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Assessing the Reliability of Health Information on the Internet

The CCO Approach

The CCO approach is accomplished by reviewing the Internet based literature and applying a set of screening criteria. One way to accomplish this is to ask yourself the following questions as you review the material. Use this worksheet to record your observations.

Screening Criteria Your observations

Credentials

What are the credentials of the individual who assembled the web site or authored the information? Are they pertinent to the content? For example, if the individual is recommending dietary advice, is he or she a Registered Dietitian (RD)?

Look to see whether the person claims to have a degree, license, or certification that relates to the topic.
Sidebar: Nutrition "experts" can claim to be nutritionists without any license requirement or specialized training. A true nutrion expert would be a Registered Dietitian (RD), which requires an accredited degree and passing an exam.

Do the credentials appear to be valid? If you don't recognize the school someone claims to have a degree from, see if you can find out anything about it. If it exists, does it appear to be a legitimate school with accreditation or is it a degree mill? Degree mills often offer degrees for "life experience" without having to actually attend classes.
If the school the person attended is identified, try looking up the school's web site to learn more about it. Some university websites have alumni databases where you can look up an individual. If so, try looking the author up.

If the author claims to be a member of a trade association or industry group that you have not heard of, make sure that it exists by searching for it on the Internet.

If the author claims to hold a license of some sort (MD, RD, RN, PT, etc.), see whether the state in which they are licensed has a web site where you can look them up to verify the information.
The Council on Licensure, Enforcement, and Regulation (CLEAR) provides a great clearinghouse where you can check the license status of almost any profession. Their website is at: http://www.clearhq.org/boards.htm
The American Board of Medical Specialties web site has an excellent online resource that allows you to look up an MD to see what board certifications they hold. The address is http://www.abms.org/newsearch.asp You can also find out quite a bit about a physician by checking the AMA's Physician lookup website at http://www.ama-assn.org/aps/amahg.htm.
California Licensed pharmacists can be found at http://www.pharmacy.ca.gov
Keep in mind that people with PhD's, DrPH's, EdD's and other legitimate non-medical doctoral degrees will not be in the MD database since they are not physicians but they can legally call themselves "Dr."

Has the person been published in a peer-reviewed journal? Try searching Medline, Lexis Nexis, or other databases by author name to see if they can be found.
This is particularly important if the author claims to have been published.

Contents

What is the substance of the information on the web site? Does it tend to be consistent with current scientific reasearch?

Does the author provide scientific research to back up health claims? (very important)

Do the authors make difficult to believe claims or voice conspiracy theories as to why their opinion is not taken seriosly? (E.G. "Drug companies don't want you to know about our herbal cancer cure because they would lose money on chemotherapy sales").

Are all of the statistics cited? Look for references to studies every time a statistic is used. You should be given adequate information to locate the article that the statistic was cited from, find the statistic or fact that was cited, and then reach your own conclusion regarding the reliability and context of the information.
Keep in mind that facts and statistics are often cited from respectable journal articles but are intentionally taken out of context to support a position. See the online case study for one example.

Can you actually find the references cited? Make sure that they are actually published articles in peer-reviewed (refereed) publications.

Are they trying to sell you anything? If so, they have a financial incentive for you to believe them. If products of any kind are sold, you should consider the information biased.

Organization

Is there an organization at which the web site is based or is it an individual effort?

If there is an organization is it:

A commercial entity?
A hospital or medical center?
A private research institute?
A college or university?
A government agency?
A religious group?

Try checking the URL to see what type of web server the site may be based at:
COM - Commercial Web Server
ORG - Non Profit Organization
NET - Probably an Internet Service Provider's web server but it could be anything.
GOV - U.S. Government Agency
EDU - Educational Institution (probably a college or university)
Keep in mind that a non-profit group is not necessarily a good thing, and a commercial organization is not necessarily a bad thing.

Try to find information regarding the reputation of the organization. Search for the name of the organization using a search engine to see what types of results you get. Try to find commentary from others.

