Self-diagnosis in the age of internet

Self-diagnosing on the internet cartoon

Some time ago in February those of us keeping an eye on news related to healthcare got quite excited by Google’s announcement that it will start displaying relevant medical facts in the answer box we started to get familiar with or within an app on your smartphone. More and more people take their healthcare queries to their search engine first and their doctor later. Which may turn out to be quite of a problem, especially where self-diagnosis is involved.

The average american may be excused in taking this as the normal way things should be, but a lot of professionals are uneasy. Think about it: it takes between eight to fourteen years for someone to get through medical school, residency and a fellowship and become a specialized doctor. Compare that to less than an hour to self-diagnose using online information. Even taking into account the fact that there are simple cases such as the common cold or the fact that many users simply want to get an idea what to ask their doctors, self-diagnosis on the basis of online healthcare tools raises the following issue: either those would-be doctors are wasting their time or you are tricking yourself into believing you can do it.

No wonder then that quite a number of professionals are quite uneasy with such proposals: some endorsing them others cautioning us about potential misuses. For instance, in July 2013, Oncologist published an editorial by Howard West (MD) examining the growing number of cancer patients (or their family members / caregivers) seeking cancer information online. Howard West drew a rather positive picture of this new type of tool available to patients, but it is clear from the context that his endorsement is for those patients that use reliable online sources or for those patients that use online information as a preliminary stage for their doctor-patient discussions.

Dr. Guido Zuccon, Queensland University of Technology in Australia

A rather different picture emerges from the research of Dr. Guido Zuccon from Queensland University of Technology in Australia. Their overall aim being to assess the effectiveness of results from Google and Bing in response to medically-focused searches, they were somewhat surprised to discover that "major search engines were providing irrelevant information that could lead to incorrect self-diagnosis, self-treatment and ultimately possible harm".

How much potential for harm? Only three of the first 10 results displayed by the search engines were were highly useful for self-diagnosis and only half of the top 10 were somewhat relevant to the self-diagnosis of the medical condition. Essentially, if you are a somewhat thorough searcher and check more than the first three results in SERP, your work can be undone: more and more links will provide you with information that will contradict the relevant stuff you’ve already found. The reason for this stems from the perverse effect human curiosity can have on search engine’s ranking of various pages: pages about brain cancer are more popular than pages about the flu; being more popular they get a more prominent place.

To be fair, though, this happens only when participants in this study worked with descriptions of symptoms. When the name of the medical condition is known to the participant the quality of information a searcher may find is usually good. So, this study is essentially about the dangers of self-diagnosing using search engine results.

One can see that Google was sensitive to this potential problem: on average, 11.1 physicians would inspect and approve healthcare related information in their knowledge graph results to ensure the information is both relevant and accurate. It is not clear what could be done for the inherent bias for spectacular, spurious, popular results that come lower in the search engine list of results.

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