The quality of online consumer health information at the intersection of complementary and alternative medicine and arthritis

Abstract Background: Complementary and alternative medicine (CAM) use is prevalent among patients living with arthritis. Such patients often seek information online, for the purpose of gaining a second opinion to their healthcare provider or even self-medication. Little is known about the quality of web-based consumer health information at the intersection of CAM and arthritis; thus, investigating the quality of websites containing this information was the purpose of this study. Methods: Four unique search terms were searched on Google across four English-speaking countries. We assessed the first 20 results of each search, including them if they contained CAM consumer health information for the treatment and/or management of arthritis. Eligible websites were assessed in duplicate using the DISCERN instrument, which consists of 16-items designed to assess quality. Results: Of total of 320 webpages, 239 were duplicates, and a total of 38 unique websites were deemed eligible and assessed using the DISCERN instrument. The mean summed DISCERN scores across all websites was 55.53 (SD = 9.37). The mean score of the overall quality of each website was 3.71 (SD = 0.63), thus the majority of websites are ranked as slightly above 'fair' quality. Conclusion: Eligible websites generally received scores better than 'moderate' in terms of overall quality. Several shortcomings included a lack of transparency surrounding references used and underreporting of risks associated with treatment options. These results suggest that health providers should be vigilant of the variable quality of information their patients may be accessing online and educate them on how to identify high quality resources.(AU)

Avaliação dos sistemas de informação em saúde no Brasil / Evaluation of Health Information Systems in Brazil

Conhecer o nível de saúde de uma população é importante para avaliar prioridades e estabelecerprogramas. Os indicadores facilitam a análise das informações, mas sua qualidade vai dependerda precisão dos sistemas de informação. Em 2000, OMS destacou cinco pontos críticos relativosaos sistemas de informação em saúde, que podem se tornar obstáculos para gestores. O trabalho objetiva mostrar as falhas nos principais sistemas de informação em saúde no Brasil, frentea esses tópicos. A incapacidade em oferecer informações necessárias aos gestores, a inexistênciade retroalimentação das informações entre níveis local, regional e nacional, dados incompletos,inadequados, não oportunos e, muitas vezes, não relacionados às ações prioritárias são comentados. Refere-se, ainda, à necessidade de serem adotados conceitos e definições internacionais,adequação na elaboração dos itens nos formulários de coleta e uso de linkage entre diferentesbancos de dados. Os próprios gestores de saúde reconhecem que uma das ferramentas maisimportantes para a vigilância em saúde é a informação, visto que ?informação-decisão-ação?sintetiza a dinâmica da vigilância epidemiológica. Em todos os Sistemas, vem ocorrendo melhorasignificativa, mas, há ainda muito a ser feito, no sentido de que as informações cumpram adequadamente o papel que lhes cabe, no contexto da saúde no Brasil.

Knowing the level of population health is necessary for the assessment of priorities and toestablish appropriate programs. Health indicators facilitate this evaluation, but their qualitydepends on the accuracy of the health information systems. In 2000, WHO highlighted fivecritical points related to health systems, which could represent obstacles for health management.This article aims to show failures in the main Brazilian health information systems according tothose five points. The inappropriate offer of needed data to the managers, the lack of datafeedback among local, regional and national levels, incomplete, inadequate, inopportune dataand information unrelated to priority actions are presented as the main problems. It is alsoobserved the need to respect standardized concepts and definitions, to adjust the elaborationof items in questionnaires and to link different data bases. Health managers recognize that oneof the most important tools for health monitoring is the information, since ?information-decisionaction? summarizes the dynamics of Epidemiological Surveillance. In all Brazilian health systemssome significant improvement is occurring, but much more has to be done for the informationto fulfill its rightful role in the context of the Brazilian health.