Increasing the reliability of health information on internet : Indian Journal of Ophthalmology

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Letters to the Editor

Increasing the reliability of health information on internet

Kothari, Mihir T1,2,; Parab, Snehanka G1

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Indian Journal of Ophthalmology: February 2018 - Volume 66 - Issue 2 - p 339-341
doi: 10.4103/ijo.IJO_916_17
  • Open


Seeking health information online is a commonly performed internet activity. Approximately eight out of every ten adults who have online access do so.[1] Recently, Kothari et al.[2] reported poor reliability of treatment-related information obtained through “Google” search for squint. There was no discussion on how to circumvent the issue. In this communication, we would like to offer five recommendations.

  • 1. The website developers must follow “codes of conduct”

The codes of conduct, for example, HONcode provides health website developers with a self-evaluation process and the best practices to be followed. The webmasters have to respect important principles [Table 1][3] regarding the information provided on their websites.

Table 1:
Principles behind the codes of conduct for the development of health-care website
  • 2. The governmental regulatory bodies shall provide the accreditation or certification of the websites

Accreditation is a way to ensure quality, in which the information provided is assessed by an external, independent entity. The Standardisation Testing and Quality Certification Directorate by the ministry of electronics and information technology defines standards for websites in India and provides certification of the websites.[4] In addition to this, health websites need further certification to ensure their health information quality. It may be included as a component of National Accreditation Board for Hospitals and Healthcare Providers' accreditation process.

  • 3. Introduction of quality filters and using them in the search strategies

Quality filter approach consists of selecting, manually or automatically, websites with quality health-related information based on predefined criteria. Health information seekers may utilize it using specialized search engines or gateways such as PudMed, OMNI, HealthFinder, Khresmoi, HONselect, MedHunt, HONmedia, HealthInsite, and HardinMD.

Another way could be to use a metadata labeling system to make health data more findable on search engines like Google. Such a system should be combined with quality criteria to give higher ranking by search engines to those sites or pages abiding with the defined quality criteria.

  • 4. Using the online quality evaluation tools

Certain preset programmed models such as Automated Quality Assessment tool, Automatic Indicator Detection tool, or Support Vector Machine tools can be employed by the government or any supervising body to ensure the quality of information on its websites. These models have algorithms to analyze the data and perform regression analysis to supervise the information on the website. An example of this is the MedCERTAIN project launched by the European Union.

User guides such as DISCERN tool help website visitors to appreciate themselves, based on a certain code and a set of quality criteria, to what extent and in what way the information on the visited websites meet quality standards.

  • 5. Publication of top ranking websites

A list of top ranking websites that have been evaluated for quality and content by the consumer and patient health information department under the ministry of health may be published every year to guide the visitors.

In an “Indian” study,[5] only 7% patients were aware of the presence of any quality standards pertaining to health information sites, and none could name any accreditation standard.

Educating the public regarding the assessment of quality of health-care information and a phase-wise implementation of the above-mentioned recommendations may usher a new era of reliable health-care information on internet.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

1. Clauson K, Vieira K Safety and Security on the Internet: Challenges and Advances in Member States: Based on the Findings of the Second Global Survey on eHealth. 2011Last accessed on 2011 Dec 01 Geneva World Health Organization Available from:
2. Kothari M, Moolani S. Reliability of “Google” for obtaining medical information Indian J Ophthalmol. 2015;63:267–9
3. Guidelines for Indian Government Websites. c2009Last accessed on 2009 Jan 01 New Delhi National Informatics Centre, Ministry of Communication and Information Technology, Government of India Available from:
4. Boyer C, Baujard V, Geissbuhler A. Evolution of health web certification through the HONcode experience Stud Health Technol Inform. 2011;169:53–7
5. Akerkar SM, Kanitkar M, Bichile LS. Use of the internet as a resource of health information by patients: A clinic-based study in the Indian population J Postgrad Med. 2005;51:116–8
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