Anyone using the Internet to look for health care information should be aware of concerns about the quality of the information that is available, and the motives of the person publishing the information.

 

The editors of the DiabetesMonitor (1) subscribe to the HONcode principles (2) of the Health On the Net Foundation (3)

We include (below) some diabetes websites that indicate their agreement with the HONcode principles.

The American College of Physicians has reprinted an article on cyberquakery from the December 1996 ACP Observer, that should be read by everyone interested in using the Internet for healthcare information. It's entitled Online advice: good medicine or cyber-quackery? Comments from the article:

"If it sounds amazing, it probably is" You don't have to venture online to check for cyber-quackery and dispel rumors about health information. Try encouraging patients to share printouts of online medical advice with you, and advise patients to follow these six rules of thumb when looking for online health information:

Consider the source. People tracking information should make sure that "sources are cited and that they are reputable and dependable," said Joel Beard, manager of a Web site called aidsnyc.org for the AIDS Treatment Data Network.

Check the date. Recommend that patients check the dates of any data they find. Mr. Beard said that AIDS information more than six months old, for example, may not be current.

Don't rely on search engines. Instead of using generic Internet search engines like AltaVista, find a reliable source of medical information. Examples include Reuters Health's eLine and ACP Online's Web Watch, whose reviews are prepared by physicians. In the future, Harvard's Dr. Slack predicts, an organization will officially approve health related sites.

Contact the site. Most medical sites generally provide contact information. If the validity of the information on the site is in doubt, Mr. Beard said, request documentation of clinical information from the webmaster. If the site refuses to comply, consider yourself warned.

Be critical. As Andrew Weil, MD, notes in his advice column on HotWired, "if it sounds amazing, it probably is."

Get educated. Conferences like the one held last spring at the Harvard Center for Clinical Computing ("The Computer as a Patient's Assistant") show attendees how to become more discriminating and informed medical consumers. Similar resources, such as Dr. Slack's forthcoming book, "Cybermedicine," and Widener University's online guide to "Teaching Critical Evaluation Skills for World Wide Web Resources," offer help.

The editors of the Journal of the American Medical Association, in an Editorial April 16, 1997, wrote about Assessing, Controlling, and Assuring the Quality of Medical Information on the Internet — Let the Reader and Viewer Beware.

Health care professionals and patients alike should view with equal parts delight and concern the exponential growth of the Internet (the Net), and especially its graphical, user-friendly subset, the World Wide Web (the Web), as a medical information delivery tool. Delight because the Internet hosts a large number of high-quality medical resources and poses seemingly endless opportunities to inform, teach, and connect professionals and patients alike. Concern because the fulfillment of that promise remains discouragingly distant. Technical glitches aside, when it comes to medical information, the Internet too often resembles a cocktail conversation rather than a tool for effective health care communication and decision making.

Health On the Net Foundation "An international initiative, [the] Health On the Net Foundation is a non-profit organisation, headquartered in Geneva, Switzerland. The Foundation is dedicated to realising the benefits of the Internet and related technologies in the fields of medicine and healthcare. With private and public sector support, the Foundation actively promotes effective Internet use and demonstrates best-in-class implementation and application."

Their HONcode Principles state:

 

Principle 1
Any medical advice provided and hosted on this site will only be given by medically trained and qualified professionals unless a clear statement is made that a piece of advice offered is from a non-medically qualified individual/organisation.

Principle 2
The information provided on this site is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician.

Principle 3
Confidentiality of data relating to individual patients and visitors to a medical website, including their identity, is respected by this Website. The Website owners undertake to honour or exceed the legal requirements of medical information privacy that apply in the country and state where the Website and mirror sites are located.

Principle 4
Where appropriate, information contained on this site will be supported by clear references to source data and, where possible, have specific HTML links to that data.

Principle 5
Any claims relating to the benefits/performance of a specific treatment, commercial product or service will be supported by appropriate, balanced evidence in the manner outlined in Principle 4. above.

Principle 6
The designers of this Website will seek to provide information in the clearest possible manner and provide contact addresses for visitors that seek further information or support. The Webmaster will display his/her E-mail address clearly throughout the Website.

Principle 7
Support for this website will be clearly identified, including the identities of commercial and non-commercial organisations that have contributed funding, services or material for the site.

Principle 8
If advertising is a source of funding it will be clearly stated. A brief description of the advertising policy adopted by the website owners will be displayed on the site. Advertising and other promotional material will be presented to viewers in a manner and context that facilitates differentiation between it and the original material created by the institution operating the site.

Quackwatch "Your Guide to Health Fraud, Quackery, and Intelligent Decisionmaking." Quackwatch, Inc., is a nonprofit corporation whose purpose is to combat health-related frauds, myths, fads, and fallacies. Its activities include:

• Investigating questionable claims,
• Answering inquiries,
• Distributing reliable publications,
• Reporting illegal marketing, and
• Improving the quality of health information on the Internet.

Some websites with diabetes information that indicate their agreement with the HONcode principles (listed alphabetically):

Aventis (http://www.aventis-us.com)
British Columbia's Children's Hospital - Endocrinology & Diabetes Unit (http://endodiab.bcchildrens.ca)
Diabetes, Incorporated (www.diabetesinc.org)
Diabetes Monitor (www.diabetesmonitor.com)
Diabetes Insight (www.diabetic.org.uk)
Diabetes Scene (www.banting.com)
Insulin Pumpers (www.insulin-pumpers.org)
John Neale's diabetes guide (http://www.webshowcase.net/diabetes/)
On-line Diabetes Resources (www.mendosa.com/faq.htm) David Mendosa

(If you are aware of other diabetes websites that subscribe to the HONcode principles, please let us know!)

We have included a separate webpage listing non-proven methods of diabetes therapy (diabetes quackery).

(1) The Medical Director of this website, William W. Quick, MD, FACP, FACE was a solo-practice endocrinologist, in a private-practice physician's office. This website (the DiabetesMonitor) incorporates his handouts about diabetes education and diabetes-related hyperlinks, and was intended to keep him and others up-to-date with what's going on about diabetes. After he left private practice in 1998, the ownership of this website was transferred to childrenwithDIABETES, and in 2004, was retransferred to him and his wife Stephanie. See About Us for more information.
(2) See the HONcode Principles (above).
(3) See Health On the Net Foundation (above).