The Internet has truly revolutionised healthcare. Whether it is the latest research into the effectiveness of implantable diagnostic monitors in patients with heart failure - which can transmit vital clinical information in people with chronic heart disease via the web to a hospital-based cardiologist - or simply allowing patients access appointments or repeat prescriptions speedily, it has brought about huge change for the better. Probably the greatest impact of the World Wide Web is the access it gives patients to health information.
Research shows that more than 50 per cent of people obtain medical information via the Internet, and that this information affects their choice of treatment. It has allowed patients to challenge the traditional paternalism of medicine. Armed with Internet research, they can now discuss treatment options with their doctors in a more balanced consultation process.
However, even for those doctors who wish to see a rebalancing of the doctor-patient relationship, there has been a constant irritation. The quality and veracity of medical information on the Internet is questionable, with the result that people are being misled, their hopes often raised inappropriately.
Last week's British Medical Journal focused on the quality of health information on the Internet. Several research papers confirmed the experience of many doctors: apparently credible websites may not be accurate.
In one study carried out in Birmingham, researchers examined the relationship between credibility features and the accuracy of the content of 120 websites. These sites provided information on chronic lung disease, ankle sprains and a number of women's health issues. While 93 per cent of websites described the source of medical information and 50 per cent displayed the date of the original document, only 18 per cent displayed any detail as to the quality or validity of the information. And while websites with high credibility scores tended to have higher levels of accuracy, the relationship was not a strong one.
In a separate piece of research, doctors from the University of Texas found that the most popular websites were not necessarily those of the highest quality. The search engine Google was used to generate a list of websites about breast cancer which were classified according to popularity. While more popular sites were more likely to contain information on ongoing clinical trials and were more likely to provide updates on other breast cancer research, there was no difference in quality between sites of low and high popularity. Most worryingly, the presence of inaccurate information did not differ between more popular and less popular websites.
The authors of this study concluded that there was an onus on doctors and others "to direct patients to sites of known quality". As if on cue, people on the island of Ireland have been offered free access to the most reliable source of medical information on the Web - the Cochrane Library.
Produced by the Cochrane Collaboration, an international organisation that prepares and maintains systematic reviews of the effects of health care interventions, the full library is now available at www.update-software.com/access/ireland.
Cochrane reviews provide systematic up-to-date summaries of the possible benefits and harms of all kinds of treatments, including some complementary therapies.
Let's say you want to find out about the treatment options for tinnitus (ringing in the ears). You log on and enter "tinnitus" in the search box. You will then be offered a number of "chapters" under various headings. The two most useful for this search are "Abstracts of quality-assessed systematic reviews" and "Cochrane Controlled Trial Register". Under the first you will find "A review of randomised clinical trials in tinnitus". Scroll down through the various headings until you come to "Results of Review". There you will find a summary of the research into different treatments for tinnitus. For example, a review of four good quality trials shows no benefit for the drug carbamezepine, while there is some evidence that "maskers" (devices to mask the constant ringing) have been found helpful in treating tinnitus.
It is also worth noting the authors' conclusions as well as the "CRD Commentary" which gives the view of the Cochrane review group itself.
Dr Ruth Barrington, the CEO of the Health Research Board who helped to negotiate the all-island access to the Cochrane resource said: "This is the gold standard for evidence of the effectiveness of healthcare interventions. It represents the work of 6,500 people around the world who are constantly updating the library, and we are pleased to make it available to everyone with an interest in health."
I would go a step further. A laminated card with details of the Cochrane website should be sent to every doctor in the country for display in their waiting rooms and surgeries. We should positively encourage people to use this immense resource which offers a real opportunity to improve health in the best tradition of preventative medicine.
E-mail Dr Muiris Houston at mhouston@irish-times.ie or leave a message at 01-6707711, ext 8511. He regrets he cannot reply to individual medical problems