Analysis of cases of harm associated with use of health information on the internet.

CONTEXT: 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. METHODS: 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 researches. RESULTS: 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. CONCLUSIONS: 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.