Health advice from internet discussion forums: how bad is dangerous?
Date Submitted: Aug 27, 2015
Open Peer Review Period: Aug 28, 2015 - Oct 23, 2015
Background: Concerns over online health information seeking behaviour point to the potential harm incorrect, incomplete or biased information may cause [1, 2, 3, 4]. Systematic reviews of health information [6, 7] have, however, found few examples of documented harm that can be directly attributed to poor quality information found online. Objective: The aim of this study is to improve our understanding of the quality and quality characteristics of information found in online discussion forum websites, so that their likely value as a peer-to-peer health information sharing platform can be assessed. Methods: Twenty-five health discussion threads were selected across three websites: Reddit, Mumsnet and Patient.co.uk, covering three health conditions – HIV, diabetes and chickenpox. An online survey enabled respondents to rate information found in the discussion threads according to five criteria: accuracy; completeness; how sensible the replies were; how they thought the questioner would act; and how useful they thought the questioner would find the replies. Results: Seventy-nine completed surveys were returned by 17 individuals (eight of whom were medically qualified, nine were not). When the scores awarded to the surveys were analysed, 25 of the surveys rated the discussion threads in the highest possible score band, scoring them between 5-10; 38 scored them between 11-15; 12 scored them between 16-20 and 3 scored them between 21-25. This suggests that health threads on internet discussion forum websites are more likely than not (25+38:12+3, or 4:1) to contain information of good or reasonably good quality. Extremely poor information is rare (the lowest score was awarded only 11 times out of 353, while the highest score was awarded 54 times) and only three out of the 79 assessments marked a discussion thread in the lowest possible score category, while 25 out of 79 scored it in the highest. Quality assessments differed depending on the health condition (Chickenpox appeared 17 times in the 20 lowest scoring threads; HIV twice and Diabetes once). While assessors tended to agree on good quality information, what constitutes poor quality information appears to be more subjective. Conclusions: Most information in online discussion forums was considered by medically qualified and non-medically qualified respondents to be of reasonably good quality. While a small amount of information was assessed as poor, not all respondents agreed that the original questioner would have been led to act inappropriately based on the information presented. This suggests that discussion forum websites may be a useful platform through which people can ask health-related questions and receive answers of acceptable quality.