The nation's top tester of products from dishwashers to cars is now weighing in on consumer health Web sites.

Consumer Reports WebWatch, an arm of the Consumers Union publishing empire, has begun rating the 20 most-trafficked health information Web sites. The ratings -- posted on a new early release Web site,, that was undergoing evident birthing pains last week -- were produced in collaboration with the Health Improvement Institute (HII), a Bethesda-based nonprofit.

The reviewers examined the sites' credibility, privacy policies, ease of use, design and advertising sponsorship. Six sites -- including those of the National Institutes of Health (NIH), the Mayo Clinic and WebMD -- received the top rating of "excellent." Five were graded "very good," eight "good" and one -- -- drew a rating of "fair." None received the dreaded black circle meaning "poor." (See "Health Online: WebWatch Rates the Sites," Page F4, for details.)

Sites ranked as excellent all made a clear distinction between sponsored and editorial content (two of the sites are nonprofit and accept no advertising) and included peer-reviewed information written by health professionals.

Reviewers gave lower scores to sites that did not indicate which health content was sponsored by advertisers or that lacked policies to correct misleading information. No sites got perfect marks; even those rated excellent were faulted for pushing users toward advertising, lacking policies to correct misinformation or failing to disclose authors' names.

For some time, Consumer Reports has had four health information sites. A few weeks ago, it launched another site, on best treatments and prescription drugs, that requires a monthly fee of $4.95. None of these sites is among the 20 described on the new ratings site.

Beau Brendler, Consumer Reports WebWatch director, said there is no conflict of interest in selling access to information on one site while evaluating the offerings of other parties on another. The subscription site, he said, "is completely separate from this health rating projects." Joel Gurin, executive vice president of Consumers Union, added that the ratings project gave an excellent rating to several commercial sites that could be considered competitors to his organization's paid site.

"We believe that people are going to go to several different health sites if they have a serious health problem, and our goal is to make sure that they find the best information available from any sites that may be helpful to them," Gurin said.

To ensure objectivity, Brendler said Consumer Reports partnered on the rating project with HII, which gives awards to reliable health sites. But Joshua Seidman, executive director of the Center for Information Therapy, a nonprofit that creates health content for consumers, said Consumers Union's dual role in selling and critiquing health information could pose an ethical conflict.

Nonetheless, he said, the site provides a valuable service in "creat[ing] an important scrutiny of health information on the Internet."

Some sites given high marks by WebWatch were quick to put the ratings to promotional use. "You have chosen the Web site rated 'excellent' by Consumer Reports WebWatch as the most trusted and credible source for online health information," read a banner ad across the top of a WebMD page Monday. But numerical rankings on WebWatch -- where WebMD is listed as number 1 -- reflect site traffic, not quality. When a WebMD spokesman was asked if the ad's wording invited a misreading that the site led all others in quality, she said that was not the intention.

The WebWatch ratings give each of the sites a familiar Consumer Reports circle symbol for excellent, good, very good, good or fair. In addition to comments about scores, each site description includes information on strengths, weaknesses, special notes and latest ratings.

But consumers who wanted to check out the ratings encountered problems during the site's debut week. For several days the ratings were absent from the site for at least four to five hours.

Although reviewers looked for transparency, accountability and separation of editorial and advertising, tests for the accuracy of the posted information would "require specific medical subject matter knowledge and thus are beyond this project's scope," according to WebWatch.

Seidman urged Consumer Reports WebWatch to add objective criteria for evaluating the veracity of information on consumer health sites. In 2002 Seidman evaluated diabetes information on 90 health Web sites and found about half the sites contained inaccurate information. "I think [the ratings site] is a good first step . . . but they are not providing objective assessments of the accuracy and comprehensiveness of the information on the Web, and I think that isn't fully serving consumers' needs," he said.

Annette Watson, vice president of URAC, a nonprofit group that accredits health Web sites, said two of the 20 sites reviewed by WebWatch -- those of WebMD and NIH -- were accredited by her organization. She said that although many of the Consumer Reports criteria for evaluating the sites were valuable, others, such as presentation and ease of navigation, were not.

"You don't want to get misled by a good-looking Web site, and I think that's one of the dangers for people," Watson said. "If it's easy on the eye and easy to use, people are going to go to that site, and that may not be one of the best sites."

Whether consumers are looking for sparkle or substance, they are clearly turning to the Internet for health information. Research released last month by the Pew Internet & American Life Project found that about 95 million American adults use the Internet to find health information. Nearly a fifth of Web seekers say they have gone online to diagnose or treat a medical condition without consulting a doctor, found earlier Pew research.

Susannah Fox, associate director of the Pew project, predicted the Consumer Reports WebWatch site would be popular with the "worried well," but doubted that it would change Web-use habits. Research shows that most people "drop in on Dr. Google" when they have a health question, she said, rather than going first to groups that vet health sites. The chronically ill tend to bookmark sites that they return to again and again.

"If you are worried about those Internet users who are casual health seekers, then you need to meet them where they are right now . . . at a search engine," she said.

Fox noted that, according to information on the new ratings site, it has already had an impact: In response to an inquiry from WebWatch, added ownership and contact information to its site.


Elizabeth Agnvall recently wrote for the Health section about women's heart risks.