- Email: [email protected]
Website Review
248
PRINT AND DIGITAL MEDIA REVIEWS
Website Review: On Inflammatory Bowel Disease found on websites WebMD, eMedicineHealth, MedicineNet, Crohn’s and Colitis Foundation of America, Foundation for Clinical Research in IBD, UpToDate, and Wikipedia The majority of patients with ulcerative colitis (UC) and Crohn’s disease (CD) utilize the web as a source of information about their disease.1,2 Several systematic reviews have reported a wide variation in the quality of online information on these 2 inflammatory bowel diseases (IBD), with many websites containing incomplete or outdated information.3-5 To help providers guide IBD patients toward reliable online resources, the following is an updated analysis of several commonly utilized websites.
WebMD (http://www.webmd.com/search/ search_results/default.aspx?queryⴝ inflammatory%20bowel%20disease) WebMD is the leading health portal in the United States. Its editorial team is made up mainly of physicians, although there are no gastroenterologists. IBD content consisted of core reference articles written separately about CD and UC, in addition to supplementary slideshows, videos, and recent research headlines. Overall, the content was accurate and nonbiased, but poorly cited. The level of detail was at a reading level suitable for most patients, although it may be too simplistic for sophisticated patients. The main disadvantage of this website was that it was too busy, with far too many links and advertisements to make it easily navigable.
eMedicineHealth (http://www. emedicinehealth.com/script/main/ srchcont_em.asp?searchwhatⴝ1&srcⴝ inflammatoryⴙbowelⴙdisease& submitimg.xⴝ47&submitimg.yⴝ10) This is a consumer health website also owned by WebMD, but produced by a larger physician editorial board, including multiple gastroenterologists. Much of the material is similar to that found on WebMD, though presented in a betterorganized and less cluttered format. However, the section on IBD medications contained important inaccurate and outdated facts (eg infliximab as the only biologic available for CD, budesonide as appropriate for severe UC).
MedicineNet (http://search.medicinenet. com/search/search_results/default.aspx? Searchwhatⴝ1&queryⴝinflammatoryⴙ bowelⴙdisease&I1ⴝSearch) This is another website within the WebMD empire, produced by a network of 70 physicians, including several gastroenterologists. Compared with its sister sites, MedicineNet contains more detailed and up-to-date information. For example, the section on medications not only describes indications and adverse effects, but also cites efficacy rates seen in major clinical trials. For some patients, the amount of detail and reading level may seem
GASTROENTEROLOGY Vol. 144, No. 1
overly complex, and articles too lengthy (the CD section is 21 pages). However, the website is easily navigable, so patients can read as little or as much as desired.
Crohn’s and Colitis Foundation of America (http://www.ccfa.org/) This website was recently updated and is maintained by a nonprofit organization that provides patient support and educational services. Basic articles on CD and UC can be accessed from the homepage, which for newly diagnosed patients provides brief but likely adequate disease and medication overviews. This website also provides a searchable “resources” database of in-depth articles and webcasts on specific issues (surgical options, pregnancy/ fertility issues, short bowel syndrome) written by national experts in the field. Also quite popular are the member forums, which allow patients to share experiences with surgery and specific drugs.
Foundation for Clinical Research in IBD (www.myibd.org) MyIBD.org is published by the Foundation for Clinical Research in IBD, a nonprofit research funding organization. This website provides an efficient overview of disease basics and medications with few links or images. Some items require updating (CT/MRI not included as diagnostic test options, adalimumab and natalizumab still listed as “Investigational Therapies”).
UptoDate (http://www.uptodate.com/ patients/contents/search?searchⴝ inflammatoryⴙbowelⴙdisease&spⴝ3) UptoDate is a clinical decision support system targeted at physicians, but it provides a limited number of free articles written for patients. Articles are regularly edited by experts in the field. There were overview articles on CD and UC as well as pregnancy in IBD. These were well organized and written clearly, although sections on diagnostics and medications were sparse. Throughout these free articles, there are multiple links to more detailed, professional-level information, although access requires a subscription.
Wikipedia (http://en.wikipedia.org/wiki/ Inflammatory_bowel_disease) Wikipedia is a free online encyclopedia based on an open-editable model (topics written by anonymous authors and edited by registered users). The website is organized in a simple, easily navigable format with quality images and tables. The articles on UC and CD cover certain areas well (symptoms, complications), but the treatment section contains multiple inaccuracies (which biologics approved for UC vs CD), and provides superficial coverage of accepted medications and a disproportionate reporting of experimental therapies (cannabanoids, fecal bacteriotherapy).
January 2013
CORRECTION
Bottom Line: Overall, all these patient websites on IBD were reasonable sources of information, although sections on diagnostic testing and medications were most prone to having incomplete, inaccurate, or outdated information. From the point of view of the patient, the 2 best websites are CCFA.org and MedicineNet.com. The CCFA website provides a curated, “patient-focused” experience with regularly updated resources and downloadable brochures, written/edited by experts in the field. The MedicineNet website provides in-depth and updated information, potentially for more sophisticated patients who may desire a more technical, data-driven reference on IBD.
