Improving the transparency of health information found on the internet through the honcode: a comparative study

Area of Science:

• Medical Informatics
• Health Communication
• Internet Ethics

Background:

• The Health on the Net Foundation (HONcode) developed quality and ethical standards to enhance transparency in online health information.
• Assessing ethical compliance is crucial for trustworthy health websites.

Purpose of the Study:

• To evaluate whether health websites not pursuing HONcode certification adhere to fundamental ethical standards.
• To compare the compliance rates of HONcode-certified websites versus non-certified websites regarding HONcode principles.

Main Methods:

• A comparative analysis was conducted on HONcode-certified websites and health websites that did not request certification.
• Compliance with all 8 HONcode principles, and specifically principles 1 (authority), 4 (attribution), 5 (justification), and 8 (honesty in advertising/editorial policy), was assessed.
• HON evaluators applied standardized criteria to all websites.

Main Results:

• Only 0.6% of non-certified health websites respected all eight HONcode ethical standards, compared to 89% of certified websites.
• For specific principles (1, 4, 5, 8), 1.2% of non-certified sites complied versus 92% of certified sites.
• HONcode certification significantly improved adherence to ethical standards and transparency in disclosing information production.

Conclusions:

• The HONcode certification process effectively drives health websites to adopt and maintain ethical and quality standards.
• Non-certified health websites demonstrate a substantial deficit in adhering to basic ethical guidelines for online health information.
• Certification encourages greater transparency regarding the origin and production of health content online.