We identified one study that had evaluated the quality of health websites related to asthma. The authors used the HON code as the basis for their evaluation [4]. They found that:

• 16% of the health websites examined met HON code criteria (principles)
• Of the websites that displayed the HON code logo (signifying that they subscribed to the principles), 38% actually complied with HON code principles [5].
  

We identified 22 criteria sets for assessing the "reliability" or "credibility" of health websites. They contained from 8 to 37 criteria. Most criteria pertained to content validity or accessibility or website transparency or credibility, including the currency of information. None of the 22 criteria sets met all 6 of our evaluation criteria. The most telling failures were lack of testing, lack of consumer-friendliness, and failure to define criteria in operational terms (virtually precluding their use to produce reliable ratings of health websites). Only one of the criteria sets was developed for use, and none was usable, by consumers.

There are no criteria sets (assessment tools) that are readily usable by consumers to assess health websites. Moreover, there are none that are readily usable by professionals to assess reliably health websites. In the next phase of the project, the Institute intends to develop, test, and apply such a tool to produce independent ratings of health websites. The Institute welcomes participation in this process. In the meantime, consumers may want to judge the "quality" of health websites based on a few consumer-friendly criteria. The website should be easy-to-use, and it should disclose at least the following information:

• Sponsorship — who owns/operates (pays) for it (to rule-out obvious potential conflicts of interest)
• Purpose/scope — the website's purpose and the scope of information presented (to judge the extent to which it matches the consumer's interests)
• Audience — for whom the information is intended, and its intended use (in this instance, it should be for consumers and the specified use of information should match the site visitor's reason for searching for information)
• Currency — when the website and/or webpage was last updated (and that should be recently)
• Source/credentials — for "facts" (articles), the source of the information, a description of authors' credentials, and, preferably, a link to the source.
  

The work described in this report builds on that started in 1997 when the Institute held a workshop on the quality of health information on the Internet [6].

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