Consumer empowerment through metadata-based information quality reporting: The Breast Cancer Knowledge Online Portal

Consumer empowerment and the role of the expert patient in their own healthcare, enabled through timely access to quality information, have emerged as significant factors in better health and lifestyle outcomes. Governments, medical researchers, healthcare providers in the public and private sector, drug companies, health consumer groups, and individuals are increasingly looking to the Internet to both access and distribute health information, communicate with each other, and form supportive or collaborative online communities. Evaluating the accuracy, provenance, authority, and reliability of Web-based health information is a major priority. The Breast Cancer Knowledge Online Portal project (BCKOnline) explored the individual and changing information and decision support needs of women with breast cancer and the issues they face when searching for relevant and reliable health information on the Internet. Its user-sensitive research design integrated multidisciplinary methods including user information-needs analysis, knowledge-domain mapping, metadata modeling, and systems-development research techniques. The main outcomes were a personalized information portal driven by a metadata repository of user-sensitive resource descriptions, the BCKOnline Metadata Schema, richer understandings of the concepts of quality, relevance, and reliability, and a user-sensitive design methodology. This article focuses on the innovative, metadata-based quality reporting feature of the BCKOnline Portal, and concludes that it is timely to consider the inclusion of quality elements in resource discovery metadata schema, especially in the health domain.

[1]  David Bomba,et al.  Evaluating the Quality of Health Web Sites: Developing a Validation Method and Rating Instrument , 2005, Proceedings of the 38th Annual Hawaii International Conference on System Sciences.

[2]  J. Griggs,et al.  Patient-centered care and breast cancer survivors' satisfaction with information. , 2005, Patient education and counseling.

[3]  Judith Bernstein,et al.  Assessing the quality of infertility resources on the World Wide Web: tools to guide clients through the maze of fact and fiction. , 2002, Journal of midwifery & women's health.

[4]  Nigel Ward,et al.  Describing Records in Context in the Continuum: The Australian Recordkeeping Metadata Schema , 2006 .

[5]  Elmer V. Bernstam,et al.  Instruments to assess the quality of health information on the World Wide Web: what can our patients actually use? , 2005, Int. J. Medical Informatics.

[6]  David Nicholas,et al.  Characterising and profiling health Web user and site types: going beyond "hits" , 2003, Aslib Proc..

[7]  J. Burkell,et al.  Health Information Seals of Approval: What do they Signify? , 2004 .

[8]  Jay F. Nunamaker,et al.  Systems Development in Information Systems Research , 1990, J. Manag. Inf. Syst..

[9]  Julie Fisher,et al.  User Centred Quality Health Information Provision: Benefits and Challenges , 2005, Proceedings of the 38th Annual Hawaii International Conference on System Sciences.

[10]  Manish Latthe,et al.  Accuracy of information on apparently credible websites: survey of five common health topics , 2002, BMJ : British Medical Journal.

[11]  Shuk Ho,et al.  An Empirical Examination of the Effects of Web Personalization at Different Stages of Decision Making , 2005, Int. J. Hum. Comput. Interact..

[12]  Anne J. Gilliland,et al.  Building an Infrastructure for Archival Research , 2004 .

[13]  Sue Childs,et al.  Developing health website quality assessment guidelines for the voluntary sector: outcomes from the Judge Project. , 2004, Health information and libraries journal.

[14]  R. Sanson-Fisher,et al.  Perceived needs of women diagnosed with breast cancer: rural versus urban location , 2000, Australian and New Zealand journal of public health.

[15]  P. Butow,et al.  The psychosocial needs of breast cancer survivors; A qualitative study of the shared and unique needs of younger versus older survivors , 2004, Psycho-oncology.

[16]  L. Weih,et al.  Mapping the quality of life and unmet needs of urban women with metastatic breast cancer. , 2005, European journal of cancer care.

[17]  Alejandro R Jadad,et al.  Examination of instruments used to rate quality of health information on the internet: chronicle of a voyage with an unclear destination , 2002, BMJ : British Medical Journal.

[18]  Robert A. Greenes,et al.  Positive attitudes and failed queries: an exploration of the conundrums of consumer health information retrieval , 2004, Int. J. Medical Informatics.

[19]  Sally Redman,et al.  Assessing the Practical and Psychosocial Needs of Rural Women with Early Breast Cancer in Australia , 2002, Social work in health care.

[20]  Julie Fisher,et al.  Breast cancer knowledge on line portal: an Intelligent decision support system perspective , 2003 .

[21]  J. Powell,et al.  Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review. , 2002, JAMA.

[22]  T Delamothe,et al.  Quality of websites: kitemarking the west wind , 2000, BMJ : British Medical Journal.

[23]  Joshua Fogel,et al.  Racial/ethnic differences and potential psychological benefits in use of the internet by women with breast cancer , 2003, Psycho-oncology.

[24]  Rosetta Manaszewicz,et al.  Breast cancer information needs and seeking: Towards an intelligent, user sensitive portal to breast cancer knowledge , 2002 .

[25]  M. T. Høybye,et al.  Online interaction. Effects of storytelling in an internet breast cancer support group , 2005, Psycho-oncology.

