Next, they assessed whether the site gave complete information, using four criteria: whether scientific references were given cautions that evidence was not always strong for all proposed probiotic benefits safety issues with probiotics regulatory status of the probiotic in question
Finally, they looked at the available scientific evidence for the efficacy of probiotics against these diseases for this purpose, they used the Cochrane library, which contains a vast amount of evidence-based information from clinical trials as well as meta-analyses.
The study also included a more practical aspect – the Google ranking of the websites and whether the information appeared within 3 or less clicks, which is the average range of the lay reader. Explains co-researcher Michael Goldman, “Often the public will not go past the first ten results - these will therefore have a higher visibility and impact.” The results
The scientists found that in only 1 in 10 webpages were high-quality, in terms of meeting all four criteria. About 40% contained a caution as to possible limitation of benefits. About the same number referenced scientific work to support the claims they made. Only a quarter even spoke about possible adverse effects.
The researchers conclude that most of the first 150 results were linked to either commercial outlets (43%) or news providers (31%). However, the top 10 websites were health portals or commercial, at 44% and 22%. All 10 had an average JAMA score of 3 out of a possible 4. Among the 10, 44% had a HONcode seal but only 6% of the remaining websites.
Based on the analysis of the diseases mentioned in the webpages and the evidence that probiotics could help significantly in managing these conditions, the results showed that most of these top-ranked pages were providing misleading information. The average commercial website promoting probiotics was unlikely to provide reliable health information. The median completeness score was 2 and 1 for the top 10 and the remaining websites respectively.
Many of them did not even mention the risks of using probiotics in individuals with weakened immunity, nor was the issue of regulatory restrictions brought up. And many of the inflated claims that probiotics had been found to be useful in treating specific conditions in humans were based, in fact, on findings in mouse experiments. Only less than a quarter had supporting evidence, and one in five had no evidence at all!
Strikingly, probiotics were strongly recommended for gastrointestinal disorders, strengthening the immune system, mental disorders and cardiovascular disorders – however, only the first area has correspondingly heavy experimental references, while the others have no Cochrane reviews at all. Even with gut disorders, the evidence is partial and uncertain, which is not reflected in the webpages.
On the other hand, Google analytics uses very tight standards to make sure that websites offering health information conform to high standards of quality. The fuller the information, and the greater the scientific support, the higher the ranking of the probiotics-linked page, according to the researchers. This is particularly so if the webpage is part of a health portal. This will push up science-based probiotics webpages to a higher rank than a commercial webpage.
However, the sheer volume of commercially oriented information is a great problem for people who want to truly know if taking probiotics could help them. In realistic terms, it is now up to the consumer to evaluate the source of information on any site. It is necessary to set up a new framework as well as policies to regulate how probiotic information is presented to the public to avoid false claims and misuse of this freedom. Journal reference:
Online information on probiotics: does it match scientific evidence? Marie Neunez, Michel Goldman and Pietro Ghezzi. Frontiers in Medicine, January 2020. https://doi.org/10.3389/fmed.2019.00296. https://www.frontiersin.org/articles/10.3389/fmed.2019.00296/full
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