JMIR Publications

ABSTRACT

Background:

As people increasingly turn to online sources for medical information, we offer some insight into what website traits influence patient’s credibility assessment. Specifically, we control for brand and content length, while manipulating three website traits: (1) authorship, (2) format, and (3) tone. Further, we focus on medical skepticism to understand how patients with high levels of medical skepticism may react to online medical information differently. Medical skepticism is related to a patient’s doubts about the value of conventional medical care, and therefore skeptics may have different practices and criteria when conducting their own online medical searches.

Objective:

This study evaluates how website traits impact the likelihood that patients follow online medical advice and how this varies in patients with differing levels of medical skepticism.

Methods:

This experiment presented participants with a hypothetical medical situation about leg cramps and offered a website with treatment advice. We varied the websites the participants observed across three traits: (1) authorship: patient or physician, (2) format: article or discussion forum, (3) tone: objective or experience-based. The 2,305 participants were randomly assigned one of eight possible conditions and then asked the extent to which they would follow the advice. Healthcare patterns and coverage, demographics, and their level of medical skepticism were captured.

Results:

Our panel data was selected to be demographically representative of the population of internet users in the United States. The 2,305 complete responses were analyzed with OLS regression. Our analysis reveals that people are more likely to accept online medical advice authored by a physician (P-value<.001) and presented with an objective tone (P-value<.001), but those preferences erode as levels of medical skepticism increase. Medical skepticism was measured via a previously established index on a 0-4 scale, and the average score was 2.26 with a standard deviation of 0.84. Individuals with higher levels of medical skepticism were more likely to follow online medical advice in our experiment (P-value<.001). Individuals with low levels of medical skepticism found online discussion forums more credible, while those with high levels of medical skepticism preferred articles (P-value<.01). We discuss the interactions between medical skepticism and all three website traits manipulated in the experiment.

Conclusions:

Our findings suggest that, generally, physician authorship and an objective tone create more persuasive online medical advice. But, there are differences in how patients with high levels of medical skepticism react to online medical resources. Medical skeptics are less discerning regarding the author’s credentials and the presentation tone of the information. Further, those with higher levels of medical skepticism prefer article format presentations, whereas those with lower levels prefer forum-style formatting.