I noticed this a few days ago and meant to comment on it.
Then, I noticed
href="http://scienceblogs.com/drcharles/2006/11/attention_paging_dr_google_1.php#more">Dr.
Charles beat me to it. He even gave some examples
in actual use. If you've already read his, skip the excerpt
and go directly to the few thoughts I've added at the end.
href="http://www.medscape.com/viewarticle/547620">Web-Based
Search Engines Help Diagnose Difficult Cases
NEW YORK (Reuters Health) Nov 10 - Using Google to conduct web-based
searches on the internet can assist in the diagnosis of difficult
cases, physicians in Australia report in BMJ Online First. In fact, the
investigators believe that Google may be more effective than using
PubMed...
...After witnessing a patient's father correctly
diagnose his son's condition as "Paget-von Schrotter syndrome," the two
clinicians analyzed in more detail how well Google is at leading
doctors to the correct diagnosis.
They obtained 26 cases published in The New England Journal of Medicine
during 2005. Without reading the differential diagnosis and conclusion
of each case, they selected three to five search terms from each case.
The researchers then did a Google search for each case using those
terms, and selected the three diagnoses that seemed to fit the symptoms
and signs.
It turns out they were correct 58% of the time.
The authors recommend using statistically improbably phrases, and say
that there isn't much point in going through more that the first five
pages on results.
Based on their methodology, though, it is not clear that this would be
helpful to most patients. Part of the trick is to know the
right jargon. It would be hard for a nonspecialist to know to
search for pruritis instead of itchiness.
Also, I've found that it helps to omit words and phrases that will
trigger hits among purveyors of alternative/complimentary medicine
products. Those hits tend to float to the top, due to various
search engine optimization tricks.
Google actually indexes Medline, so it is not a big surprise that it
would work effectively for medical conditions. In fact, I'd
like to see a Google take a stab at improving the usefulness of its
search engine for this particular application. My worry is
that, as more people start doing this, then more purveyors of
questionable products and bizarre opinions will be motivated to find
more ways to subvert the results.
If patients do try this, it would be good for them to remember that it
is easy to get misled into thinking you've found an explanation for a
problem, but to be widely mistaken. On the other hand, it is
important for physicians to keep an open mind, because sometimes the
patient's intuition is a valuable tool.
Because of the emphasis on the value of statistically improbably terms,
I suspect the greatest value will be in diseases with particular
anatomical or laboratory anomalies, because that is where the most
obscure terms will arise. I doubt that it would be very
useful in my own field. In part, that is because the
technical terms often are appropriated into common parlance, then
misused. For example, the word paranoid is used commonly in
everyday speech, but it is unusual to hear a nonspecialist use the word
correctly.
- Log in to post comments
I appreciate the balanced look at how the internet is changing medicine. It is because of the availability of this information, that I figured out what I was suffering from. I was quickly educated on the medical terms (highlight, right-click, 'search Web for...'), audited a course in patient humility, bought insurance to protect against easy cures, and stocked my bookshelf with a section on self-criticism.
At first, all I found was sites promising a cure-all with this vitamin or herb. It was when I used the correct medical terminology for my symptoms, along with snippets from people's comments about their experiences, that I was able to cash in on the wealth of information out there (and come one step closer to getting an answer).
It is because of the wealth of information I gathered from the net, that I was able to go to my doctor and present my hypothesis. I got three firm "no's" from two other doctors and one from my PCP, before I was able to open the door for testing into the rare genetic disorder. I agree that there are a lot of patients who use the internet, and come up with diagnoses that are way off. But I also realize that doctors are human beings who have to deal with a dizzying array of situations, policies, and people.
There needs to be a meeting of the minds in the near future, otherwise there will be a lot of vulnerable patients looking for an answer, and a lot of unscrupulous scoundrels out there who are too willing to help them.
Here is how I did it. When you are ready to give up, think outside the box and off the bell curve. Not everyone's situation lands somewhere inside that box or on the fattest part of the bell curve. If a doctor feels more comfortable with the statistics, then I propose that they remember that it takes actual people to make up those statistics for diseases that show themselves in one in a million people(or in my case two in a million).
Google Empowered Porph Patient