QHII HWR project underpinnings

Quality of health information on the internet (QHII)
Health Website Ratings (HWR) project: Conceptual underpinnings

For purposes of assessing health websites, Health Improvement Institute (HII) has developed the following 3 dimensions/levels of website assessment. The ratings instrument is primarily intended to address the first 2 levels. The third one requires specific subject matter expertise, and, thus may be beyond raters' knowledge and/or capacity, and hence this project's scope.

Transparency/Accountability — a test that all types of website should pass
Editorial adequacy (based on policies/procedures) — a test that health information, self-help, and other types of health websites should pass
Information reliability — a test that "reliable" health information should pass (including that displayed on a health website), and one that is common to any published or communicated health information (and is thus not a special characteristic of health websites on which such information may be displayed). The routine assessment of the reliability (or accuracy or validity) of health information displayed on a website (that is, the completeness and accuracy of what is stated) is impractical for one or more of the following reasons:
1. A website may contain information on many health subjects, and it would be necessary to rate the validity of statements about each one
2. To rate the validity of health information requires a medical expert, or, preferably, panels of such experts; there might be considerable disagreement among experts
3. Ultimately, assessments of the reliability/validity of health information reflects the state of medical science.

The Institute recognizes an additional website dimension or attribute: Design.

Assessments of website transparency/accountability and editorial adequacy are important in their own right; not as a predictor of the reliability or validity ("accuracy") of the health information displayed on the website. The relationship between conformance to health website transparency/accountability and/or editorial policy/procedure criteria and the reliability or validity of health information displayed on the website is an empirical question that is beyond the scope of the current project. In the future, the Institute may compile an inventory of published research reports and/or undertake additional empirical research on the subject.