The Internet Dilemma: Awash in Information, Drowning in Ignorance

Despite the importance of the recently enacted federal healthcare law, a remarkable 50% of the public does not know its current status, according to a recent poll. This alarming example illustrates why scientists and public health officials must use the Internet to fill the need for reliable sources.

How does one explain the results of a Kaiser Family Foundation poll conducted among the general public about the specific status of the recently enacted federal healthcare reform legislation?¹

Nearly one-quarter of those surveyed believed the law had been repealed, and another quarter was not sure of the status. Remarkably, despite the enormous impact this law will have on the future direction of healthcare for every American, approximately 50% of those surveyed were unaware of the current status of this massive initiative.

As important as this legislation is to the future of healthcare delivery in the United States, it is clear that there is considerable confusion and misunderstanding. Is this the result of information overload, an inability of many members of the public to understand the relevance of the complex debate, too little time to absorb the nuances of legislative maneuvers, or the apparent absence of information sources that are recognized as unbiased and authoritative?

While it is most unlikely that a single factor or even a limited group of factors will be identified that can explain the apparent inadequacy of public knowledge regarding facts so vital to their own futures and their children’s futures, it is reasonable to conclude that information overload, both the total content and the proliferation of purported sources of such information, are major contributors to the rather alarming status quo.

Unfortunately, the impressively democratic nature of the Internet, which makes this spectacular form of communication such a powerful educational tool, does not ensure the quality, objectivity, or even the basic safety of its content.

Maurie Markman, MD

Editor-in-Chief of OncLive

Vice President of Patient Oncology Services and National Director for Medical Oncology Cancer Treatment Centers of America, Eastern Regional Medical Center

Consider, for example, the use of the Internet to promote truly dangerous “stem cell clinics,”² to intensely market unsubstantiated claims for unregulated e-cigarettes,³ or to suggest health benefits from a “miracle mineral solution” that the FDA warns becomes a “potent bleach when mixed according to package directions.⁴

In fact, the Internet has become a major force in the marketing strategies of the legitimate pharmaceutical industry, with one report noting a billion dollars has been spent employing this form of direct-to-consumer advertising.⁵

Unfortunately, the actual ability to effectively regulate what is stated on the Internet will be very difficult, as will the ability to monitor and control what patients and the public ultimately purchase. Finally, in the absence of physician oversight of such practices, adverse events will likely be substantially underreported, further negatively impacting the effects of promoted strategies on the well being of individuals and the general public.

As has been noted previously in this column, the Internet is completely agnostic to quality or facts. But despite the potential for genuine harm to result from the activities of unscrupulous individuals, the Internet can truly become the focus of effective and intense communication strategies undertaken by highly reputable health-related organizations that desire to present factual data objectively and to educate the public and patients regarding complex and potentially difficult, as well as emotional, topics.

In this regard, one only needs to look as far as the recent events in Japan and the understandable concern about the risk of exposure to radiation among populations far from the heavily damaged nuclear power plants. Internet sites with scientifically accurate and easily understandable information regarding risks and potential strategies that might reduce that risk (eg, potassium iodide pills)⁶ were profoundly important.

The health-related information flow may be both fast and massive, but that does not mean it will be easy to separate the valid from the invalid, and the frankly truly dangerous. In this, and many other circumstances, one can only hope that the community of scientists and public health officials can effectively employ the Internet to fill a concerning void.

References

1. Haberkorn J. Repeal has Americans flummoxed. Politico. February 24, 2011. Politico. Accessed February 28, 2011.
2. Mitka M. Troubled by “stem cell tourism” claims, group launches Web-based guidance. JAMA. 2010; 304:1315-1316.
3. Yamin CK, Bitton A, Bates DW. E-cigarettes: a rapidly growing Internet phenomenon. Ann Intern Med. 2010; 153:607-609.
4. FDA Consumer Health Information. ‘Miracle’ treatment turns into potent bleach. FDA. Published October 2010. Accessed May 26, 2011.
5. Liang BA, Mackey T. Direct-to-consumer advertising with interactive Internet media: global regulation and public health issues. JAMA. 2011; 305:824-825.
6. Rockoff JD. Potassium iodide runs low as Americans seek it out. The Wall Street Journal. March 15, 2011. Wall Street Journal. Accessed May 26, 2011.