249
FERNANDO VELAYOS University of California, San Francisco Center for Crohn’s and Colitis San Francisco, California CAROLINE HWANG University of Southern California Los Angeles, California References 1. 2. 3. 4. 5.
Cima RR, et al. 2007;13:1266 –1270. Cawdron R, et al. J Pediatr Gastroenterol Nutr 2002;35:518 –521. Bernard A, et al. Am J Gastroenterol 2007;102:2070 –2077. van der Marel S, et al. Inflamm Bowel Dis 2009;15:1891–1896. Langille M, et al. Clin Gastroenterol Hepatol 2010;8:322–328.
REVIEWER RATING CCFA Symptom description
夝夝夝夝
WebMD
eMedicine health
MedicineNet
夝夝夝夝夝
夝夝夝夝夝
夝夝夝夝夝
MyIBD 夝夝夝
Up To Date 夝夝夝夝
Wikipedia 夝夝夝
Differential diagnosis
夝夝
夝夝夝夝
夝夝夝夝
夝夝
夝
夝夝
夝
Testing
夝夝夝夝
夝夝夝夝夝
夝夝夝夝
夝夝夝夝夝
夝夝
夝
夝夝夝夝
Treatment
夝夝夝夝夝
夝夝夝夝
夝夝夝
夝夝夝夝夝
夝夝夝夝
夝夝夝
夝
Complications
夝夝夝夝夝
夝夝夝夝
夝夝夝
夝夝夝夝夝
夝夝
夝夝
夝夝夝夝
Supporting citation
夝夝夝
夝
夝夝
夝夝夝夝
夝
夝夝夝
夝夝夝夝
Quality of images
夝夝
夝夝夝
夝夝夝
夝夝夝
夝
夝夝
夝夝夝夝
Ease of navigation
夝夝夝夝
夝夝
夝夝夝
夝夝夝夝
夝夝夝夝
夝夝夝夝
夝夝夝夝
Stars: 夝: poor; 夝夝: adequate; 夝夝夝: fair; 夝夝夝夝: good; 夝夝夝夝夝: excellent.
Correction
Gross ER, Gershon MD, Margolis KG, et al. Neuronal serotonin regulates growth of the intestinal mucosa in mice. Gastroenterology 2012;143:408 – 417. Dr Zhishan Li should be listed as the 5th author in the above article but was inadvertently left off of the author byline. Dr Li’s affiliation is the Department of Pathology and Cell Biology, Columbia University, New York, New York.
PRINT AND DIGITAL MEDIA REVIEWS
Website Review: On Inflammatory Bowel Disease found on websites WebMD, eMedicineHealth, MedicineNet, Crohn’s and Colitis Foundation of America, Foundation for Clinical Research in IBD, UpToDate, and Wikipedia The majority of patients with ulcerative colitis (UC) and Crohn’s disease (CD) utilize the web as a source of information about their disease.1,2 Several systematic reviews have reported a wide variation in the quality of online information on these 2 inflammatory bowel diseases (IBD), with many websites containing incomplete or outdated information.3-5 To help providers guide IBD patients toward reliable online resources, the following is an updated analysis of several commonly utilized websites.
WebMD (http://www.webmd.com/search/ search_results/default.aspx?queryⴝ inflammatory%20bowel%20disease) WebMD is the leading health portal in the United States. Its editorial team is made up mainly of physicians, although there are no gastroenterologists. IBD content consisted of core reference articles written separately about CD and UC, in addition to supplementary slideshows, videos, and recent research headlines. Overall, the content was accurate and nonbiased, but poorly cited. The level of detail was at a reading level suitable for most patients, although it may be too simplistic for sophisticated patients. The main disadvantage of this website was that it was too busy, with far too many links and advertisements to make it easily navigable.
eMedicineHealth (http://www. emedicinehealth.com/script/main/ srchcont_em.asp?searchwhatⴝ1&srcⴝ inflammatoryⴙbowelⴙdisease& submitimg.xⴝ47&submitimg.yⴝ10) This is a consumer health website also owned by WebMD, but produced by a larger physician editorial board, including multiple gastroenterologists. Much of the material is similar to that found on WebMD, though presented in a betterorganized and less cluttered format. However, the section on IBD medications contained important inaccurate and outdated facts (eg infliximab as the only biologic available for CD, budesonide as appropriate for severe UC).
MedicineNet (http://search.medicinenet. com/search/search_results/default.aspx? Searchwhatⴝ1&queryⴝinflammatoryⴙ bowelⴙdisease&I1ⴝSearch) This is another website within the WebMD empire, produced by a network of 70 physicians, including several gastroenterologists. Compared with its sister sites, MedicineNet contains more detailed and up-to-date information. For example, the section on medications not only describes indications and adverse effects, but also cites efficacy rates seen in major clinical trials. For some patients, the amount of detail and reading level may seem
GASTROENTEROLOGY Vol. 144, No. 1
overly complex, and articles too lengthy (the CD section is 21 pages). However, the website is easily navigable, so patients can read as little or as much as desired.