Look for news stories about organizations in online access to newspapers. Look for both positive stories (awards, grants, etc) and for negative ones (lawsuits, federal indictments, etc.).

Screening Criteria	Your observations
Credentials
What are the credentials of the individual who assembled the web site or authored the information? Are they pertinent to the content? For example, if the individual is recommending dietary advice, is he or she a Registered Dietitian (RD)? Look to see whether the person claims to have a degree, license, or certification that relates to the topic. Sidebar: Nutrition "experts" can claim to be nutritionists without any license requirement or specialized training. A true nutrion expert would be a Registered Dietitian (RD), which requires an accredited degree and passing an exam.
Do the credentials appear to be valid? If you don't recognize the school someone claims to have a degree from, see if you can find out anything about it. If it exists, does it appear to be a legitimate school with accreditation or is it a degree mill? Degree mills often offer degrees for "life experience" without having to actually attend classes. If the school the person attended is identified, try looking up the school's web site to learn more about it. Some university websites have alumni databases where you can look up an individual. If so, try looking the author up.
If the author claims to be a member of a trade association or industry group that you have not heard of, make sure that it exists by searching for it on the Internet.
If the author claims to hold a license of some sort (MD, RD, RN, PT, etc.), see whether the state in which they are licensed has a web site where you can look them up to verify the information. The Council on Licensure, Enforcement, and Regulation (CLEAR) provides a great clearinghouse where you can check the license status of almost any profession. Their website is at: http://www.clearhq.org/boards.htm The American Board of Medical Specialties web site has an excellent online resource that allows you to look up an MD to see what board certifications they hold. The address is http://www.abms.org/newsearch.asp You can also find out quite a bit about a physician by checking the AMA's Physician lookup website at http://www.ama-assn.org/aps/amahg.htm. California Licensed pharmacists can be found at http://www.pharmacy.ca.gov Keep in mind that people with PhD's, DrPH's, EdD's and other legitimate non-medical doctoral degrees will not be in the MD database since they are not physicians but they can legally call themselves "Dr."
Has the person been published in a peer-reviewed journal? Try searching Medline, Lexis Nexis, or other databases by author name to see if they can be found. This is particularly important if the author claims to have been published.
Contents
What is the substance of the information on the web site? Does it tend to be consistent with current scientific reasearch?
Does the author provide scientific research to back up health claims? (very important)
Do the authors make difficult to believe claims or voice conspiracy theories as to why their opinion is not taken seriosly? (E.G. "Drug companies don't want you to know about our herbal cancer cure because they would lose money on chemotherapy sales").
Are all of the statistics cited? Look for references to studies every time a statistic is used. You should be given adequate information to locate the article that the statistic was cited from, find the statistic or fact that was cited, and then reach your own conclusion regarding the reliability and context of the information. Keep in mind that facts and statistics are often cited from respectable journal articles but are intentionally taken out of context to support a position. See the online case study for one example.
Can you actually find the references cited? Make sure that they are actually published articles in peer-reviewed (refereed) publications.
Are they trying to sell you anything? If so, they have a financial incentive for you to believe them. If products of any kind are sold, you should consider the information biased.
Organization
Is there an organization at which the web site is based or is it an individual effort?
If there is an organization is it: A commercial entity? A hospital or medical center? A private research institute? A college or university? A government agency? A religious group?
Try checking the URL to see what type of web server the site may be based at: COM - Commercial Web Server ORG - Non Profit Organization NET - Probably an Internet Service Provider's web server but it could be anything. GOV - U.S. Government Agency EDU - Educational Institution (probably a college or university) Keep in mind that a non-profit group is not necessarily a good thing, and a commercial organization is not necessarily a bad thing.
Try to find information regarding the reputation of the organization. Search for the name of the organization using a search engine to see what types of results you get. Try to find commentary from others.
Look for news stories about organizations in online access to newspapers. Look for both positive stories (awards, grants, etc) and for negative ones (lawsuits, federal indictments, etc.).