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I nvestigators from Nottingham, UK used the Google search engine to find answers and advice for five common pediatric questions. The questions had clear and distinct answers: 1) Is there a link between MMR and autism? 2) Should an HIV-positive mother breastfeed? 3) Should a mother with mastitis breastfeed? 4) Should a baby sleep prone or supine? and 5) What action should be taken for a baby with green vomit? For each of the five items, the researchers assessed the first 100 web sites that appeared from their search and categorized them into seven different types: government/national health service, educational, new sites, company, interest group, individual person's site, and sponsored link. The information given on the web sites was classified as: correct or consistent with current recommendations, incorrect or against current recommendations, or did not answer the question.Of the 500 web sites reviewed, a correct answer to the question of interest was provided in 197 (39%), but the question was not answered on many sites and when those were discounted, 78% gave correct answers. However, incorrect answers were provided on 57 of 500 sites (11%). Governmental sites were flawless, giving correct answers every time. Correct answers were given from news sites 55% of the time and none of the responses on sponsored sites were correct. The other four site categories were accurate approximately 80% of the time. The question regarding MMR and autism was answered correctly 44% of the time, while information regarding HIV and breastfeeding was correct in 35% of the web sites. Inappropriate responses were given 41% of the time on the question relative to mastitis and breastfeeding, 57% of the time on the question relative to a baby's sleeping position, and 83% of the time on the question relative to green vomit.The authors conclude that the quality of medical advice provided by the internet is variable and that physicians should continue to strive to be the major source of health care information for their patients, and should refer patients to reliable internet sources.

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