How to use internet resources in PEDIATRIC PRACTICE

By Dr. Yasser Sami Amer

MSc Pediatrics, MSc Healthcare InformaticsClinical Practice Guidelines Advisor

CONTENTS

I. Best CPGs websites

II. Best Children’s Hospitals website

III. Quality of medical info

IV. Medical Internet Ethics

Clinical Guidelines on the Web

GUIDELINES ON THE WEB

Guideline Producers

Guideline Finders

GUIDELINE PRODUCERS

Specialized societies

National agencies NICE SIGN

Organization NameCountry

URL Producer

Finder FREE PAID

Guidelines International Network (G-I-N) Int’l http://www.g-i-n.net F √ √

World Health Organization (WHO) Int’l http://www.who.int/topics P √

National Institute for Health & Clinical Excellence (NICE) UK http://www.nice.org.uk/page.aspx?o=ourg

uidanceP √ √

National Library for Health (NLH) UK http://www.library.nhs.uk F √

Scottish Intercollegiate Guidelines Network (SIGN) Scotland http://www.sign.ac.uk/guidelines/index.ht

mlP √

New Zealand Guideline Group (NZGG) NZ http://www.nzgg.org.nz P √Registered Nurses Association of Ontario (RNAO) Canada http://www.rnao.org P √

National Guidelines Clearinghouse (NGC) USA http://www.guidelines.gov F √

US National Library of Medicine, National Institutes of Health (PubMed)

USA http://www.ncbi.nlm.nih.gov/pubmedOR http://www.pubmed.gov F

√(Abstracts)

√(Full

Text)

Institute for Clinical Systems Improvement (ICSI) USA http://www.icsi.org/knowledge/ P √

CPG PRODUCERS:SPECIALIZED

SOCIETIES: AAP

SIGNScottish

Intercollegiate Guidelines Network

www.sign.ac.uk

CPG Producers:National Agencies

CPG PRODUCERS:NATIONAL AGENCIES

NICENational Institute for

Health & Clinical Excellence

www.nice.org.uk

CPG FINDERS

AHRQ

National Guideline Clearinghouse

www.guidelines.gov

CPG FINDERS

National Library for Health (UK)

www.library.nhs.uk

CPG FINDERS

Guidelines International Network

(G-I-N)

www.g-i-n.net

CEBCPGs, HCQD-AUHs

Org. Member since 2009

CPG FINDERS

PubMed

US National Library of Medicine

National Institutes of Health (NIH)

WORLDWIDE BEST CHILDREN’S HOSPITALS

2012-13

THESE HOSPITALS EXCEL IN CARING FOR SICK KIDS

USA UK Arab World – Arab Gulf – Middle East - EMRO

BOSTON CHILDREN'S HOSPITALHTTP: / /WWW.CHILDRENSHOSPITAL.ORG/

1st US Nationally Ranked #2 in Pediatrics: Cancer

#1 in Pediatrics: Cardiology & Heart Surgery

#2 in Pediatrics: Diabetes & Endocrinology

#2 in Pediatrics: Gastroenterology

#3 in Pediatrics: Neonatology

#1 in Pediatrics: Nephrology

#1 in Pediatrics: Neurology & Neurosurgery

#3 in Pediatrics: Orthopedics

#4 in Pediatrics: Pulmonology

#2 in Pediatrics: Urology

HTTP://WWW.CHOP.EDU/

2nd US Nationally Ranked

#1 in Pediatrics: Cancer

#2 in Pediatrics: Cardiology & Heart Surgery

#1 in Pediatrics: Diabetes & Endocrinology

#1 in Pediatrics: Gastroenterology

#4 in Pediatrics: Neonatology

#2 in Pediatrics: Nephrology

#2 in Pediatrics: Neurology & Neurosurgery

#1 in Pediatrics: Orthopedics

#1 in Pediatrics: Pulmonology

#1 in Pediatrics: Urology

HTTP:/ /WWW.CINCINNATICHILDRENS.ORG/DEFAULT/ JAMES M. ANDERSON CENTER FOR HEALTH SYSTEMS

EXCELLENCEEVIDENCE-BASED GUIDELINES

3rd US Nationally Ranked

#3 in Pediatrics: Cancer

#8 in Pediatrics: Cardiology & Heart Surgery

#5 in Pediatrics: Diabetes & Endocrinology

#3 in Pediatrics: Gastroenterology

#1 in Pediatrics: Neonatology

#3 in Pediatrics: Nephrology

#4 in Pediatrics: Neurology & Neurosurgery

#4 in Pediatrics: Orthopedics

#2 in Pediatrics: Pulmonology

#4 in Pediatrics: Urology

HTTP: / /WWW.HOPKINSCHILDRENS.ORG/TPL_NAV1UP_NAV2UP.ASPX?ID=1090

9th US Nationally Ranked

#15 in Pediatrics: Cancer

#16 in Pediatrics: Cardiology & Heart Surgery

#8 in Pediatrics: Diabetes & Endocrinology

#24 in Pediatrics: Gastroenterology

#10 in Pediatrics: Neonatology

#16 in Pediatrics: Nephrology

#5 in Pediatrics: Neurology & Neurosurgery

#19 in Pediatrics: Orthopedics

#11 in Pediatrics: Pulmonology

#20 in Pediatrics: Urology

UK

THE CHILD FIRST AND ALWAYSHT TP://WWW.GOSH.NHS.UK/HEALTH-PROFESSIONALS/CLINICAL-GUIDELINES/

Health Professionals > Clinical Guidelines

SEARCH by: Search bar Alphabetical A-Z

How To Judge the Quality of Medical Web Sites ?

