title: Consumer health information seeking as hypothesis testing.
abstract: OBJECTIVE
  Despite the proliferation of consumer health sites, lay individuals often experience difficulty finding health information online. The present study attempts to understand users' information seeking difficulties by drawing on a hypothesis testing explanatory framework. It also addresses the role of user competencies and their interaction with internet resources.
  
  
  METHODS
  Twenty participants were interviewed about their understanding of a hypothetical scenario about a family member suffering from stable angina and then searched MedlinePlus consumer health information portal for information on the problem presented in the scenario. Participants' understanding of heart disease was analyzed via semantic analysis. Thematic coding was used to describe information seeking trajectories in terms of three key strategies: verification of the primary hypothesis, narrowing search within the general hypothesis area and bottom-up search.
  
  
  RESULTS
  Compared to an expert model, participants' understanding of heart disease involved different key concepts, which were also differently grouped and defined. This understanding provided the framework for search-guiding hypotheses and results interpretation. Incorrect or imprecise domain knowledge led individuals to search for information on irrelevant sites, often seeking out data to confirm their incorrect initial hypotheses. Online search skills enhanced search efficiency, but did not eliminate these difficulties.
  
  
  CONCLUSIONS
  Regardless of their web experience and general search skills, lay individuals may experience difficulty with health information searches. These difficulties may be related to formulating and evaluating hypotheses that are rooted in their domain knowledge. Informatics can provide support at the levels of health information portals, individual websites, and consumer education tools.
authors.affiliation: Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institute of Health, Bethesda, MD, USA. keselmana@mail.nih.gov
authors.forename: Alla
authors.initials: A
authors.lastname: Keselman
authors.forename: Allen C
authors.initials: AC
authors.lastname: Browne
authors.forename: David R
authors.initials: DR
authors.lastname: Kaufman
mesh_terms: D000787:Angina Pectoris; D054626:Consumer Health Information; D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods*; D007257:Information Theory; D020407:Internet; D049293:MedlinePlus; D014584:User-Computer Interface