Internet health resources: from quality to trust.
OBJECTIVE
Quality of online health resources remains a much debated topic, despite considerable international efforts. The lack of a systematic and comprehensive conceptual analysis is hindering further progress. Therefore we aim at clarifying the origins, nature and interrelations of pertinent concepts. Further, we claim that quality is neither a necessary nor a sufficient condition for Internet health resources to produce an effect offline. As users' trust is also required, we examine the relation of quality aspects to trust building online.


METHODS
We reviewed and analyzed the key documentation and deliverables of quality initiatives, as well as relevant scientific publications. Using the insights of philosophy, we identified the elementary dimensions which underlie the key concepts and theories presented so far in the context of online health information quality. We examined the interrelations of various perspectives and explored how trust as a phenomenon relates to these dimensions of quality.


RESULTS
Various aspects associated with the quality of online health resources originate from four conceptual dimensions: epistemic, ethical, economic and technological. We propose a conceptual framework that incorporates all these perspectives. We argue that total quality exists only if all four dimensions have been addressed adequately and that high total quality is conducive to warranted trust.


CONCLUSIONS
Quality and trust are intertwined, but distinct concepts, and their relation is not always straightforward. Ideally, trust should track quality. Apprehending the composition of these concepts will help to understand and guide the behavior of both users and providers of online information, as well as to foster warranted trust in online resources. The framework we propose provides a conceptual starting point for further deliberations and empirical work.
Finnish Office for Health Care Technology Assessment, STAKES, Helsinki, Finland. kristian.lampe@stakes.fi
K
K
Lampe
P
P
Doupi
M Jeroen
MJ
van den Hoven
D005060:Europe; D006295:Health Resources / Q000941:ethics / Q000592:standards*; D006801:Humans; D007255:Information Services / Q000941:ethics / Q000592:standards*; D020407:Internet / Q000941:ethics / Q000592:standards*; D019359:Knowledge; D011786:Quality Control; D035502:Trust