AAOS Bulletin - October, 2005

Health sites: The good, the decent, the unreliable

Visit www.healthratings.org for independent ratings of the 20 most-visited health Web sites

By Carolyn Rogers

Do you know where your patients obtain their basic health information? Millions of patients explore the Internet every day in search of answers to a range of health questions and concerns, and hundreds—if not thousands—of “health Web sites” are presenting themselves as reliable sources of this information. While some of these sites do post medically accurate information, many others do not, and consumers may have difficulty distinguishing between the health and the hype.

Fortunately, a new site—the Consumer Health WebWatch—is providing health consumers with the facts they need to navigate the online world more safely. The site provides independent evaluations and ratings for the 20 most-trafficked health information Web sites, according to Nielsen/NetRatings data.

The Consumer Reports WebWatch (CRW) and Health Improvement Institute (HII) launched the site earlier this year with a three-part mission: 1) to provide consumers with independent evaluations/ratings of health Web sites; 2) to enable consumers to be more effective health Web site users; and 3) to improve the credibility practices of health Web site publishers.

Consumer Health WebWatch plans to expand the number of Web sites it rates and to update ratings every six months. For health sites that do not currently appear on the list, a “checklist” is provided to help consumers determine a site’s credibility for themselves.

The ratings process

Each of the top 20 sites has been given an overall rating that takes into account factors such as identity, credibility and trustworthiness, privacy and security, coverage and contents, ease of use and design. CRW raters tested the sites based on WebWatch’s credibility guidelines, and HII raters—all health care professionals—tested the sites on a broad range of criteria developed by the Institute, focusing on editorial policies and procedures. Each site’s final score is a combination of both organizations’ ratings.

What do the ratings mean?

The top sites—those rated as Excellent or Very Good—clearly disclose important information about the site’s ownership, mission, sources of site content, and scope of third-party business relationships and sponsorships. Advertising, if present, is clearly recognizable, expert information is clearly sourced and a range of information is available on controversial topics. Usability and design reflect modern aesthetic principles.

Middle-of-the-road sites—rated as Good—meet basic user needs. These sites have adequate policies and disclosure information, or a mix (some are good, while others are problematic). However, navigation, browsing and searching may be inefficient or tedious. These sites offer some helpful features that take advantage of interactive technologies, but these features may not be entirely useful or may function poorly.

Sites that score as Fair or Poor have some serious problems or shortcomings. Policy or disclosure information may be missing, or advertising may be misleadingly labeled or not labeled at all. Some policy disclosures or statements may be unsatisfactory, raising concerns about completeness, objectivity or currency of information. Navigation, browsing or searching may be awkward, confusing or frustrating.

The top five

Here are summaries of the Consumer Health WebWatch ratings for the five most-trafficked health Web sites:

#1: Web MD Health

Overall Score: Excellent. Good news articles; something for everyone.


• Provides up-to-date information on current health news and popular trends

• Library of interesting interactive health tools

• Huge amount of trustworthy information on mainstream health topics (but not on complementary and alternative medicine)


• Busy with distracting advertisements; poor visual representation of pages

• Confusing arrangement of health topics; Categories seem to correspond with advertisers’ interests, rather than patients’ interests.

• Inconsistent positioning and presentation of authors’ and reviewers’ names; date the information was last updated, etc.

Special notes: WebMD.com offers a variety of health tools, including a physician finder, a symptom checker, quizzes, calculators and self-assessment guides.

#2: National Institutes of Health

Overall Score: Excellent. High-quality health Web site; useful for consumers


• Easy to use and to navigate; has advanced search engine.

• Considerable amount of trustworthy information; no advertising

• Reading level fits average consumer


• Lack of citations to journal articles

• Articles are not updated often enough

• Information on some complementary and alternative medicine topics is not sufficiently critical

Special notes: Text-only version is available for disabled consumers; links to clinical trials and NIH research are included.

#3: Yahoo! Health

Overall Score: Good. News, other health information and tools; may be useful to consumers. Articles are drawn from various sources. Site seems to lack editorial quality control. Not recommended as a primary resource.


• Easy to use; consistent page design facilitates access to information

• Serves as a gateway to many discussion groups and boards


Search results begin with links to advertisements rather than relevant articles; cluttered by many advertisements.

• “Healthwise Encyclopedia” seems under-utilized and poorly integrated.

• No posted editorial policies

#4: About Health and Fitness

Overall Score: Good. Contents cover popular consumer health topics. Information is of uneven quality. Not recommended as a primary resource.


• Variety of articles on popular health topics

• Easy-to-read writing style


• Information and authors lack credibility; unable to identify original sponsor; no sources cited and no links to resources.

• Takes too many clicks to find textual information; many unrelated links attached to subject links

• Distracting and irrelevant pop-up advertisements are confusing when intertwined with textual information.

Special note: Site contains videos.

#5: MayoClinic.com

Overall Score: Excellent. High-quality resource for consumers seeking health information


• Site is easy to navigate and use; no scrolling.

• In-depth articles with reliable health information and relevant links to helpful resources both within and outside the site.


• Some articles are very long.

• Article authors are not named.

• Lacks text-only option

Special note: Site offers various tools, such as calculators, quizzes and recipes.

Rounding out the top 10 most popular sites are two written by physicians (Medicine Net.com and eMedicine.com), two pharmaceutical sites (Drugs.com and Pfizer.com) and one insurance site (Aetna’s Inteli-health.com). Of these sites, only MedicineNet.com earned an Excellent rating from Consumer Health WebWatch.

To review the complete ratings for all 20 health Web sites, visit http://www.healthratings.org

Guide your patients to reliable online sources

To ensure that your patients receive accurate health information from the Web:

1. Ask what health sites they use most frequently.

2. Inform them about the Consumer Health WebWatch site (www.healthratings.org).

3. Refer them to the AAOS patient education Web site, Your Orthopedic Connection (YOC). Use the AAOS “Rx for patient education” notepads—complete with the YOC Web site address as well space for individualized notes and recommendations. E-mail Leslie Hanson for more information.

4. Use the new, customized “Rx for patient education” handouts, now available online. Printed with your name, office information and logo, the printouts list the YOC article titles that you “check off” for patients to read. Try it yourself at: http://www.aaos.org/rx. Simply log in with your last name/password, choose titles of articles in your specialties, then print as many customized sheets as you need.

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