How the users make the judgment on the quality of online health information: A cross-sectional survey study (Preprint)

BACKGROUND People are increasingly using the Internet to seek for health information. However, the overall quality of online health information remains low. The situation is exacerbated by the unprecedented “infodemic”, the flood of rumors and conspiracy theories through various online platforms, which brings about negative consequences to patients. Therefore, it is important to understand how users make these judgments to help them in making better judgments on health information quality, as well as providing customized information services for different groups of users during the pandemic. OBJECTIVE The objective of this study is to find out how patients apply these different criteria in their judgment of online health information quality during the pandemic, in terms of how frequently they apply these criteria and how important they consider them. In particular, we are going to investigate whether there is a consistency between the likelihood to use a particular criterion and its perceived importance in judging the quality of health information among group of users with different demographics (age, gender, educational and income levels) and levels of health literacy. METHODS A cross-sectional survey was conducted in one of the leading hospitals from a coastal province of China with a population of forty million. A combined-strategy sampling (randomization stratification and systematic sampling) was taken to balance the randomness and the practicality of the recruiting process. 1063 patients were recruited in this study. Two kinds of statistical analysis were adopted in this study. For whether a particular criterion was used by the patient, Chi-square analysis was used to compare the group differences in the frequency of criterion use since it was a binary variable. For the perceived importance of each criterion, non-parametric analysis (Kruskal-Wallis) was used to compare the group differences (the normal distribution assumption was not guaranteed). RESULTS It was found that the pattern of the inclination to use certain criteria to judge the quality of online information was not always consistent with the pattern of their perceived importance among patient groups with different ages, genders, educational levels, and eHealth literacy levels. For particular criteria such as familiarity, identification, and readability, patients in one demographic group may not use them more frequently than other groups even they consider these criteria as more important than the other groups do. Moreover, patients in particular groups may use these criteria more frequently even they do not consider them as more important than other groups do. Furthermore, it is surprised to find that patients merely with the primary school degree considered the comprehensiveness criterion as more important than those with the bachelor's degree but less likely to use it in practice, which is counter-intuitive to our commonsense. In the coming sections, the results are interpreted and discussed with both theoretical and practical implications. CONCLUSIONS To the best of our knowledge, it is the first study to investigate the consistency between the pattern of the likelihood to use certain quality judgment criteria and the pattern of their perceived importance among patients grouped by different demographic variables and eHealth literacy levels. The findings share lights on how to improve the online health information services and provide fine-grained customization of information for users, which make the judgment easier and faster.