NEW YORK (Reuters Health) - Health-information seekers too ashamed to admit to their physicians that they were harmed in some way by following bad health advice gleaned from the Internet may account, at least in part, for the lack of published accounts of such harm, according to a Canadian researcher.

Many studies published over the years have outlined the inadequacies of health information available on the Internet. But there have been few reports of people being harmed as the result of obtaining misleading health information on the Internet, according to a report in the June 5th issue of The Journal of the American Medical Association.

Lead author Dr. Anthony G. Crocco of McGill University in Montreal, Canada and colleagues reviewed 186 journal articles on Internet health information and found few cases of actual harm, they report.

"We only found four cases, but we were expecting to find many more," Dr. Alejandro R. Jadad of Toronto General Hospital, one of the study's authors, told Reuters Health in an interview. "This could be because the Internet is less harmful than we thought, but we doubt that.

"We believe that there is more harm, but people do not share that information with their doctors because they feel embarrassed," he added.

In their investigation, the team of researchers identified just three published articles that satisfied their criteria--meaning they described "at least one case of harm associated with the use of health information found on the Internet."

One article described two cases in which parents' misguided searches of the Internet for information on birth defects led to severe emotional distress. Another article described an owner's inadvertent poisoning of three dogs, after the person had obtained false information about heartworm treatment on the Web.

The third article, and the only one to report a death, described a 55-year-old man with cancer who took an alternative remedy that he had obtained on the Internet for several months. The medication caused multiple complications that resulted in liver and kidney failure and death.

While the lack of published articles on harm associated with Internet health information is "unfortunate," the authors write, it is "not unexpected."

Crocco and his team rule out several explanations, noting that it is "possible but unlikely," that little harm actually occurs as a result of inaccurate health information taken from the Web. They suggest that many cases do happen, but go unreported.

Jadad said he is inclined to believe that the main reason for the lack of published case studies describing people harmed by false information obtained on the Internet is people's unwillingness to admit that something bad happened to them.

"Patients do not feel comfortable talking about their use of the Internet, especially when it has led to harm," Jadad told Reuters Health.

"But also health professionals are not used to asking people about their use of the Internet," he added. "Physicians should be asking patients about the use of the Internet as part of their interview and history taking."

SOURCE: The Journal of the American Medical Association 2002;287:2869-

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