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A Web of information untangled

We are drowning today in medical information -- and, by and large, that's a wonderful thing.

It was only a generation or so ago that it was considered radical when a bunch of Boston feminists dug out the kind of information we feel entitled to today and published the first ''Our Bodies, Ourselves," a nitty-gritty, user-friendly medical guide for women.

Now, 62.6 million Americans -- 37 percent of those who use the Internet -- mine it for medical information. In just a year, from August 2004 to August 2005, visits to medical websites grew a whopping 23 percent, according to ComScore Media Metrix, an Internet audience measurement company based in Reston, Va.

With such a surfeit, the challenge these days is to find trustworthy medical information amid all the profit-driven, misleading, or just plain erroneous stuff on the Net.

With 350 big medical sites to choose from, and thousands more lesser sites, zooming in efficiently on reliable information takes some practice. On the other hand, that's what I do all day.

So here, without further ado, are my favorite sites -- the ones I use frequently and trust for carefully vetted, understandable information:

The government actually does a wonderful job on medical websites. The best site by far for researching any disease -- and the only site you really need if you're trying to get the basics in a few hours -- is www.nih.gov, run by the National Institutes of Health.

From the main NIH site, you can get reasonably detailed information on many diseases, plus links to other excellent government sites such as www.clinicaltrials.gov, which lets you plug in your disease and state and get information on studies you can join.

Other good government sites for researching diseases and general health information are www.medlineplus.gov, which is run by the NIH and the National Library of Medicine; www.healthfinder.gov, put together by the department of Health and Human Services; and www.cancer.gov , run by the National Cancer Institute.

A more esoteric site that requires some heavy slogging is www.ahrq.gov, run by the Agency for Healthcare Research and Quality, part of HHS; it's not too user-friendly, but has excellent reviews of research on selected topics.

And if you're really a medical junkie, or have already mastered the basics of your disease and want to read medical studies, try PubMed, www.pubmed.gov, a search service from the National Library of Medicine that provides access to more than 11 million citations in medical journals. Once you find a journal article, you can usually get the abstract free; if you want the whole text, you can go to the journal in which it appeared, though you may have to register and pay.

Among the nongovernmental sites, my favorite is Consumer Reports' Medical Guide, www.consumerreportsmedicalguide.org. Much of the information here is free, though for some of the specific material, you have to pay $19 a year or $4.95 per month. The guide can help you sort out with your doctor whether you need a mastectomy or lumpectomy for breast cancer, for instance, or whether you need to treat your prostate cancer or not. (Consumer Reports also compiles a list of what it deems the 20 best sites on the web at www.healthratings.org.)

The country's most popular medical site is WebMD, www.webmd.com, which also ranks number one for quality on Consumer Reports' top 20 list. In the interest of full disclosure: I have a contract with WebMD to publish my columns. That said, I find the site too busy visually. On the other hand, there's a good reason the site is popular -- it's extensive and quite user-friendly.

Among the sites run by teaching hospitals, my favorite is the Mayo Clinic's, www.mayoclinic.com. It has clear information on many diseases and carries the two seals of approval you should look for on any medical website, one from Health on the Net, www.healthonnet.org, and the other from URAC, www.urac.org.

Both of these independent, nonprofit organizations use specific criteria to vet information on health websites. At URAC, website creators have to pay $7,000 to go through the accreditation process, though this does not assure accreditation. Health on the Net does not charge.

Many medical schools also have websites, though some of these are better at promoting their own doctors or research than giving general medical information.

One good one is Harvard's: Go to www.hms.harvard.edu and then click on ''consumer information," then ''intelihealth." The site is owned by Aetna Inc. but Harvard Medical School has editorial responsibility. The site has encyclopedic health information, as well as reviews of breaking medical news stories, an ''ask-the-expert" feature that answers selected e-mailed questions, and a number of interactive tools.

If it's drug information you're looking for, skip the US Food and Drug Administration's site, because it's not very helpful, and go to www.PDRHealth.com, which gives consumer-friendly information based on FDA-approved information taken from the Physicians' Desk Reference, the doctors' bible of drug information. Or try www.safemedication.com, run by the American Society of Health-System Pharmacists.

For comparisons of cost, safety and effectiveness of some commonly prescribed drugs, check out Consumer Report's relatively new offering, Best Buy Drugs, www.crbestbuydrugs.org.

Three final thoughts:

Steer clear of sites that promote a particular product, treatment, or doctor.

Check out your health plan on the web. Some offer medical, as well as insurance, information. Blue Cross Blue Shield of Massachusetts, www.bcbsma.com, for instance, has good, interactive material, though you have to cruise around a bit to find it.

And visit -- with caution -- the patient advocacy groups for whatever disease you're interested in. Some of the information may be biased, but going to these sites may at least suggest questions to ask your doctors about new treatments. Many patient advocacy sites also guide you to support groups.

Bottom line? It can be a jungle out there in medical cyberspace. But if you stick to the reputable sites, you can quickly become a very savvy patient.

Judy Foreman is a freelance columnist who can be contacted at foreman@globe.com.

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