More and more people rely on the internet for information about healthcare. This is particularly true for complementary medicine, not least because most conventional healthcare providers know too little about it to advise their patients responsibly. If you enter "alternative medicine" into Google you find something like 41 million hits! If ever there was such a thing as information overload, this must be it.
So is this abundance a good thing? Several studies have cast considerable doubt on the reliability of the guidance provided by the net on complementary medicine. My own unit has investigated websites offering advice on complementary medicine for patients suffering from Aids, cancer, diabetes or depression. The results were less than reassuring. The data provided were often misleading or inaccurate and frequently had the potential to cause harm.
Our findings were confirmed by other researchers who found that web-based information about herbal cancer treatments was frequently unreliable. Many sites were commercially motivated, and these were usually the ones that were the most inaccurate and so hazardous. Seven per cent of sites discouraged the use of conventional medicine, which means crossing the line between responsible and irresponsible behaviour.
Perhaps it is better to use the internet for contacting healthcare professionals directly? We also carried out five separate surveys to evaluate the guidance given by different groups of complementary practitioners to their clients in a range of different situations. We were disappointed to find that a considerable proportion of acupuncturists, reflexologists, chiropractors, homeopaths and herbalists behaved less than responsibly when advising patients in that way. The overall picture that emerged from these studies was somewhat disquieting: the information provided was often misleading and all too frequently it had a clear potential to put people's health at risk.
These hazards are not merely theoretical; they have already resulted in real harm. Some patients may buy ineffective products. In such cases, only their bank account suffers. In other instances, products may be toxic or cause harm through the fact that they are used as a replacement for effective treatments. Patients have died prematurely because of alternative medicines bought over the net.
How can such harm be avoided? You could decide not to use the internet at all for information on health-related matters. But perhaps this would be a shame - after all, among all this junk there are some valuable websites that provide relevant and reliable data. The question is how to tell the wheat from the chaff.
If you feel you are being persuaded to purchase a product, think twice. In addition, always ask the following questions. Who exactly is behind the information? Who "owns" the website? Could there be a conflict of interest? Are the claims made supported by reliable evidence? Is any information provided about risks associated with the treatments? Is the information up-to-date and is the website regularly serviced? Is an attempt being made to interfere with your prescribed treatments? If all the answers are positive, chances are that it is a high-quality website that can be of value to you.
Perhaps the safest way to navigate through the vagaries of the net is to visit web addresses that experts have checked and approved. Here are a few sites that I can personally recommend:
· The National Center for Complementary and Alternative Medicine www.nccam.nih.gov
· Focus on Alternative and Complementary Therapies (Fact) www.pharmpress.com/fact
· Natural Standard Database, www.naturalstandard.com
· www.healthy_living/complementary_medicine/ This is a good website for general information.
Readers who have an interest in a specific medical condition should try charity sites, such as the National Cancer Institute, the American College of Rheumatology, Asthma.org, etc.
My list is not nearly complete, but it's a start. Whenever you use the internet for information on complementary medicine, remember my motto - if it sounds too good to be true, it probably is.
· Edzard Ernst is professor of complementary medicine at the Peninsula medicine school at the universities of Exeter and Plymouth.
