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      Health Information Obtained From the Internet and Changes in Medical Decision Making: Questionnaire Development and Cross-Sectional Survey

      research-article
      , MD, MPH, PhD 1 , , MSc, MD 2 , , PhD 3 , , , PhD 3
      (Reviewer), (Reviewer), (Reviewer), (Reviewer), (Reviewer)
      Journal of Medical Internet Research
      JMIR Publications
      internet, help-seeking behavior, literacy, decision making

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          Abstract

          Background

          The increasing utilization of the internet has provided a better opportunity for people to search online for health information, which was not easily available to them in the past. Studies reported that searching on the internet for health information may potentially influence an individual’s decision making to change her health-seeking behaviors.

          Objective

          The objectives of this study were to (1) develop and validate 2 questionnaires to estimate the strategies of problem-solving in medicine and utilization of online health information, (2) determine the association between searching online for health information and utilization of online health information, and (3) determine the association between online medical help-seeking and utilization of online health information.

          Methods

          The Problem Solving in Medicine and Online Health Information Utilization questionnaires were developed and implemented in this study. We conducted confirmatory factor analysis to examine the structure of the factor loadings and intercorrelations for all the items and dimensions. We employed Pearson correlation coefficients for examining the correlations between each dimension of the Problem Solving in Medicine questionnaire and each dimension of the Online Health Information Utilization questionnaire. Furthermore, we conducted structure equation modeling for examining the possible linkage between each of the 6 dimensions of the Problem Solving in Medicine questionnaire and each of the 3 dimensions of the Online Health Information Utilization questionnaire.

          Results

          A total of 457 patients participated in this study. Pearson correlation coefficients ranged from .12 to .41, all with statistical significance, implying that each dimension of the Problem Solving in Medicine questionnaire was significantly associated with each dimension of the Online Health Information Utilization questionnaire. Patients with the strategy of online health information search for solving medical problems positively predicted changes in medical decision making ( P=.01), consulting with others ( P<.001), and promoting self-efficacy on deliberating the online health information ( P<.001) based on the online health information they obtained.

          Conclusions

          Present health care professionals have a responsibility to acknowledge that patients’ medical decision making may be changed based on additional online health information. Health care professionals should assist patients’ medical decision making by initiating as much dialogue with patients as possible, providing credible and convincing health information to patients, and guiding patients where to look for accurate, comprehensive, and understandable online health information. By doing so, patients will avoid becoming overwhelmed with extraneous and often conflicting health information. Educational interventions to promote health information seekers’ ability to identify, locate, obtain, read, understand, evaluate, and effectively use online health information are highly encouraged.

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          Most cited references30

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          Multivariate Data Analysis

          For over 30 years, this text has provided students with the information they need to understand and apply multivariate data analysis. This text provides an applications-oriented introduction to multivariate analysis for the non-statistician. By reducing heavy statistical research into fundamental concepts, the text explains to students how to understand and make use of the results of specific statistical techniques. In this revision, the organization of the chapters has been greatly simplified. New chapters have been added on structural equations modeling, and all sections have been updated to reflect advances in technology, capability, and mathematical techniques. :Pearson New International Edition.
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            Major health care problems such as patient dissatisfaction, inequity of access to care, and spiraling costs no longer seem amenable to traditional biomedical solutions. Concepts derived from anthropologic and cross-cultural research may provide an alternative framework for identifying issues that require resolution. A limited set of such concepts is described as illustrated, including a fundamental distinction between disease and illness, and the notion of the cultural construction of clinical reality. These social science concepts can be developed into clinical strategies with direct application in practice and teaching. One such strategy is outlined as an example of a clinical social science capable of translating concepts from cultural anthropology into clinical language for practical application. The implementation of this approach in medical teaching and practice requires more support, both curricular and financial.
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              The news media are an important source of information about new medical treatments, but there is concern that some coverage may be inaccurate and overly enthusiastic. We studied coverage by U.S. news media of the benefits and risks of three medications that are used to prevent major diseases. The medications were pravastatin, a cholesterol-lowering drug for the prevention of cardiovascular disease; alendronate, a bisphosphonate for the treatment and prevention of osteoporosis; and aspirin, which is used for the prevention of cardiovascular disease. We analyzed a systematic probability sample of 180 newspaper articles (60 for each drug) and 27 television reports that appeared between 1994 and 1998. Of the 207 stories, 83 (40 percent) did not report benefits quantitatively. Of the 124 that did, 103 (83 percent) reported relative benefits only, 3 (2 percent) absolute benefits only, and 18 (15 percent) both absolute and relative benefits. Of the 207 stories, 98 (47 percent) mentioned potential harm to patients, and only 63 (30 percent) mentioned costs. Of the 170 stories citing an expert or a scientific study, 85 (50 percent) cited at least one expert or study with a financial tie to a manufacturer of the drug that had been disclosed in the scientific literature. These ties were disclosed in only 33 (39 percent) of the 85 stories. News-media stories about medications may include inadequate or incomplete information about the benefits, risks, and costs of the drugs as well as the financial ties between study groups or experts and pharmaceutical manufacturers.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                February 2018
                12 February 2018
                : 20
                : 2
                : e47
                Affiliations
                [1] 1 Graduate Institute of Medical Education & Bioethics National Taiwan University College of Medicine Taipei Taiwan
                [2] 2 Department of Family Medicine National Taiwan University Hospital Bei-Hu Branch Taipei Taiwan
                [3] 3 Program of Learning Sciences National Taiwan Normal University Taipei Taiwan
                Author notes
                Corresponding Author: Jyh-Chong Liang aljc@ 123456ntnu.edu.tw
                Author information
                http://orcid.org/0000-0003-4924-9053
                http://orcid.org/0000-0002-0402-243X
                http://orcid.org/0000-0002-2423-5950
                http://orcid.org/0000-0001-7744-9971
                Article
                v20i2e47
                10.2196/jmir.9370
                5826978
                29434017
                462baf34-7216-4a09-9b47-352ada7c3287
                ©Yen-Yuan Chen, Chia-Ming Li, Jyh-Chong Liang, Chin-Chung Tsai. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.02.2018.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 9 November 2017
                : 16 December 2017
                : 26 December 2017
                : 8 January 2018
                Categories
                Original Paper
                Original Paper

                Medicine
                internet,help-seeking behavior,literacy,decision making
                Medicine
                internet, help-seeking behavior, literacy, decision making

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