You Get What You Pay for on Health Care Question and Answer Platforms: Nonparticipant Observational Study

Area of Science:

• Health Informatics
• Digital Health
• Information Science

Background:

• Internet health information seeking is popular but quality is variable.
• Web-based Question and Answer (Q&A) platforms offer personalized health advice.
• Ensuring the quality of health advice on these platforms is unclear.

Purpose of the Study:

• To determine how platform design influences the quality of online health advice.
• To assess the impact of design on equitable access to internet health information.

Main Methods:

• Collected 900 Q&As from 9 distinct Q&A platforms.
• Quantified health advice quality using paid physician evaluations.
• Analyzed design features impacting information quality via statistical methods (LASSO, unbiased regression trees).

Main Results:

• Platform design is linked to health advice quality.
• Key predictors of quality include provider expertise (β=.48), financial incentives (β=.4), external reputation (β=.28), and question quality (β=.12).
• Virtual incentives, Web 2.0, and reputation systems did not correlate with quality.

Conclusions:

• Internet health advice quality is unequally distributed, favoring affluent and highly literate populations.
• High-quality health advice can be generated at no cost.
• Platform design elements are crucial for improving online health information quality and access.