2009 - About.com Health's Disease and Condition content

is reviewed by the Medical Review Board

THERE IS A LOT OF MEDICAL INFORMATION ON THE INTERNET: SOME VERY GOOD, AND SOME VERY BAD.THE FOLLOW STEPS WILL HELP YOU JUDGE THE QUALITY OF MEDICAL WEB SITES. HERE IS HOW:-

1. Figure out what type of group owns the site. By looking at the middle or end of the Uniform Resource Locator (URL), you can get clues to the site's ownership. (Sometimes the URL also gives clues to the country in which the site is registered.) Educational institutions: .edu, .ac Commercial (for profit) sites: .com, .co (but remember that

lots of hospitals have .com domain names) Government sites: .gov, .gouv Organizations (usually nonprofit): .org Networks: .net

2. ASK YOURSELF: AM I BEING GIVEN FACTS, OR OPINIONS? 

Reliable medical web sites clearly distinguish between factual information and opinion or advice; you shouldn't be left wondering. All medical facts and statistics should be referenced, and you should be given all the information you'd need if you wished to verify the facts yourself in a medical library (including the names of the researchers who did the research and the name of the journal in which it was published, the issue number and date, and the page numbers). Also, the site should make it easy to tell the difference between ads and editorial content.

3. MAKE SURE YOU KNOW WHO’S RESPONSIBLE FOR THE SITE'S CONTENT. 

Who owns this website, and who creates the content? The answers should be obvious. The site’s sponsors should take credit for all the information on the site, or if they did not create the content, they should clearly state who did. Be wary of medical sites that post information collected from around the web. Also, you should be provided with a way to contact the site owners by email and by postal mail.

4. ASK YOURSELF: WHO'S PAYING FOR THIS SITE?

What is the source of the site's financial support? Advertisements? User fees? Organization funds? Your tax dollars? A corporate sponsor trying to sell a product? The answer to this question can be a clue to whether the content is objective or biased.

5. VERIFY THE SITE'S CREDIBILITY. 

Unless the site is sponsored by a hospital or medical school, make sure all medical content is reviewed by an editorial board of physicians with solid qualifications. No completely reliable medical site can be written and reviewed by a single person.

6. BE SURE THE INFORMATION IS CURRENT. 

Reliable medical web sites are regularly reviewed and updated, and the date of the most recent update or review should be clearly posted.

7. Make sure you know what information is being collected about you, and how it will be used.

Does the site collect your personal information? Do they guarantee to respect your privacy and confidentiality? Be sure you read their privacy policy, and don't agree to anything you don’t understand.

8. LEARN MORE ABOUT HOW TO RECOGNIZE GOOD

MEDICAL WEBSITES. 

Learn more about how to recognize reliable medical information on the internet by reviewing the guidelines on the following sites:- Health on the Net Foundation

http://www.hon.ch/pat.html

Medical Library Association

National Library of Medicine

Human Genome Project

HON: HEALTH ON THE NET FOUNDATION

HTTP://WWW.HON.CH/PAT.HTML

NATIONAL LIBRARY OF MEDICINE

HTTP://WWW.NLM.NIH.GOV/MEDLINEPLUS/WEBEVAL/WEBEVAL.HTML

MEDICAL LIBRARY ASSOCIATIONHTTP: / /WWW.ML ANET.ORG/RESOURCES /USERGUIDE .HTML

Medical Internet Ethics: A Field in Evolution

MEDICAL INTERNET ETHICS:MERGING DIVERSE FIELDS OF STUDY

Healthcare Delivery

Applied Computing

Science & Research

Government Agencies

Healthcare services, e-commerce

End Users

Healthcare Organizations

Administration & Management

Medical Ethics

Law

Medical InternetEthics

MAJOR AREAS NEEDING GUIDELINES IN MEDICAL

INTERNET ETHICS· Doctor-patient, provider-patient, therapist-

client relationships · Online medicine, online therapy · Online research · Quality of information on medical and

healthcare Web sites · Ethical conduct of medical and healthcare

Web sites · Privacy and security

MEDICINE & HEALTHCARE ON THE INTERNET

Medical websites, more than any other type of site on the Internet, should ensure visitors’ personal privacy and prevent personal medical information, including patterns of use and interests, from being sold, purchased, or inadvertently entering the hands of marketers, employers, and insurers.

Principles Governing AMA Web Sites

Winker MA JAMA 2000;283:1600-1606

GUIDELINES FOR QUALITY MEDICAL AND HEALTH WEBSITES

1996 - Health on the Net Foundation Code of Conduct

1999 - Medscape “The Ethics of the Medical Internet”

2000 - AMA’s “Guidelines for Medical and Health Information Sites on the Internet”

- Internet Healthcare Coalition’s “International Code of Ethics”

- MedCERTAIN development of an international trustmark

2001 - URAC & Hiethics Fee-based Health Website Accreditation program