>
> It is also an issue in the various 'rating scales' currently
> being used. It
> is not sufficient that a site has (eg) an HON rating, we need
> to know for
> which populations it is suitable.
Which is why the MedCERTAIN seal will contain information questions on where
the server is located, where the company is a legal entity, and where most
employees are working (see http://www.MedCERTAIN.org and
http://www.medcertain.org/medpics05.html for the pilot rating vocabulary
used by MedCERTAIN.
-----------------------------------------------------------
| Gunther Eysenbach, MD |
| University of Heidelberg, Germany |
| Dept. of Clinical Social Medicine |
| (Epidemiology, Public Health, Health Systems Research) |
| Head, Research Unit on Cybermedicine |
| Bergheimer Str. 58, 69115 Heidelberg |
| Ph. ++49-(0)6221-56 88 97, ++49-(0)172-82 49 0 86 |
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| http://yi.com/ey/ |
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| Email: [log in to unmask] |
| |
| Secretary: |
| Ms. Myra Sidrassi, Ph. ++49-(0)6221-56 47 42 |
| Mailto:[log in to unmask] |
-----------------------------------------------------------
> -----Original Message-----
> From: Ray Jones [mailto:[log in to unmask]]
> Sent: Thursday, November 30, 2000 11:36 AM
> To: [log in to unmask]
> Subject: global health info
>
>
> Global Health Resources
>
> On 10th November I mailed the list and a few others asking
> for views about
> the suitability of sites developed in one country for people in other
> countries....I said "Nevertheless the question arises how
> 'global' are these
> ten sites? When constructed they will have had an American or
> even more
> specific (New York eg?) audience in mind. So how applicable
> are they to my
> Glasgow Granny, my Adelaide Aunty, or even my (English
> speaking) cousin in
> Cordoba?"
>
> I said I would 'report' back to the list with what I found. This is a
> SELECTION (not all) of replies.
>
>
> MICHAEL HARDY from University of Southampton said: "I have
> found that for
> example, people from minorities that might practice the
> Muslim medical
> system Unani will give greater credence to sites that
> originate in Asia.
> Other issues here include the different use of proprietary
> drug names in
> different countries. More broadly people do recognise the
> different origin
> of sites and may use this to challenge treatment, practice or
> policy locally."
>
> DR MALPANI from India said "I guess a sophisticated reader ( " health
> consumer" ) would be able to extract the relevant info and
> customise it for
> his local situation, but most patients would much rather be
> "spoon-fed""
>
> DIANE BARNET, Information Officer from 'Contact a Family' in
> England said
> (in respect of her search of the MLA recommended sites for
> Syringomyelia)
> "I think we have to accept that an American listing will look
> at American
> sites! information officers working in the UK should recommend quality
> sites whatever their source and these sites are ok. At the same time I
> would be ensuring that an enquirer is informed of the UK
> support available.
> Healthfinder was very good at listing the US support orgs so
> all that I
> would then do would refer UK enquirers to UK Equivalents: ANTS (Anne's
> Neurological Trust Society)c/o the Syringomyelia Service at the Queen
> Elizabeth Hospital in Birmingham, ASBAH (covers the Chiari
> Malformation
> aspects of Syringomyelia), Stroke Association and Pain orgs.
> Having said
> all of this, I am an information officer and the 'man/woman
> in the street'
> would have to have some knowledge to ferret all this out."
>
> ANDREW STOREY AND MARILYN MARTIN, Researchers in Nutrition at Glasgow
> University looked at two sites AMA Health Website and NOAH
> for information
> on nutrition. They said Both sites lack immediate relevance
> to Glaswegians.
> This may be largely due to the cultural differences
> between the US and
> here. Health and nutritional recommendations and guidelines differ in
> America, so for example recommended daily intakes of vitamins
> and minerals
> as well as main dietary constituents have less relevance
> outwith the US. We
> had not heard of some of the foodstuffs that were mentioned
> on both websites.
>
> DIANE BENTAL from Heriot Watt University gave the following
> detailed reply.
> She discusses this and personalised sites on her web site at
> http://www.cee.hw.ac.uk/~diana/DIP/medical.html
>
> She said
> --------------------
> I'm aware of four areas where national or even regional
> differences matter:
> 1. US assumptions about how healthcare is *delivered* can be
> very different
> from eg the UK. For example, while pregnancy is pretty universal, the
> medical *professionals* and *procedures* are different. A UK
> mother-to-be
> needs to be clear that a midwife rather than an obstetrician could be
> running her show (and a UK midwife is different from a US
> midwife), that
> she shouldn't expect a glucose stress test, and so on. For a
> patient, who
> and how the service is delivered, who to ask and what to
> expect, are often
> as important as the more universal "raw" medical/scientific
> data, and on
> consumer sites they are often closely mixed. These
> differences in medical
> practice and delivery turned up in the AMA site
> http://www.ama-assn.org/consumer.htm on your list of
> recommended sites. I
> looked up 2-3 year olds: there were separate pages for communications,
> medical care, fitness and growth. Most of the
> "communications" page was
> universal, but one fifth of the information - i.e. the
> section on what to
> do if your child has a problem - was specific to US practice and
> terminology. The "medical care" page was the most highly
> US-specific, for
> instance assuming that your child would have a "yearly
> well-child visit"
> (as opposed to the irregular UK schedule), listing a US vaccination
> schedule (which may not be quite the same as the UK one), and so on.
> 2. Another factor is that different issues are also "live" in
> different
> places. A few months ago, a relative asked me to look for
> info on a drug
> and cancer - I think it was HRT and breast cancer. We found a
> brief, clear
> and readable page on the CancerHelp UK site, but nothing
> about the issue on
> the US sites including (at the time) Oncolink. UK sites
> highlight UK concerns.
> 3. Occasionally, even the recommendations vary. Dietary
> restrictions in
> pregnancy are different - in the US, alcohol is forbidden,
> while in the UK
> it's pate, scrambled eggs and Brie :-)
> 4. Finally, the raw data can sometimes differ. The AMA
> children's page gave
> growth charts which were not explicitly labelled as US data
> (although the
> AMA heading on the pages should be a hint!). The AMA has a
> long page about
> Web quality guidelines, but does not mention the fact that a
> US audience is
> presupposed throughout, nor does it raise the issue of what their site
> might mean to readers outside the US.
> ------------------------
>
> IN CONCLUSION.
> I agree with Diane's conclusion "Diversity is interesting but
> it can also
> be confusing. I'd like to see medical *World* Wide Web sites
> be much more
> explicit about how local or diverse their different items of
> information
> are, with explicit relevance information onscreen probably
> supported by
> tagging of pages or paragraphs."
>
> It is also an issue in the various 'rating scales' currently
> being used. It
> is not sufficient that a site has (eg) an HON rating, we need
> to know for
> which populations it is suitable.
>
> Ray Jones
>
> Ps (Ahmad Risk thought that Health Which had published a report on a
> similar topic about 18 months ago, but as yet I have been
> unable to locate
> it. If you know the article I would appreciate the title and date.)
>
>
> Dr Ray Jones
> Senior Lecturer in Health Informatics
> Department of Public Health
> 1 Lilybank Gardens
> Glasgow G12 8RZ
> Email: [log in to unmask]
> Fax: 0141-330-5018
>
> Secretary
> Rebecca Flanagan: [log in to unmask]
> Tel: 0141-330-6110
>
|
