August 1999 Bulletin

Strong, weak points of top health sites

By J. Sybil Biermann, MD

This following list is a compilation of some of the best orthopaedic patient education sites and some of the most well-known health information sites. Taking into account the expansive and dynamic nature of the Internet, any list of this sort cannot be comprehensive, and some excellent sites may be absent. Information and critiques are based on accessing of web sites between April 15, 1999 and July 2, 1999.

American Academy of Orthopaedic Surgeons

http://www.aaos.org

Author: American Academy of Orthopaedic Surgeons

Description: A thorough, well-organized list of information with easy to understand information on symptoms, diagnosis, and treatment of common orthopaedic conditions.

Strong Points

• Produced by the AAOS.
• Provides a balanced look at operative and nonoperative conditions and treatments.
• Several topics available in Spanish.
• Prevention information-generally not available on other web sites.

Weak Points

• There is limited use of illustrations.

Arthritis Foundation

http://www.arthritis.org

Author: the Arthritis Foundation

Description: Fact sheets available on a wide variety of nonsurgical topics frequently not addressed by surgeons. Also, good detail on a wide variety of arthritis

Strong points

• Reasonably good site medical information, alternative information contact numbers/addressed.
• Surgical information relatively limited. Great information about other resources, current events.

Weak Points

• Medical information organized in such a way that it's hard to follow from one topic to another easily.

Drkoop.com

http://www.drkoop.com/

Author: Website states that it "relies on many dedicated medical professionals" under the direction of CEO, former Surgeon General C. Everett Koop, MD.

Description: Site dedicated to medical information on a wide variety of topics with standardized headings for organization. Patient education materials on orthopaedic topics mainly limited to arthritis (RA and OA), low back pain and osteoporosis. Chat rooms and message boards.

Strong Points

• Written at a very basic level that virtually anyone who can read English will understand.

Weak Points

• Requires cumbersome sign-in to access chat rooms or mailing lists. Very little depth, few pictures and little surgical information. Really a better general medical site than orthopaedic specific.

Interactive Orthopaedic Patient Education

http://www.medicalmultimediagroup.com/index.html

Author: Randale Sechrest, private practice orthopaedic surgeon

Description: Patient education materials with excellent graphics, easy-to-read descriptions of common orthopaedic maladies. Lots of links to pictures or other graphics. Comprehensive, readable explanations of both operative and nonoperative conditions.

Strong points

• Comprehensive topic listing with a surgical bent.
• Good illustrations.

Weak points

• Index is at the bottom of a long, disorganized list of other links.
• Represents only one surgeon's opinion.
• Several links are missing.

National Cancer Institute: Cancernet

http://cancernet.nci.nih.gov/cancer_information/

Author: Consensus Statements

Description: Presents peer-reviewed, up-to-date relevant information for patients with primary and metastatic musculoskeletal malignancies in a general, not institutionally directed fashion. Best general information for the orthopaedic oncology patient.

Strong Points

• Peer-reviewed consensus statements with frequent updates.
• Clinical trials database excellent, especially for poor prognosis patients.
• Good references for other contact information for patients.

Weak points

• Like most government sites, no extra money wasted on graphics or fancy text presentation, so although information content is outstanding, "net appeal" is low.

National Institutes of Health/National Institute of Arthritis, Musculoskeletal and Skin Diseases Consumer Health Information

http://cancernet.nci.nih.gov/cancer_information/

Author: Multiple

Description: A government-sponsored site which features recent news releases, peer-reviewed consensus statements, MEDLINE searching and clinical trials databases on arthritis and musculoskeletal diseases.

Strong points

• Solid facts on musculoskeletal diseases.
• Statements are generally of a consensus nature and have little individualization-applicable to a wide variety of practitioners of musculoskeletal heath.
• Searchable database.
• Places to write or go for additional information.
• Frequently updated.

Weak points

• Although very well written and obviously carefully reviewed for errors, very boring visually. No color, no figures, just text.

Orthoweb

Authors: not listed, no credits

Description: Patient level information on selected topics, heavy on arthritis and surgical treatments.

Strong points

• Good organization of site, descriptions of maladies and anatomy with colorful illustrations.
• Searchable site.

Weak points

• Commercial flavor; site appears designed to attract orthopaedic practice sponsors.
• Overambitiously describes itself as the "new clearinghouse of orthopaedic information on the World Wide Web."
• Missing niceties like date of last update and authorship.

InteliHealth

http://www.intelihealth.com/IH/ihtIH

Author: Johns Hopkins Health Information Service.

Description: Information from Johns Hopkins, physician interviews, a wide variety of other sources. A broad-based patient information site. Very frequent updates and good for "current events" in health. Good search capabilities.

Strong points

• Very up-to-date with "late-breaking" health news.
• Good search capabilities.
• Careful referencing of all information as to source and date.

Weak points

• Very "busy" with lots of ads and blinking.
• Most pictures are part of ads, few diagrams or pictures in actual text.

New York Online Access to Health (NOAH)

http://www.noah-health.org/

Author: Varied according to page linked.

Description: A link page for health topics, started and maintained with federal grants and other philanthropy, now maintained by federal and state nonprofit organizations. Although a general health resource, it has some great sections on orthopaedic topics.

Strong points

• Excellent Foot and Ankle section, with great links.
• Arthritis section also good.
• Very well organized, easy to follow outline and links.

Weak points

• A link resource, no original material, but held together so seamlessly that one hardly notices.

Orthopaedic Web Links

http://www.orthopaedicweblinks.com/

Author: Myles Clough

Description: Extremely thorough link page to a wide variety of sources of patient education materials.

Strong points

• Draws on material from many places.
• Very comprehensive, draws on many international sources as well as from U.S.

Weak points

• Organization fair; large sections of "recent additions" and miscellaneous make searching for specific topic more complicated.

• Last updated nearly a year ago.
• Many broken links.

Southern California Orthopaedic Institute

http://www.scoi.com/

Author: not stated, presumably members of the SCOI

Description: Brief blurbs on orthopaedic conditions and procedures in easy-to-read script with nice basic diagrams. Mainstream information.

Strong Points

• Good readability, well organized.

Weak Points

• Material not referenced as to source or date.
• Web site has clearly self-promotional bent.

University of Washington Orthopaedic Physicians

http://www.orthop.washington.edu/

Author: University of Washington faculty.

Description: General information articles with up-to-date information on selected orthopaedic topics.

Strong points

• Endorsed by well-known academic institution.

Weak points

• Patient information intermingled with physician information, links to administrative topics.
• Not comprehensive. For example, an excellent section on arthritis, but nothing on hand.

J. Sybil Biermann, MD, is assistant professor of surgery, University of Michigan, Ann Arbor, Mich.