developments in medical information distribution and that is; patient research on the internet. This site wouldn't exist without this capability so it's interesting to read about the usefulness or not of people doing their own medical research. It also talks about cyberchondria and the potential for scaring yourself to death by what you discover when Googling your symptoms. Doctors seem to be divided on the issue and I'm sure many would prefer us to stay well clear of internet medical sites but the reality is that there is probably much more good than harm to be got from increasing patient knowledge about his/her problem. Both doctors and patients are already adjusting to this new information reality; not always without teething problems but there's no denying the fact that pandora's box is open!
What Doctors Think About Your Online Health Searches
June 15, 2012 by Stephanie Buck
I’ll admit it: I’ve Googled “scalp sunburn” before. Hey, when you have a combination of fair skin and fine hair, these things happen. Plus, let’s be real — a hat really didn’t go with pigtails.
In the grand scheme of things, though, a peeling scalp isn’t a huge deal (although my black shirts would disagree). People turn to the Internet for information on all kinds of health issues, whether for a lump in one’s breast or a sudden asthma attack.
For most, Googling “diaper rash” is more convenient than loading the baby in the minivan and heading to the doctor’s office. But what happens when you read on a website that your baby’s sore buns might be caused by a yeast infection, and thus, would require topical antifungal cream? As a first-time parent, do you panic? Do you search for pictures of diaper rash and compare the next hundred Google images to your infant’s bottom?
In the past, a mother may have referred to one of many baby books or official medical pamphlets for advice. Now the Internet provides access to scholarly journals, videos of surgeries, testimonials and online health communities, effectively putting medical information (both valuable and inaccurate) in the hands of non-experts, both empowering and endangering today’s connected patient.
Husband-wife team Drs. Jerome Groopman and Pamela Hartzband evaluate today’s level of access to medical information online. “While previous technologies have been fully under doctors’ control, the Internet is equally in the hands of patients,” they write. “Such access is redefining the roles of physician and patient.”
When it comes to patients researching health advice on the web, Hartzband and Groopman have been exposed to consequences both positive and negative. They applaud that physicians, like patients, can now access the wealth of medical information on the Internet. “Journal articles can be obtained within seconds, and experts’ evidence-based analyses are readily available…” they write. “Primary care physicians now have easy access to many guidelines whose reach was previously limited to specialists.”
But when in the hands of patients, this surplus of medical information can prove hazardous. The pair explains how easily falsehoods propagate on the Internet: Inaccurate sites often link to other information that reinforces those misconceptions and rumors.
As a primary care physician at Harvard Medical School and Beth Israel Deaconess Medical Center, Dr. Aditi Nerurkar sees patients every day who use the Internet to diagnose themselves. She says many of those people come in after sleepless nights spent worrying about dangerous diseases they’ve learned about through web searches. “While I love their sense of curiosity and ownership of their health,” she says, “their online searches can (and often do) go awry.”
This kind of fear brought on by web-based self-diagnosis is called cyberchondria, the preoccupation with medical concerns caused by health research online.
Microsoft Research defined cyberchondria as “the unfounded escalation of concerns about common symptomatology, based on the review of search results and literature on the web.”
Many people turn to the Internet to learn more about their ailments and, hopefully, match their symptoms to a likely cause. But the web’s vast stockpile of (sometimes false) information can actually backfire when people come across rare and horrific diseases that have no bearing in the first place.
That is, until people match one or two of their symptoms to those serious and fatal diseases pictured online. Virginia Kwan, a psychologist at Arizona State University, explains to the Daily Beast the psychology behind cyberchondria. “The way gamblers say they have a ‘hot hand,’ cyberchondriacs believe they have ‘hot symptoms,’” says Kwan. “If they hit the first two in a list, they believe they must have the third one as well.”
For instance, nausea and fatigue are two of the more common symptoms, appearing in medical conditions from pregnancy to hyperthyroidism. Cyberchondriacs could potentially jump to conclusions about either issue.
“Most signs and symptoms are not exclusive to one disease,” explains Dr. Nerurkar. “Doctors use these symptoms as well as their ‘clinical sense’ when making a diagnosis. It’s a question of the art vs. the science of medicine.”
According to a 2011 Pew study, 80% of Internet users look for health information online, making medical inquiries the third most popular web-based pursuit, following only email and search engine use.
Top health information searches involve food safety or recalls (29%), drug safety or recalls (24%) or pregnancy and childbirth (19%). Top symptom-related searches involve information about a specific disease or medical problem (66%), medical treatment or procedures (56%) or doctors or other health professionals (44%).
The most commonly searched medical conditions on WebMD in 2010 were shingles, gallbladder and gout, in that order, whereas the most commonly searched treatments were pain relievers, antidepressants and high blood pressure medication.
Sometimes those searches save lives. You may recall San Diego Padres pitcher Tim Stauffer’s 2010 medical emergency. Upon suffering abdominal pain, Stauffer researched his symptoms on the web via his iPhone and correctly diagnosed his condition as appendicitis. He was transported to the hospital, where doctors removed his appendix in a routine surgery.
Thirty-six percent of people online perform medical-related searches for themselves. But surprisingly, 48% use the Internet to research health advice on behalf of another person.
