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This past fall the Boston Globe reported that several organizations have already started to develop variations along these lines. For example, officials with the American Medical Association have published “core standards” consumers can use to consider the relative value of online health information, and the Health on the Net Foundation in Geneva has created a logo for medical Web sites that include “principles” set forth by that organization. This coming spring the Health Information Technology Institute (HITI)-which is associated with Mitretek, a nonprofit environmental and engineering-technology organization of McLean, Va.-plans to publicly offer medical-information “quality” criteria. HITI has spent the past year organizing the group developing the criteria so that it has the kinds of constituents I’m suggesting; the group’s members range from doctors to consumer representatives.

Physicians and researchers need to recognize that since the public now has easy access to their literature, clarity is a virtue. Moreover, papers that lay readers can understand may help provide something of a bridge to those people who mistrust doctors because we want treatments to undergo proper scientific review and insist on or at least try to provide evidence-based medicine. Doctors would also do well to make the effort to refer individuals and families with serious or rare conditions to appropriate lay support groups that usually offer the benefits of collective experience and good sources of information-which can include Web sites.

The information revolution has compounded the complexity of doctor-patient relationships. The Internet has essentially enabled patients and families to easily seek second opinions, and third ones, and more. Given two provisos, this can produce benefits for both concerned patients and busy medical practitioners, who presumably want the best outcomes for their patients. Laypeople must have the means to understand and evaluate the strength and validity of the information they obtain. At the same time, they should not expect their doctors to have the luxury of time or economy of practice to “surf” with them.

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