Section VI - Ancillary Responsibilities and Problems
Chapter 80
- Medical Information on the Internet
- Ira J. Rampil
The Internet and its component the World Wide Web (WWW) have become
ubiquitous features of first- and second-world culture. Recent assessments of the
membership of the American Society of Anesthesiologists (ASA) estimate that more
than 90% have Internet access. The original purpose of the Internet was to share
information among widely separated academic and military sites. A number of valuable
inventions were developed in support of the Internet project, including Ethernet
technology, e-mail, and distributed computing. The WWW began as a method of experimentation
with the presentation of nonlinear hypertext information. The basic concept of hypertext
was conceived by Vannevar Bush[1]
and developed
by Theodore Nelson.[2]
Text is converted to hypertext
by annotating or cross-referencing key words within the text. These "hot word links,"
or simply "links," appear as underlined, colored words within the hypertext that,
if activated by the reader with a graphic pointer (mouse), expose a new section of
text that expands on the original linked words ( Fig.
80-1
). Reading is converted from a sequential or linear process predefined
by the author to a reader-controlled nonlinear experience in which the reader can
skip around, or "surf," as interest or curiosity strikes. Although the innovation
of hypertext browsing of remote computers with a "web browser" was invented by a
physicist named Tim Berners-Lee,[3]
the first few
publicly accessible web pages dealt with a medical topic (epilepsy). The power of
hypertext files (web pages) for learning and for inexpensive dissemination of information
was quickly recognized, and the Internet was transformed from a small government-supported
research project into a commercially supported public access web fully encompassing
the globe. In many instances, the web has replaced physical media such as paper
and film, which must be copied for each user, with digital representations stored
at remote locations, but freely and quickly downloaded for temporary viewing by end
users.
With the growth in numbers and bandwidth supported by commercial
interests also came dilution and diminution of the quality of the information because
the WWW allows instant global publication of ideas by anyone at nearly no cost and
irrespective of motives or qualifications. Furthermore, many websites support themselves
economically with often irritating advertising. Reliable medical information is
copiously available on the WWW, but the challenge now is for the busy practitioner
to efficiently find it while ignoring the chaff.
In its current state, it is often difficult to assess the provenance
of information on web pages. Medical websites in particular span the gamut from
peer-reviewed articles by acknowledged experts to unreviewed manuscripts by earnest
clinicians, to fringe alternative medicine practitioners, to commercially biased
information, to outright fraud and hucksterism. Therefore, in the interest of efficiency
rather than entertainment, this chapter will concentrate on peer-reviewed data sources
of federal or responsible, nonprofit corporate origin.