As parents and caregivers, should we really be relying on the Internet and our own judgment for sound medical care?
If it’s a non-emergency, general wellness inquiry, the resounding answer among doctors seems to be “yes.” Dr. Nerurkar encourages people to become better informed about the health of loved ones under their care. For example, if a child has a pre-existing condition like asthma, a caregiver may access web resources to determine ways to make their home more comfortable. Someone else may research ways to make a home safer for his elderly mother.
“But making a diagnosis based on information culled from the Internet is never recommended,” says Nerurkar. “Leave that to the doctor.”
Nottingham University’s department of pediatrics released a 2010 study that evaluated the reliability and accuracy of health information accessed via the web. Researchers sought advice for five common pediatric questions and analyzed the first 100 search results for each inquiry. Of the 500 total sites, 39% contained correct information, 11% were incorrect and a whopping 49% failed to answer the question. Among the sites that supplied an answer, 78% gave the correct information, but consistency varied by type of medical query.
In general, the study found that the most reliable information came from government websites, and that 55% of news sites supplied correct advice. But none of the sponsored websites that researchers encountered provided accurate medical information.
A different study, published in the Journal of Bone and Joint Surgery, found that nearly half of the top medical condition search results turned up commercial sites. Of those sites, some, like eMedicine and WebMD, provided valuable and relatively accurate information. But the rest of the sites promoted their own products as treatment options, without medical evidence to support the claims.
Dr. Dina Strachan, a New York-based medical and cosmetic dermatologist, believes the problem is more serious than inaccuracy. Our very skills of assessing the quality and meaning of online information are not yet up to par. She says information can be empowering and reassuring for some patients, while it can overwhelm and possibly mislead others. Some people simply can’t weigh the value of information in a teenager’s blog vs. a vetted medical site vs. a doctor’s assessment, she says.
“People provide the information on a medical site,” she says. “Are the people providing it actual experts, or do they just have the microphone? When you start saying to yourself ‘they’ said I must have condition X, ask yourself who ‘they’ are.”
In addition to accuracy, people need to account for the shelf-life of online health information. Some doctors believe that information published just five years ago can possibly be outdated.
However, Dr. Nerurkar says you shouldn’t have to worry about the possibility of expired health information as long as you stick to reliable websites, like those of government agencies (e.g., the NIH or CDC) or well-known academic medical institutions.
The Medical Library Association lists what it considers the most useful consumer health websites: Centers for Disease Control and Prevention, Healthfinder, Kidshealth, MayoClinic, MedlinePlus and others.
Furthermore, the web cannot personalize health consultations on a patient-by-patient basis. Many people still prefer speaking with their doctors, who are theoretically more familiar with each patient’s history.
A survey by Harris Interactive for iVillage determined that women are more comfortable speaking with medical professionals about health issues or questions as opposed to taking those concerns online. While 80% of women are extremely or somewhat comfortable discussing “embarrassing” health concerns with medical professionals, only 38% are extremely or somewhat comfortable discussing the same concerns in an online community. And 11% are extremely uncomfortable making health queries on the web.
One of the chief concerns for women was privacy. But 43% of online women said that they were comforted by the option to engage in anonymous discussions on the web. Forty percent welcome the opportunity to get advice from someone online who has had a similar experience. One-third of online women think it’s beneficial to be able to access the web for health information, and 30% said researching health information online can better prepare them for a doctor’s visit, or convince them that there is no need for a doctor’s visit in the first place. Perhaps that new mother found an at-home remedy for diaper rash, saving her a trip to the clinic.
It’s true that online self-diagnosis and medical research can be beneficial — and even successful — when practiced responsibly.
Some doctors, medical practices and associations are attempting to combat inaccurate medical information by curating their own caches of health research. For instance, the Cleveland Clinic shares health tips and clinical research information through its Twitter account and Facebook page. The clinic also invites physicians and medical teams to regularly contribute current information and resources to its blog.
This wealth of reliable online health information makes some doctors feel more comfortable. Pediatric emergency physician Dr. Amy Baxter encourages patients to educate themselves via online media — she believes it makes for a better-informed medical experience. Baxter references a current debate that examines the safety of CT scan radiation in children. She says the more online media focuses its attention on the issue, the less time she has to spend explaining its pros and cons to her patients. “Five years ago, I spent a lot of time dissuading parents insisting on a CT. Today, that discussion is almost moot,” she says. “I think our health system needs to have more involved consumers.”
And that involvement can ultimately lead to empowerment, insists Dr. Nerurkar. Alongside regular doctor visits, “If what you learn from your online searches can help make positive changes in your life, like eating healthier, exercising, getting more sleep or managing your stress, then that’s great.”
Or as the case may be, scalp sunburn. I certainly didn’t need to stampede to the emergency room for my crispy cranium, but I nonetheless turned to Google for reassurance and at-home treatment suggestions. Then again, I can pretty efficiently determine the difference between a shady website and a vested resource. Others may not have the same eye.
If you consider yourself a discerning web surfer, how do you feel knowing inaccurate health information is so readily available to those who aren’t Google-fluent? Have you ever headed that risk off at the pass by performing medical searches for your loved ones? How do you imagine your doctor would react?
http://mashable.com/2012/06/15/online-medical-searches/
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