There is concern about the potential harm associated with the use of
poor quality health information on the Internet. To date, there have been
no systematic attempts to examine reported cases of such harm.
We conducted a systematic review of the peer-reviewed literature, to
evaluate the number and characteristics of reported cases of harm associated
with the use of health information obtained on the Internet. Using a refined
strategy, we searched MEDLINE (from 1966 to February 2001), CINAHL (from 1982
to March 2001), HealthStar (from 1975 to December 2000), PsycINFO (from 1967
to March 2001), and EMBASE (from 1980 to March 2001). This was complemented
with searches of reference lists. Two authors separately reviewed the abstracts
to identify articles that describe at least 1 case of harm associated with
the use of health information found on the Internet. Articles of any format
and in any language deemed possibly relevant by either researcher were obtained
and reviewed by both researchers.
The search yielded 1512 abstracts. Of these 186 papers were reviewed
in full text. Of these, 3 articles satisfied the selection criteria. One article
described 2 cases in which improper Internet searches led to emotional harm.
The second article described dogs being poisoned because of misinformation
obtained on the Internet. The third article described hepatorenal failure
in an oncology patient who obtained misinformation about the use of medication
on the Internet.
Despite the popularity of publications warning of the potential harm
associated with using health information from the Internet, our search found
few reported cases of harm. This may be due to an actual low risk for harm
associated with the use of information available on the Internet, to underreporting
of cases, or to bias.