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Today's parents solve their children's health problems in very different ways than they did even five years ago.

In the past, they may have called a friend or a mother-in-law for advice. Now, parents call Telehealth, check with Dr. Google, discuss treatment strategies on chat lines and e-mail experts for timely advice.

Last month, in response to this change, the Canadian Paediatric Society issued guidelines for parents on how to use the Internet. Their suggestions range from understanding what features to look for in a good website to tips for dealing with teens who are constantly on Facebook.

It is debatable whether parents' wired strategy works better than a traditional one. Downsides include "cyberchondria," or Internet-induced fear of a terrible diagnosis, and being marketed health products that don't work.

Most parents view being wired as a complementary rather than an either-or proposition. Health professionals are of a mixed mind, but most believe there is a good middle ground where parents become more informed, but are not diagnosing their child who has the sniffles with rare leukemia.

It can be tough, when clicking your way through various cyber-health resources, to discriminate between good information and bad advice. What follows is a look at what I think are some of the best resources for parents who are searching beyond a visit to the clinic.

Let's say Angus, your five-year-old, has a cough with fever, stuffy nose and a slight wheeze. Otherwise he looks okay. At this stage you want to make sure his symptoms are not serious, you want a diagnosis and an effective treatment, especially one that you could implement at home.

Let's start with the diagnosis. Begin with the "symptom checker" services of WebMD, Mayo Clinic or EasyDiagnosis. WebMD offers 20 possible diagnoses for Angus. You can continue to check out the ones you think are relevant.

The problem with this site is that 20 diagnoses are too many and, in my opinion, you need help prioritizing. Diagnosis can be a tricky business, since we want to consider all options from the common to the rare and the benign to the serious.

At MayoClinic.com the symptom checker gives you eight possible diagnoses and prioritizes them based on how many of the symptoms correlate with each problem. For example, three symptoms could be cold-related, but just one (the wheeze) makes us think of asthma. This is better, but the problem is that it's difficult to tell how likely it is to be asthma as opposed to a common cold.

EasyDiagnosis.com narrows it down to three possibilities and informs you that Angus has a 77 per cent chance of having a cold, a 15 per cent chance of having asthma and an 8 per cent chance of having pneumonia, which sounds about right.

I love this precision. The questions are more in-depth and mimic what I ask in the clinic. I would use it all the time, but the only catch is that the site has only worked out the math for a limited set of symptoms.

At this point, after trawling the sites, you are thinking it is probably a cold, maybe asthma, possibly pneumonia (or a combination thereof).

Now you need a management plan. As you look for a course of action, you may encounter a major conundrum of Web medicine: Some of the most useful sites are funded by industry, and bias can be an issue.

For example, WebMD declares that anything marked as "sponsored" is not reviewed by the WebMD editorial department for accuracy, objectivity or balance. This sounds easy to differentiate, but as I surf through the site I am aware of the subtle pushing of new medications. The Mayo Clinic site is not quite as rich a resource, but the line between advertising and editorial content is much clearer.

When searching for a management plan on the Web, I recommend three basic starting points, none of which are sponsored by an industry.

The first is MedlinePlus, which pulls together the best resources on a wide variety of topics that are typically excellent. Next are two local resources, HealthyOntario.com (which I help edit) and CanadianHealthNetwork.com.

Both are useful in that they provide generic health information as well as local advice (Is there an influenza outbreak in my area?) and steer users to local resources.

Child-focused sites are also an option. AboutKidsHealth.ca is set up by Toronto's Hospital for Sick Children. A pediatrician vets every page and it has an excellent section on the common cold with practical symptom management advice.

The African proverb tells us it takes a village to raise a child. With the Web, the village gets a whole lot bigger. PatientsLikeMe.com or Ning.com are two classic examples of Web villages, or Internet social networks, that connect people struggling with the same disease.

I often tell patients that the solution to health problems rarely lies with one resource, and being a wired parent extends those options. Whether that means taking Angus to the doctor as soon as possible, spending some time researching options, or trying a home remedy, it's probably best if your strategy includes a combination of both old and new.

Dr. Michael Evans is an associate professor and physician at the University of Toronto, where he is leading both the Health Media Lab at the Li Ka Shing Knowledge Institute of St. Michael's Hospital and Patient Self-Management at the Centre for Effective Practice in Family & Community Medicine.

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RESOURCES: HOME HEALING

Taking health research into your hands

Web Workhorses

MedlinePlus.gov is published by the National Library of Medicine and the National Institutes of Health in the United States. I often leave patients in the room to watch the site's interactive tutorials about common diseases, and when I return they have all the basics covered.

Most provinces now have a health portal such as HealthyOntario.com. These services offer the usual health advice but have local tools such as e-mail an expert, dial a dietitian, smokers' help lines, newsletters, and connections to local clinics and resources. When local crises such as West Nile disease or SARS evolve, these sites are a vital destination.

CanadianHealthNetwork.ca is another version of a local resource, except it connects federal resources. For example, Albertans can access a schizophrenia handbook for families that was developed in Ontario.

Diagnosis and Treatment

EasyDiagnosis.com is a basic site that gives you the likelihood of certain diseases given the symptoms. But the symptom list is short and the site steers you to other sites for management.

WebMD.com is an excellent full-service, interactive resource. But parents should keep in mind that although most of the content is developed internally, the site allows third parties to provide funding for WebMD to independently create information about certain topics, and it carries sponsored content (with a logo) that is not subject to the site's editorial policy.

MayoClinic.com is a well designed site with a focus on common health questions. The site is sponsored, but there is a clear separation between advertising and editorial content.

Kids' Sites

AboutKidsHealth.ca is funded by a donation from TD Securities and published by Toronto's Hospital for Sick Children. It covers common problems along with rare ones that are seen within the hospital.

DrGreene.com is built around an individual rather than an organization. This seems to add something by putting a face to the advice.

http://www.CaringForKids.cps.ca is developed by the Canadian Paediatric Society. Look under resources for the position statement called "Guiding parents in their search for high-quality health information on the Internet." The site offers parents excellent evidence-based reviews on common problems such as allergies and constipation.

By phone

Telephone services provide free access to registered nurses 24 hours a day, seven days a week. Half the callers are parents, and even though the service is predisposed to sending you to the doctor or emergency room, not all of us are connected to the Web and sometimes it is nice to talk with someone. The services will often now send you to a pharmacist or other specialized care provider.

B.C.: 1-866-215-4700

Alberta: 1-866-408-5465

Saskatchewan: 1-877-800-0002

Manitoba: 1-888-315-9257

Ontario: 1-866-797-0000

Montreal: 514-488-9163 (If you live elsewhere in Quebec, call the same number and the nurses will refer you to the correct number for your city or town.)

New Brunswick: 1-800-244-8353

Northwest Territories: 1-888-255-1010

Bibliotherapy

Often my patients find it helpful to read about others who have similar challenges. The Trusted Advisor program is a good starting point. Doctors and other health-care professionals volunteer their time to review health books within their area of expertise and provide a "stamp of approval" for those they would feel confident recommending to patients. Go to Chapters.indigo.-

ca, click on health and wellbeing, then look under From Our Trusted Advisors.

Michael Evans

mevans@globeandmail.com