The doctor's Internet handbook

By Robert Kiley Royal Society of Medicine 75 pages£6.99

The trouble with writing books about the Internet is their short shelf-life. The first one I bought went into great detail about using tools such as Gophers, Veronica, Archie and WAIS to find useful file transfer sites. Less than six months later it was worthless: everybody had put their documents on an HTTP server. The web had taken over.

That particular revolution is in the past, but The Doctor's Internet Handbook still has to face the problem that any site it recommends might, by the time the reader consults it, be dead or subscription-only, or unusable because the webmaster has decided to brush up on their Javascript.

Still, for the moment, the book is worth buying (provided you read this review quickly). Instead of just quoting site addresses, the author talks about search techniques to keep your bookmarks up to date, various routes to online databases such as PubMed, and - most importantly - how to bypass the web and explore specialist services like closed-group mailing lists. These are surely the best hope for online medicine.

Useful, too, are the author's warnings of when use of a site has to be paid for (which rules it out for most people, if only because of the administrative problems). But he missed out what I would most like to see - a warning of whether a site uses frames or Javascript. Any such site should only be visited in the wee small hours during periods of insomnia so that one can go and make a cup of tea, paint the spare bedroom or read War and Peace while the home page is downloading.

And a medical Internet handbook wouldn't be complete without dire warnings about misinformation and the 'quality' of Internet sites.

In fact, the author introduces us to this on the very first page, pillorying QHI, a mail-order company, for advertising Melatonin on its website. 'Numerous studies are being conducted to investigate whether Melatonin has anti- ageing and anti-cancer properties,' QHI apparently claims. Personally, I don't see what's wrong with that. Maybe Mr Kiley thinks that anything not formally proven to work shouldn't be sold. Maybe he thinks the Melatonin anti-ageing business is cobblers.

It probably is, but so is much of the stuff on Medline. If you don't believe me, ask the people at Cochrane. Most of the 'quality factor' of a Medline-indexed article comes from the fact that your average paper in a learned journal happens to be written by a doctor, although their combined knowledge of experimental method could probably be printed on the back of a matchbox.

Despite this, Mr Kiley reckons that quality information is simply what qualified doctors publish - a view naturally shared by all doctors and, regrettably, by too many senior NHS staff.

The real challenge of Internet medical publishing is that in a few years this cosy, all-chaps-together, peer-review club will be destroyed. Quality accreditations issued by the royal colleges won't save it, because the Internet has already taught us that the value of information doesn't depend on the social rank of the people in charge of the world of medicine. It depends only on the evidence that can be quoted in support of the claim being made.

Oddly enough, the web's hypertext nature is ideally suited to provide exactly that. I bet the professions won't let it, though.