title: Automated Detection of HONcode Website Conformity Compared to Manual Detection: An Evaluation.
abstract: BACKGROUND
  To earn HONcode certification, a website must conform to the 8 principles of the HONcode of Conduct In the current manual process of certification, a HONcode expert assesses the candidate website using precise guidelines for each principle. In the scope of the European project KHRESMOI, the Health on the Net (HON) Foundation has developed an automated system to assist in detecting a website's HONcode conformity. Automated assistance in conducting HONcode reviews can expedite the current time-consuming tasks of HONcode certification and ongoing surveillance. Additionally, an automated tool used as a plugin to a general search engine might help to detect health websites that respect HONcode principles but have not yet been certified.
  
  
  OBJECTIVE
  The goal of this study was to determine whether the automated system is capable of performing as good as human experts for the task of identifying HONcode principles on health websites.
  
  
  METHODS
  Using manual evaluation by HONcode senior experts as a baseline, this study compared the capability of the automated HONcode detection system to that of the HONcode senior experts. A set of 27 health-related websites were manually assessed for compliance to each of the 8 HONcode principles by senior HONcode experts. The same set of websites were processed by the automated system for HONcode compliance detection based on supervised machine learning. The results obtained by these two methods were then compared.
  
  
  RESULTS
  For the privacy criterion, the automated system obtained the same results as the human expert for 17 of 27 sites (14 true positives and 3 true negatives) without noise (0 false positives). The remaining 10 false negative instances for the privacy criterion represented tolerable behavior because it is important that all automatically detected principle conformities are accurate (ie, specificity [100%] is preferred over sensitivity [58%] for the privacy criterion). In addition, the automated system had precision of at least 75%, with a recall of more than 50% for contact details (100% precision, 69% recall), authority (85% precision, 52% recall), and reference (75% precision, 56% recall). The results also revealed issues for some criteria such as date. Changing the "document" definition (ie, using the sentence instead of whole document as a unit of classification) within the automated system resolved some but not all of them.
  
  
  CONCLUSIONS
  Study results indicate concordance between automated and expert manual compliance detection for authority, privacy, reference, and contact details. Results also indicate that using the same general parameters for automated detection of each criterion produces suboptimal results. Future work to configure optimal system parameters for each HONcode principle would improve results. The potential utility of integrating automated detection of HONcode conformity into future search engines is also discussed.
authors.affiliation: Health On the Net Foundation, Chêne-Bourg, Switzerland. Celia.Boyer@HealthOnNet.org.
authors.forename: Célia
authors.identifier: http://orcid.org/0000-0002-1607-3066
authors.initials: C
authors.lastname: Boyer
authors.forename: Ljiljana
authors.identifier: http://orcid.org/0000-0002-0656-5315
authors.initials: L
authors.lastname: Dolamic
mesh_terms: D000329:Advertising; D001331:Automation; D002568:Certification / Q000379:methods*; D054626:Consumer Health Information / Q000592:standards*; D030881:Disclosure; D006801:Humans; D020407:Internet / Q000592:standards*; D009323:Natural Language Processing; D018907:Privacy; D057386:Search Engine
keywords: HONcode; artificial intelligence; classification; natural language processing; quality standards