Oncology health information quality on the Internet: a multilingual evaluation.

BACKGROUND: Oncologic Internet information quality is considered variable, but no comprehensive analysis exists to support this. We compared the quality of common malignancy Web sites to assess them for language or disease differences and to perform a quality comparison between medical and layperson terminology. METHODS: World Health Organization Health on the Net (HON) principles may be applied to Web sites by using an automated toolbar function. We used the Google search engine ( http://www.google.com ) to assess 10,200 Web sites using the keywords "Breast," "Colorectal," "Stomach," "Liver," "Pancreas," "Bile Duct," "Melanoma," and "Thyroid," plus "cancer," in English, French, German, and Spanish. The searches were then repeated with alternative terms, such as "Bowel" and "Skin cancer." RESULTS: Less than a quarter of Web sites are HON accredited, with significant differences by malignancy type (P < 0.0001), language (P < 0.0001), and tertiles of the first 150 Web sites returned (P < 0.0001). French-language queries resulted in the most accredited Web sites returned. The use of alternative terms resulted in marked differences in accredited Web sites for hepatobiliary cancers. CONCLUSIONS: A lack of validation of most oncologic sites is present, with discrepancies in the quality and number of Web sites across diseases and languages, as well as medical and alternative terms. Physicians should encourage and participate in the development of informative, ethical, and reliable health Web sites on the Internet and direct patients to them.

Are 1994 alcohol production and the sales deregulation policy in Japan associated with increased road traffic fatalities among adult and teenage males and females in Japan?

INTRODUCTION: International studies have shown a significant association between alcohol availability and traffic crashes that involve alcohol-impaired drivers. A key limitation to previous alcohol availability and motor vehicle crash (MVC) evaluation research is the assumption of population homogeneity in responding to the policies. The present analysis focuses on the evaluation of the impact of alcohol availability on different segments of the Japanese population by comparing MVC fatality rates from before and after implementation of the alcohol deregulation policy in 1994. SUBJECTS AND METHOD: Poisson regression with robust standard error was used to model the before-to-after change in incidence rate ratios (IRR) in adult males, adult females, teenage males and teenage females. To control potential confounders, unemployment rate, vehicle miles of travel (VMT), vehicle registration, and number of drivers licensed in Japan were added to the model. The exponents of the fitted coefficients are equivalent to incidence rate ratios. RESULTS: Implementation of the policy deregulating alcohol sales and production did not appear to increase traffic fatalities among adult or teenage males or females in Japan. We found that male adult fatalities demonstrated a statistically significant decline following enactment of the deregulation policy in 1994. DISCUSSION: Contrary to previous research, the findings of this study demonstrated lower rates of fatalities and higher compliance with alcohol-related driving legislation in Japanese society following implementation of the deregulation policy in 1994. Further well designed, nonaligned studies on alcohol availability and traffic fatalities in other countries are urgently needed.

Does obesity increase the risk of injury or mortality in motor vehicle crashes? A systematic review and meta-analysis.

The objective of this review was to assess the risk of obesity in injuries and fatalities resulting from motor vehicle crash (MVC), as compared with individuals with a normal-range body mass index. A systematic review of the literature was conducted yielding 824 potential studies. Nine of these studies met our inclusion criteria. Meta-analyses examining obesity as a risk factor for various injury types and risk of fatality were conducted using data from these studies. Obesity was associated with higher fatality risk (odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.51-2.37, P = .0001; pooled estimate from 6 studies), and increased risk of lower extremity fractures (OR = 1.39, 95% CI = 1.18-1.65, P = .0001; pooled estimate from 2 studies). No significant differences were observed when considering abdominal injuries or pelvic fractures. Interestingly, for head injuries obesity was a protective factor (OR = 0.67, 95% CI = 0.46-0.97, P = .0001; pooled data from 3 studies). Evidence strongly supports the association of obesity with higher fatality and fractures of the lower extremities in MVCs. Contrary to our hypothesis, 3 studies showed that obesity was a protective factor in reducing head injuries. Furthermore, the review shows that obesity was not a risk factor of MVC-related pelvic fractures and abdominal injuries.