Neunez Marie, Goldman Michel, Ghezzi Pietro
Institute for Interdisciplinary Innovation in Healthcare, Université Libre de Bruxelles, Brussels, Belgium.
Department of Medicine, Brighton and Sussex Medical School, Brighton, United Kingdom.
Front Med (Lausanne). 2020 Jan 15;6:296. doi: 10.3389/fmed.2019.00296. eCollection 2019.
Probiotics are over-the-counter products marketed for enhancing human health. Online information has been key in promoting probiotics worldwide. However, only few rigorous clinical studies have met the stringent criteria required to establish the efficacy and safety of probiotics. The present study was undertaken to assess the information quality of webpages referring to probiotics and to compare the recommendations available online with the information collected from trusted scientific sources. We evaluated 150 webpages returned by Google searching "probiotics" in terms of typology of website, health information quality based on the JAMA score and the HONcode certification, as well as completeness of the information based on the presence of four criteria: (1) links to scientific references supporting health claims, (2) cautionary notes about level of evidence for alleged benefits, (3) safety considerations, and (4) regulatory status. We then enumerated the health claims mentioned online and the corresponding clinical trials and reviews registered in the Cochrane library. Finally, the conclusions of Cochrane reviews were used to assess the level of scientific evidence of the information available through Google search. HON-certified websites were significantly more frequent in the top 10 websites than in the remaining websites. In terms of completeness of information, only 10% of webpages met all four criteria, 40% had a cautionary note on benefits, 35% referred to scientific literature, and only 25% mentioned potential side effects. The results of the content analysis led us to conclude that: (1) the most frequent typologies of webpages returned by Google are commercial and news, (2) commercial websites on average provide the least reliable information, and (3) significant numbers of claimed benefits of probiotics are not supported by scientific evidence. This study highlights important biases in the probiotics information available online, underlining the need to improve the quality and objectivity of information provided to the public.
益生菌是作为促进人类健康销售的非处方产品。在线信息在全球推广益生菌方面发挥了关键作用。然而，只有少数严格的临床研究符合确立益生菌功效和安全性所需的严格标准。本研究旨在评估提及益生菌的网页的信息质量，并将在线提供的建议与从可靠科学来源收集的信息进行比较。我们根据网站类型、基于《美国医学会杂志》评分和健康在线网络认证的健康信息质量，以及基于四个标准的信息完整性，对谷歌搜索“益生菌”返回的150个网页进行了评估：（1）支持健康声明的科学参考文献链接；（2）关于所谓益处证据水平的警示说明；（3）安全考虑因素；（4）监管状态。然后，我们列举了在线提及的健康声明以及在考克兰图书馆注册的相应临床试验和综述。最后，考克兰综述的结论被用于评估通过谷歌搜索获得的信息的科学证据水平。在排名前十的网站中，获得健康在线网络认证的网站比其他网站更为常见。在信息完整性方面，只有10%的网页符合所有四个标准，40%的网页对益处有警示说明，35%的网页引用了科学文献，只有25%的网页提到了潜在的副作用。内容分析结果使我们得出以下结论：（1）谷歌返回的网页中最常见的类型是商业和新闻类；（2）商业网站平均提供的信息最不可靠；（3）大量声称的益生菌益处没有科学证据支持。这项研究突出了在线益生菌信息中存在的重要偏差，强调了提高向公众提供信息的质量和客观性的必要性。