Crohn’s and Colitis Foundation of America (http://www.ccfa.org/) This website was recently updated and is maintained by a nonprofit organization that provides patient support and educational services. Basic articles on CD and UC can be accessed from the homepage, which for newly diagnosed patients provides brief but likely adequate disease and medication overviews. This website also provides a searchable “resources” database of in-depth articles and webcasts on specific issues (surgical options, pregnancy/ fertility issues, short bowel syndrome) written by national experts in the field. Also quite popular are the member forums, which allow patients to share experiences with surgery and specific drugs.
Foundation for Clinical Research in IBD (www.myibd.org) MyIBD.org is published by the Foundation for Clinical Research in IBD, a nonprofit research funding organization. This website provides an efficient overview of disease basics and medications with few links or images. Some items require updating (CT/MRI not included as diagnostic test options, adalimumab and natalizumab still listed as “Investigational Therapies”).
UptoDate (http://www.uptodate.com/ patients/contents/search?searchⴝ inflammatoryⴙbowelⴙdisease&spⴝ3) UptoDate is a clinical decision support system targeted at physicians, but it provides a limited number of free articles written for patients. Articles are regularly edited by experts in the field. There were overview articles on CD and UC as well as pregnancy in IBD. These were well organized and written clearly, although sections on diagnostics and medications were sparse. Throughout these free articles, there are multiple links to more detailed, professional-level information, although access requires a subscription.
Wikipedia (http://en.wikipedia.org/wiki/ Inflammatory_bowel_disease) Wikipedia is a free online encyclopedia based on an open-editable model (topics written by anonymous authors and edited by registered users). The website is organized in a simple, easily navigable format with quality images and tables. The articles on UC and CD cover certain areas well (symptoms, complications), but the treatment section contains multiple inaccuracies (which biologics approved for UC vs CD), and provides superficial coverage of accepted medications and a disproportionate reporting of experimental therapies (cannabanoids, fecal bacteriotherapy).
January 2013
CORRECTION
Bottom Line: Overall, all these patient websites on IBD were reasonable sources of information, although sections on diagnostic testing and medications were most prone to having incomplete, inaccurate, or outdated information. From the point of view of the patient, the 2 best websites are CCFA.org and MedicineNet.com. The CCFA website provides a curated, “patient-focused” experience with regularly updated resources and downloadable brochures, written/edited by experts in the field. The MedicineNet website provides in-depth and updated information, potentially for more sophisticated patients who may desire a more technical, data-driven reference on IBD.
249
FERNANDO VELAYOS University of California, San Francisco Center for Crohn’s and Colitis San Francisco, California CAROLINE HWANG University of Southern California Los Angeles, California References 1. 2. 3. 4. 5.
Cima RR, et al. 2007;13:1266 –1270. Cawdron R, et al. J Pediatr Gastroenterol Nutr 2002;35:518 –521. Bernard A, et al. Am J Gastroenterol 2007;102:2070 –2077. van der Marel S, et al. Inflamm Bowel Dis 2009;15:1891–1896. Langille M, et al. Clin Gastroenterol Hepatol 2010;8:322–328.
REVIEWER RATING CCFA Symptom description
夝夝夝夝
WebMD
eMedicine health
MedicineNet
夝夝夝夝夝
夝夝夝夝夝
夝夝夝夝夝
MyIBD 夝夝夝
Up To Date 夝夝夝夝
Wikipedia 夝夝夝
Differential diagnosis
夝夝
夝夝夝夝
夝夝夝夝
夝夝
夝
夝夝
夝
Testing
夝夝夝夝
夝夝夝夝夝
夝夝夝夝
夝夝夝夝夝
夝夝
夝
夝夝夝夝
Treatment
夝夝夝夝夝
夝夝夝夝
夝夝夝
夝夝夝夝夝
夝夝夝夝
夝夝夝
夝
Complications
夝夝夝夝夝
夝夝夝夝
夝夝夝
夝夝夝夝夝
夝夝
夝夝
夝夝夝夝
Supporting citation
夝夝夝
夝
夝夝
夝夝夝夝
夝
夝夝夝
夝夝夝夝
Quality of images
夝夝
夝夝夝
夝夝夝
夝夝夝
夝
夝夝
夝夝夝夝
Ease of navigation
夝夝夝夝
夝夝
夝夝夝
夝夝夝夝
夝夝夝夝
夝夝夝夝
夝夝夝夝
Stars: 夝: poor; 夝夝: adequate; 夝夝夝: fair; 夝夝夝夝: good; 夝夝夝夝夝: excellent.
Correction
Gross ER, Gershon MD, Margolis KG, et al. Neuronal serotonin regulates growth of the intestinal mucosa in mice. Gastroenterology 2012;143:408 – 417. Dr Zhishan Li should be listed as the 5th author in the above article but was inadvertently left off of the author byline. Dr Li’s affiliation is the Department of Pathology and Cell Biology, Columbia University, New York, New York.