[26]  Julie Fisher,et al.  A Role for Information Portals as Intelligent Decision Support Systems: Breast Cancer Knowledge Online Experience , 2006 .

[27]  Joanne Evans,et al.  The Role of Domain Expertise in Smart, User-Sensitive, Health Information Portals , 2009, 2009 42nd Hawaii International Conference on System Sciences.

[28]  M. Winker,et al.  Guidelines for medical and health information sites on the internet: principles governing AMA web sites. American Medical Association. , 2000, JAMA.

[29]  Julie Fisher,et al.  Applying a user-centred design approach to building a personalised health information portal for decision support , 2006 .

[30]  Susannah Fox Finding Answers Online in Sickness and in Health , 2006 .

[31]  Daniel P Lorence,et al.  The zeitgeist of online health search. Implications for a consumer-centric health system. , 2006, Journal of general internal medicine.

[32]  Marc Berg,et al.  Looking for answers, constructing reliability: An exploration into how Dutch patients check web-based medical information , 2006, Int. J. Medical Informatics.

[33]  Carolyn Petersen,et al.  Health information on the internet: quality issues and international initiatives. , 2002, JAMA.

[34]  Funda Meric-Bernstam,et al.  Commonly cited website quality criteria are not effective at identifying inaccurate online information about breast cancer , 2008, Cancer.

[35]  Falk Schubert,et al.  Quality markers of drug information on the Internet: an evaluation of sites about St. John's wort. , 2002, The American journal of medicine.

[36]  Ahmad Risk,et al.  Review Of Internet Health Information Quality Initiatives , 2001, Journal of medical Internet research.

[37]  Enric Mor,et al.  Towards personalization in digital libraries through ontologies , 2005 .

[38]  A Coulter,et al.  Sharing decisions with patients: is the information good enough? , 1999, BMJ.

[39]  Wenhong Luo,et al.  Trust-building measures: a review of consumer health portals , 2004, CACM.

[40]  E Ernst,et al.  ‘Alternative’ cancer cures via the Internet? , 2002, British Journal of Cancer.

[41]  S M Christian,et al.  Medical genetics and patient use of the Internet , 2001, Clinical genetics.

[42]  Austin Henderson,et al.  Interaction design: beyond human-computer interaction , 2002, UBIQ.

[43]  Petra Wilson,et al.  How to find the good and avoid the bad or ugly: a short guide to tools for rating quality of health information on the internet. , 2002, BMJ : British Medical Journal.

[44]  M. Peterson,et al.  An evaluation of the quality and contents of asthma education on the World Wide Web. , 2002, Chest.

[45]  Patricia Radin "To me, it's my life": medical communication, trust, and activism in cyberspace. , 2006, Social science & medicine.

[46]  Jane Austin,et al.  Peer mentoring and survivors' stories for cancer patients: positive effects and some cautionary notes. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[47]  Linda Tetzlaff,et al.  Online cancer patient education: evaluating usability and content. , 2002, Cancer practice.

[48]  Elizabeth Sillence,et al.  Trust and mistrust of online health sites , 2004, CHI.

[49]  J. Chin,et al.  Use of the internet for self-education by patients with prostate cancer. , 2001, Urology.

[50]  Batya Friedman,et al.  Value-sensitive design , 1996, INTR.

[51]  Phyllis N Butow,et al.  Qualitative study of how women define and use information about breast symptoms and diagnostic tests. , 2006, Breast.

[52]  Kathleen M Griffiths,et al.  The quality and accessibility of Australian depression sites on the World Wide Web , 2002, The Medical journal of Australia.

[53]  Christian Köhler,et al.  How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews , 2002, BMJ : British Medical Journal.

[54]  G D Lundberg,et al.  Assessing, controlling, and assuring the quality of medical information on the Internet: Caveant lector et viewor--Let the reader and viewer beware. , 1997, JAMA.

[55]  S. Dickerson,et al.  Therapeutic connection: help seeking on the Internet for persons with implantable cardioverter defibrillators. , 2000, Heart & lung : the journal of critical care.

[56]  E Ernst,et al.  Assessing websites on complementary and alternative medicine for cancer. , 2004, Annals of oncology : official journal of the European Society for Medical Oncology.

[57]  E. Bernstam,et al.  Accuracy and self correction of information received from an internet breast cancer list: content analysis , 2006, BMJ : British Medical Journal.

[58]  F. Mackenzie,et al.  Information contained in miscarriage-related websites and the predictive value of website scoring systems. , 2003, European journal of obstetrics, gynecology, and reproductive biology.

[59]  Steven Muncer,et al.  Reliability of Health Information on the Internet: An Examination of Experts' Ratings , 2002, Journal of medical Internet research.

[60]  Jane Klobas Research Methods for Students and Professionals: Information Management and Systems , 2001 .

[61]  HON code of conduct for medical and health Web sites. , 2000, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[62]  Ulrike Lechner,et al.  Success factors of communites of patients , 2006, ECIS.

[63]  Judy E Garber,et al.  Breast Cancer Screening: A Final Analysis? , 2003, CA: a cancer journal for clinicians.