Patients with low education levels more likely to get health information from poorer quality websites

When searching the internet for health information, people with less education and lower literacy levels are more likely to visit poorer quality commercial websites, according to a study by researchers at Loyola Medicine and Loyola University Chicago Stritch School of Medicine.

"These findings should encourage physicians to guide patients towards appropriate high quality websites, particularly patients with low literacy and/or education levels," senior author Gopal N. Gupta, MD and colleagues wrote in the ARC Journal of Urology.

Researchers conducted a prospective study of 27 patients who were newly diagnosed with urologic cancer such as cancer of the bladder, kidney, prostate or testicles. Patients were asked to do an internet search about their cancer, and the computer was equipped with software that tracked their activity. Participants also took a literacy test and were asked about their education.

Among the findings:

• 17 patients sought information from advertisement websites. Of those, 71 percent had below-average literacy scores.
• 10 patients sought information on non-advertisement websites. Of those, 80 percent had above-average literacy scores.
• Of the websites visited by those with a high school education, 32.9 percent were advertisements.
• Among patients with at least a bachelor's degree, only 12.7 percent of the visited websites were advertisements.

An advertisement website was defined as a website that promoted the sale of a product, service or therapy. Previous studies have found that such sites are less credible and of lower quality than noncommercial websites.

The findings are concerning because many Americans turn to the internet to learn about their disease, prognosis and treatment options. The National Adult Literacy Survey estimates that as many as 50 million American adults have marginal literacy skills.

Dr. Gupta and colleagues wrote that the study's findings likely would be applicable to other diseases and treatments, including preventative services. "Clinicians need to be mindful of the variability in literacy and education of their patients in order to guide their patients towards balanced and reputable online health information sources," the researchers concluded.