Box 1.
Quotes from focus groups and in-depth interviews—criteria for credibility of healthcare information on the internet
Authority of source
“I want to know where that information comes from. Sometimes it is hard to detect who is responsible for the content, and this is bugging me”
“I consider it to be reliable if information is from public institutions or scientific publications”
“I certainly trust more an official website of an organisation or association rather than a private site”
“I would like to know whether this is the opinion of a single person or an institution, whether the content is selected according to scientific criteria or whether it is based on a personal experience”
Layout and appearance
“The presentation of the site is very important, so that it appears professional”
“The design and the advertising, the whole appearance must be pleasing. That's very important”
Advertising
“I have been on a [AIDS] site that was not too bad actually, but there have been some strange banners on top [advertising banners for pornographic websites]. This, of course, badly affected the credibility of that site”
Readability
“To me, the text shouldn't use too much professional terminology. It should appear in a language a medical layperson can understand without great difficulties”
“The text should be in a respectable and comprehensible diction, not too sensational.”
Outbound links
“If a trustworthy site provides links to other sites, I assume they are trustworthy as well”
Picture of the site owner
“Perhaps a picture of the owner of the site would be helpful. It would be a plus if the site owner would have a pleasing face or appears likeable”
“I think it is the first impression. If there is a picture of a honestly smiling man, that would be very important”
Email
“One should have the ability to contact the provider, such as by email. And the owner should respond”
Credentials and qualifications
“If possible, the site owner should provide evidence of his credentials, that he is qualified to make such statements. For example, references to his previous work, or his curriculum vitae”
Updating of content
“I have seen pages that say ‘Last updated in 1998.’ In this case, I don't need to go any further. But I have seen on the site of that institute of tropical medicine that they were giving advice concerning anthrax. In this case I know that this site is updated frequently”
[The interview was conducted shortly after the first cases of mail contaminated with anthrax in the United States occurred]
Quality seal and third party endorsements
“The content should be checked by the Federal Department of Health or any authority that can say ‘Yes, this is OK.’ ”