By ANDREA PETERSEN
Staff Reporter of THE WALL STREET JOURNAL
12/23/98
THE WORLD Wide Web has become a medical-information candy store. Patients can learn what their symptoms might mean, get details on treatments for almost any illness, read about clinical trials testing experimental medications-even find leads on the best specialists.
But like anything on the Internet, it can be difficult to sort the gems from the junk. Anyone can throw up a Web site and claim to have good information. Sufferers of spe-cific illnesses often put up their own home pages, but their experiences may not mimic the norm. And a lot of health-related sites are sponsored by manufacturers of pharmaceuticals or nutritional supplements, so what may look like unbiased health information may actually be intended to push products.
"There is no filter for quality control," says Michael Rich, a pediatrician at Children's Hospital in Boston. "I think there is probably a sense on the Internet that anything you read is probably the truth. But that's not the case."
Simply searching for an ailment such as "asthma" on Yahoo!, for instance, yields 209 different Web sites, from sources as varied as the American College of Allergy, Asthma & Immunology to Dave Nowosleiski's Home Page.
We asked a group of experts to help cut through the clutter. Below are the sites that they trust and recommend to patients:
DAVID NAGEY
Obstetrician and gynecologist, specialist in high-risk fetal medicine
JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE, BALTIMORE
For good basic information on pregnancy, neonatal and gynecological issues and ailments, Dr. Nagey recommends ObGyn.net (http://www.obgyn.net), an independent commercial site that is overseen by an advisory board of more than a dozen doctors.
"It is a good, solid site," Dr. Nagey says. "They have articles written for the consumer, and it is a great way for patients to find support groups in a number of different areas."
ObGyn.net welcomes visitors with a funky solar system-inspired front page and has separate sections for doctors and patients. The site is also presented in Spanish and Portuguese-with German on the way. There are medical articles and numerous chat rooms focusing on issues such as pregnancy, menopause and miscarriage. There is a free link to Medline, the database of medical journal articles, and an image library with dozens of graphic photos of all sorts of procedures.
Another general site with impeccable credentials, Dr. Nagey says, is the one run by the American College of Obstetricians and Gynecologists (http://www.acog.org). While a good portion of this site is restricted to doctors, there are dozens of brief online pamphlets covering contraception, childbirth, infertility and osteoporosis, and a database that lets you search for an ob/gyn in your area.
MICHAEL RICH
Pediatrician, adolescent-medicine specialist
CHILDREN'S HOSPITAL, BOSTON
While Dr. Rich cautions his patients to be wary when venturing onto the World Wide Web for medical information, he often guides both parents and children to the sites he trusts. "I think the Web is replacing the brochures we once handed people," he says. "These sites are more easily tailored to the patient's interest and level of awareness."
He likes sites that can speak to both adults and kids. "One of my major points in choosing sites is, 'Is it going to be fun?"' Dr. Rich says. "Because if it isn't, I'm just like the kids. I'm out of there."
One site he sticks around for is Band-Aides and Blackboards (http://funrsc.fairfield.edu/~jfleitas/contents.html).
Produced by Joan Fleitas, an assistant professor of nursing at Fairfield University, the site is especially helpful for kids living with a chronic illness. Its pages are separated into kids, teens and adults sections-just jump into the appropriate graphic "frog pond." The kids' pages have helpful advice for sick kids, such as whether or not to tell school friends about an illness and how to handle being teased. "If you're being teased, just laugh at the teasers," the site says. "They hate that!"
Other kid-friendly sites Dr. Rich recommends include the Yuckiest Site on the Internet (http://www.yucky.com), which teaches about the body in kid-speak, and the Children's Hospital of Iowa's Virtual Children's Hospital (http://www.vh.org/VCH/), where hospital-bound children can learn about IVs and monitors, and parents can get tips on how to help their kids deal with pain and fear.
BERTRAM WARREN
Psychiatrist, private practice
FANWOOD, N.J.
The anonymity of the Internet can be comforting to those coping with mental illnesses. Dr. Warren has a long list of sites that he goes to for either general mental-health information or to home in on a specific illness, such as depression or anxiety.
Dr. Warren uses the American Psychiatric Association's site (http://www.psych.org) mostly to keep up with his professional education, but it does have useful sections for consumers, such as a catalog of online pamphlets and state association contacts who can give referrals to qualified clinicians. The National Alliance for the Mentally Ill's site (http://www.nami.org) contains volumes of sophisticated reports on a wide range of illnesses, including serious ones like schizophrenia and manic-depression. Patients can get details on cutting-edge research and the latest breakthroughs in medications. "That's where I get my side-effect information," Dr. Warren says.
Dr. Warren sends his patients who suffer from depression to Dr. Ivan's Depression Central (http://www.psycom.net/depression.central.html). Run by New York psychiatrist Ivan Goldberg, Depression Central may be graphically boring, but it is chock full of plain-spoken information on depression, bipolar disorder and other mood ailments. It also includes abstracts from medical journals, rankings of psychiatric hospitals, links to online support groups and biographies of afflicted famous people, such as Scott and Zelda Fitzgerald and Virginia Woolf.
HARLAN KRUMHOLZ
Cardiologist
YALE UNIVERSITY SCHOOL OF MEDICINE NEW HAVEN, CONN.
Dr. Krumholz is a cautious Web surfer. "Some sites have million-dollar-looking front ends, but you often don't know who is behind them," he says. "People ought to stick to organizations they have a lot of confidence in." Dr. Krumholz uses the American Heart Association's site (http://www.americanheart.org) as an all-purpose clearinghouse for stroke and heart-disease information. The "Heart and Stroke A-Z Guide" is an easy index to pages on everything from aortic aneurysm to diabetes. Separate sections on the heart and strokes give detailed prevention and treatment information. Healthy people who want to avert illness can take a quick heart-disease risk quiz and get tips on healthy eating and exercise.
Dr. Krumholz says the government is also an excellent source of medical information. His pick for heart-related data is the National Heart, Lung and Blood Institute at the National Institutes of Health (http://www.nhlbi.nih.gov/nhlbi/nhlbi.htm). There are lively interactive pages to teach you how to lower your cholesterol. Its obesity section has a calculator where you can assess your body mass and risk for weight-related illnesses.
While Dr. Krumholz says he presses his patients to check any information they get online with him, he says that on the whole the Internet can help both doctors and patients do their job better. "I really believe the Internet is going to change the relationship between doctors and their patients," he says. "And it is just going to get better and more refined."