# HIPPP: Health Information Portal for Patients and Public
## 1 Introduction  
In the pre-internet era, individuals typically acquired information through direct interaction with what could be defined as reliable sources: experts, teachers, professionals, or printed media (encyclopedias, newspapers, etc. ), which were subject to content supervision/vetting and strict publishing standards. In the online era, the nature of how people obtain information has changed significantly, moving towards indirect, ad hoc connections with a multiplicity of sources that may have low levels of reliability [1]. As of 2019, 91% of Irish households had internet access and 63% of Irish internet users used the internet to access general healthcare information [2]. A 2011 study found that 63% of cancer patients use the internet to find healthcare information [3]. Given the general increase in internet adoption since then, it is likely that the current figures are even higher. For individuals with a non-medical education, such as most cancer patients and their loved ones, it is difficult to judge the reliability of WBHI. In the circumstance of a cancer diagnosis, it is natural that such individuals may turn to the internet to better educate themselves, verify the information they received from their physician, develop questions to discuss with their physician and/or seek alternative treatments. Given that inaccurate or incomplete healthcare information is so prevalent, the current information space is difficult to navigate. Considering that a 2014 study found that \"improvement of knowledge obtained through personal research on the internet, books and other media\" is an independent predictor of an active role in the choice of therapy [4], the current WBHI landscape may be causing some patients to base their healthcare decisions on incomplete or inaccurate information, with a detrimental effect on their health outcomes. The need for evaluation of WBHI quality was already recognised in the early days of the internet and a number of tools have been developed in the intervening years. The most notable evaluation tools are the JAMA criteria [5] and DISCERN [6]. Another instrument of note is The Health On the Net Code of Conduct (HONcode) for medical and health websites [7]: websites may display the HONcode seal if they agree to comply with their listed standards and are subjected to random audits to ensure compliance. However, there are significant issues with these existing methods for combating low-quality WBHI. JAMA and DISCERN are both manual: an expert must examine a website and evaluate it against the scoring criteria outlined in the respective framework. Given the volume of WBHI information currently on the internet and the rate at which new WBHI is being published, manual and time-consuming processes are not feasible because they do not scale and they are prone to individual interpretation of the criteria, violating uniformity. With respect to the HONcode instrument, a 2020 study about COVID-19 misinformation found that less than 2% of the websites returned by their Google searches had the HONcode seal [8]: HONcode is de facto irrelevant for the majority of internet users. Given both the growing but fragmented WBHI landscape and the current deficiencies in tools to combat low-quality WBHI, our project within the UL Cancer Network (ULCan) ([[https://www.ul.ie/hri/university-limerick-cancer-network-ulcan](https://www.ul.ie/hri/university-limerick-cancer-network-ulcan)]([https://www.ul.ie/hri/university-limerick-cancer-network-ulcan](https://www.ul.ie/hri/university-limerick-cancer-network-ulcan)) (accessed on 1 June 2023)) PPI Pillar aims to develop a web application that efficiently automates the evaluation of WBHI sources with respect to a number of criteria adopted from the established WBHI evaluation framework QUEST [9]. QUEST is designed to reduce the need for subjective judgement calls when compared to similar tools. QUEST has undergone a validation process and was bench-marked against the DISCERN and HONcode tools.