title: Web search behavior and information needs of people with multiple sclerosis: focus group study and analysis of online postings.
abstract: BACKGROUND
  Multiple sclerosis (MS) patients and their family members increasingly seek health information on the Internet. There has been little exploration of how MS patients integrate health information with their needs, preferences, and values for decision making. The INtegrating and Deriving Evidence, Experiences, and Preferences (IN-DEEP) project is a collaboration between Italian and Australian researchers and MS patients, aimed to make high-quality evidence accessible and meaningful to MS patients and families, developing a Web-based resource of evidence-based information starting from their information needs.
  
  
  OBJECTIVE
  The objective of this study was to analyze MS patients and their family members' experience about the Web-based health information, to evaluate how they asses this information, and how they integrate health information with personal values.
  
  
  METHODS
  We organized 6 focus groups, 3 with MS patients and 3 with family members, in the Northern, Central, and Southern parts of Italy (April-June 2011). They included 40 MS patients aged between 18 and 60, diagnosed as having MS at least 3 months earlier, and 20 family members aged 18 and over, being relatives of a person with at least a 3-months MS diagnosis. The focus groups were audio-recorded and transcribed verbatim (Atlas software, V 6.0). Data were analyzed from a conceptual point of view through a coding system. An online forum was hosted by the Italian MS society on its Web platform to widen the collection of information. Nine questions were posted covering searching behavior, use of Web-based information, truthfulness of Web information. At the end, posts were downloaded and transcribed.
  
  
  RESULTS
  Information needs covered a comprehensive communication of diagnosis, prognosis, and adverse events of treatments, MS causes or risk factors, new drugs, practical, and lifestyle-related information. The Internet is considered useful by MS patients, however, at the beginning or in a later stage of the disease a refusal to actively search for information could occur. Participants used to search on the Web before or after their neurologist's visit or when a new therapy was proposed. Social networks are widely used to read others' stories and retrieve information about daily management. A critical issue was the difficulty of recognizing reliable information on the Web. Many sources were used but the neurologist was mostly the final source of treatment decisions.
  
  
  CONCLUSIONS
  MS patients used the Internet as a tool to integrate information about the illness. Information needs covered a wide spectrum, the searched topics changed with progression of the disease. Criteria for evaluating Internet accuracy and credibility of information were often lacking or generic. This may limit the empowerment of patients in health care choices.
authors.affiliation: IRCCS-Mario Negri Institute for Pharmacological Research, Milano, Italy, Department of Public Health, Laboratory for medical research and consumer involvement, Milano, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Colombo
authors.forename: Paola
authors.initials: P
authors.lastname: Mosconi
authors.forename: Paolo
authors.initials: P
authors.lastname: Confalonieri
authors.forename: Isabella
authors.initials: I
authors.lastname: Baroni
authors.forename: Silvia
authors.initials: S
authors.lastname: Traversa
authors.forename: Sophie J
authors.initials: SJ
authors.lastname: Hill
authors.forename: Anneliese J
authors.initials: AJ
authors.lastname: Synnot
authors.forename: Nadia
authors.initials: N
authors.lastname: Oprandi
authors.forename: Graziella
authors.initials: G
authors.lastname: Filippini
keywords: Internet; Web search behavior; evidence-based information; information needs; multiple sclerosis; patients’ involvement
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