Identifying Credible Sources of Health Information in Social Media: Principles and Attributes

12 October, 2022

Dear HIFA colleagues,

I was interested to read this paper and invite discussion on the isues raised. Below are the citation, abstract and selected extracts, followed by a comment from me.

CITATION: Identifying Credible Sources of Health Information in Social Media: Principles and Attributes

Raynard S. Kington et al.

Perspectives - Expert Voices in Health & Health Care, National Academy of Medicine

July 16, 2021

ABSTRACT: Social media is widely used as a source of health information for the general public. The potential for information shared through social media to influence health outcomes necessitates action by social media platforms to enhance access and exposure to high-quality, science-based information. This paper summarizes the work of an independent advisory group convened by the National Academy of Medicine that deliberated and gathered information to develop a set of initial principles and attributes that could inform platforms’ identification and possible elevation of credible sources of health information. Using these principles and attributes as a framework, the authors discuss the likelihood of credibility among major categories and types of nonprofit and government organizations that share health information through social media. The authors also emphasize the need for parallel strategies in addition to source evaluation, including assessment of content, as well as important ethical considerations such as the protection of free speech and individual autonomy. The paper also stresses that, in order to be considered credible themselves, social media platforms should share data with behavioral and public health researchers to understand the effects of such policies on both online

and offline behaviors.

SELECTED EXTRACTS

Algorithms used by SMPs and other web platforms often recommend content on the basis of users’ past behaviors and expressed interests, leading to passive or incidental exposure [6]. In

the case of low-quality health information, such reinforcement loops can be harmful...

Determining what constitutes high-quality health information is a complex and multidimensional process...

This paper focuses specifically on the evaluation of sources of health information, rather than content or design...

SMPs should invest in ongoing, rigorous research and analysis of this subject...

Scientific and medical collaborations with social media companies offer a unique opportunity to share high-quality health information with a broad audience.

People are resourceful when seeking health information, meaning that they consult many sources and often will not settle for the word of a single, “authoritative” entity...

A perfect solution to this challenge may not exist, but achieving something “better than” the status quo is a worthy goal.

Health on the Net (HON) Foundation Certification. HON is an international nonprofit organization based in Switzerland. HON certification holds health and medical websites accountable to basic ethical standards in the presentation of information, including sharing information from only trained and qualified professionals, respecting patient and consumer privacy, providing evidence in support claims, and disclosing financial interests, among others. Websites with HON certification earn the right to display a visual seal as an indication of their integrity...

Source evaluation cannot yield a complete solution to the challenge of increasing access to high-quality health information in social media. The credibility of a source is, at most, an indicator of information quality and by no means a guarantee.

The authors further limit their consideration in this paper to government and nonprofit organizations [based in the United States]

For the purposes of this paper, the authors present their own definition of credible in the context of sources of online health information: “offering information that is consistent with the best scientific evidence..."

Principle 1: Science-Based. Sources should provide information that is consistent with the best scientific evidence available at the time and meet standards for the creation, review, and presentation of scientific content...

Principle 2: Objective. Sources should take steps to reduce the influence of financial and other forms of conflict of interest or bias that might compromise or be perceived to compromise

the quality of the information they provide...

Principle 3: Transparent and Accountable. Sources should disclose the limitations of the information they provide, as well as confl icts of interest, content errors, or procedural missteps...

The authors suggest that SMPs do not at this time affix a formal label such as “credible” or “non-credible.” Instead, SMPs should provide contextual information that may serve as a “credibility cue” but stop short of a formal designation of credibility...

COMMENTS (NPW): This paper raises several issues/questions:

1. The need for reliable information and protection from misinformation is not in question, nor is the need for socialmedia companies to be less 'part of the problem' and more 'part of the solution'

2. Language is important. The authors choose the word 'credibility' and define it as 'offering information that is consistent with the best scientific evidence'. But the word 'credibility' is as much to do with the attitude of the user as it is with the inherent quality of the information. I prefer to use the word 'reliability' for 'consistent with the best scientific evidence'.

3. The three principles are self-evident.

4. 'The authors suggest that SMPs do not at this time affix a formal label such as “credible” or “non-credible.”' In my view, SMPs should not decide whether any given source is “credible” or “not-credible”.

5. The paper does not provide a simple way forward. This is badly needed.

6. The paper mentions the Health on the Net Foundation, which is an important acknowledgement given that the paper is supposed to be looking at US-based organisations only. Ever since I met the director Celia Boyer at the HoN Foundation in Geneva some 10 years ago, I have been impressed with their work. Their approach, for me, remains the most compelling (credible!) rationale and way forward. Like so many good initiatives, the HoN Foundation is limited by the size of their capacity relative too the task.

7. My suggestion, therefore, would be to bring stakeholders together to examine the potential of the HoN approach vis a vis other approoaches, and fund it accordingly.

Best wishes, Neil

Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org

Global Healthcare Information Network: Working in official relations with WHO