom of the homepage or on the "About" page. b. Look for copyright symbol. 2. Does the source have any political or social (financial) bias? a. Individual vs. Organization 1) A website owned by an individual may be more likely to contain only opinion or to have a specific agenda. b. Profit vs. Nonprofit 1) If profit is a website's goal, there is usually more political or social bias. 2) If website is nonprofit, it is usually free from bias. c. Government Sponsored (.gov) - usually trustworthy information

describe assessing the source?

B. Computer fluency - having an adequate foundation in computer concepts to learn new skills and programs independently (dynamic) 1. Need a lifelong commitment to acquiring new skills to be more effective 2. Computer is a mind tool to help with data processing - must use intelligently.

describe computer fluency

E. Use information technology skills to disseminate their knowledge with other nurses and patients to share the information. 1. The ability to use computers, computer software, and peripherals to access electronic information efficiently. 2. Up-to-date knowledge of available computer applications and Internet search tools 3. Also requires the ability to do abstract thinking about information technology and how to use it to solve problems and use technology resources to improve information literacy.

describe using information technology skills:

A. Evaluation Resources: Does the website meet a recognized standard, such as "Health on the Net"? 1. Looks at 8 principles 2. Evaluates online sources of health and medical information a. Reliable? b. Understandable? c. Relevant? d. Trustworthy? 3. HON will certify that websites have verified quality health information. 4. Look for the HONcode certification on your website. 5. Read the statement at the bottom of the HON webpage. (www.hon.ch/) "The Health On the Net Foundation (HON) promotes and guides the deployment of useful and reliable online health information, and its appropriate and efficient use. Created in 1995, HON is a non-profit, non-governmental organization, accredited to the Economic and Social Council of the United Nations. For 15 years, HON has focused on the essential question of the provision of health information to citizens, information that respects ethical standards. To cope with the unprecedented volume of healthcare information available on the Net, the HONcode of conduct offers a multi-stakeholder consensus on standards to protect citizens from misleading health information."

evaluation resources:

a. Walt Disney publishing an article about the superiority of Disney Land over Sea World. b. Not a big deal when looking for opinion, but needs to be researched if you're looking for facts.

example of conflict of interest:

a. Does the owner gain money or prestige as a result of people learning the information? Or is the information published to simply educate people? b. Ex: Meade Johnson publishing an article about the benefits of infant formula - company that makes infant formula. c. These conflicts should be clearly specified on the website.

example of social bias:

1. source 2. authority 3. funding 4. validity and quality 5. privacy and disclosure

factors to consider when evaluating a website:

7. Nurses need to understand how to obtain information, sort it for relevance, and choose the most appropriate. 8. Requires computer skills, but also Critical thinking and problem-solving 9. Critical thinking will help improve information literacy. a. Requires a solid foundation of accurate, up-to-date information. b. The ability to analyze the information from multiple angles to arrive at the solution or recognize the need for more information. 10. *Healthcare professionals need to be ahead of the consumers to be able to guide consumers to make wise decisions.*

further describe information literacy :

f

t or f: A website author who mentions the American Heart Association in his online content would be considered a credible authority.

t

t or f: Health information should be held to a much higher standard than other factual information on the Internet.

t

t or f: Health information sponsored by nonprofit organizations are often reliable resources.

t

t or f: Many of the websites on the Internet have misleading and incorrect health information

t

t or f: When evaluating websites, keep in mind that health information sponsored by nonprofit organizations are often good resources.