NET BENEFIT? A study showing no benefit from taking glucosamine to relieve osteoarthritis symptoms may be more significant for what it says about the research than about the dietary supplement. Scientists from Tufts -- New England Medical Center and Boston University School of Medicine were examining not only the effectiveness of glucosamine on osteoarthritis -- which has been the subject of trials with both positive and negative results -- but also whether a clinical trial can be conducted over the Internet. Their report appears in the American Journal of Medicine.

The authors were able to recruit more than 200 participants and conduct most of the procedures of a controlled clinical trial, such as outcome assessment, pill counts and ascertainment of adverse events, completely over the Internet.

The authors stress that the negative results on the supplement's effects should not be considered conclusive; several large trials of glucosamine, sometimes taken in combination with other supplements, are expected to report results over the next few years. But they do say "the Internet-based clinical trial approach may be an effective way to perform . . . studies quickly and efficiently."

NET LOSS? In a less sanguine report from the electrosphere, a new analysis finds that people who use the Internet to research chronic disease often wind up in worse condition than if they had listened to their doctor.

"This whole finding confounds conventional wisdom," said lead author Elizabeth Murray of the University College Medical School in London. The review appears in the October issue of the Cochrane Library, published by the Cochrane Collaboration, a widely respected international group that evaluates medical research.

Using interactive computer tools does improve the medical knowledge of people with diabetes, asthma and other chronic conditions, the report finds. And it does provide users with positive feelings of social support, according to researchers reviewing 28 randomized controlled trials involving 4,042 participants. But there was no evidence that cyber-medicine helps people change their behavior -- and startling evidence that it may leave them in worse health. Several studies demonstrated worse health outcomes for Net users.

Murray said there are two possible reasons for the paradox. Learning about small effects of a treatment may leave people less motivated to make changes than if, say, a doctor bluntly told them to control blood sugar or face death.

It's also possible that patients become so steeped in information from the Internet, the authors said, that they make treatment choices on their own, contradicting advice from their doctors.

-- From News Services and Staff Reports