“Dr. Google” may not be so bad after all. Doctors complain about “cyberchondia” — increased anxiety inducted by the internet — but a new study finds that consumers’ ability to arrive at a correct diagnosis is often helped by their internet searches. Other studies, however, are less cheery.
“I have patients all the time, where the only reason they come into my office is because they Googled something and the Internet said they have cancer. I wondered, ‘Is this all patients? How much cyberchondria is the Internet creating?’” said David Levine, MD, MPH, one of the researchers involved in the study, published in JAMA Network Open.
“Our work suggests that it is likely OK to tell our patients to ‘Google it,’” said Levine. in a news release. “This starts to form the evidence base that there’s not a lot of harm in that, and, in fact, there may be some good.”
Notably, Levine, of Brigham and Women’s Hospital and co-author Ateev Mehrota, MD, MPH, a hospitalist at Harvard Medical School, found that people were slightly better at diagnosing their cases correctly after performing an Internet search. Participants demonstrated no difference in their abilities to triage nor did they report a change in anxiety after using the Internet.
The study involved 5,000 participants. Each person was asked to read a short case vignette describing a series of symptoms and imagine someone close to them was experiencing the described symptoms. Participants were asked to provide a diagnosis based on the given information, then look up their case symptoms on the Internet and again offer a diagnosis.
Cases ranged from mild to severe, but described illnesses that commonly affect everyday people, such as viruses, heart attacks and strokes. In addition to diagnosing a given condition, participants each selected a triage level, ranging from “let the health issue get better on its own” to “call 911.” Study members then recorded their individual anxiety levels.
Less positive outcomes
Not all studies are so encouraging, however. In January 2021, researchers in England examined how women reacted when they encountered symptoms that could point to breast cancer.
“The way that a person will capitalize on the internet for health purposes depends on many factors, like the nature of their symptoms or their fear about coming across misleading information, so we should not assume that ‘Dr Google’ is valuable and credible to all,” said Dr Afrodita Marcu, Research Fellow at the University of Surrey.
“The internet is a valuable source of medical information. However, it also contains a lot of poor quality information, or information which cannot be easily interpreted by lay people or applied to an individual situation, so it is not surprising that some people feel they cannot trust it,” Marcu said.
Marcu’s team interviewed 27 women, between 47 and 67 years old. They found different levels of engagement with the internet for health information that were driven by a range of attitudes and levels of trust.
Some women, especially those with less education, were less positive about the usefulness of “Dr. Google” and were largely against using the internet for health information, claiming it could lead to misdiagnosis or to unnecessary worry about what their symptoms might mean. The study was published in Health, Risk & Society.
‘Unreliable at best’
And then there’s a study conducted in Australia in May 2020. Conducted by researchers at Edith Cowan University, it looked primarily at online symptom checkers.
“While it may be tempting to use these tools to find out what may be causing your symptoms, most of the time they are unreliable at best and can be dangerous at worst,” said Michella Hill, the Master’s candidate who wrote the study.
“These websites and apps should be viewed very cautiously as they do not look at the whole picture – they don’t know your medical history or other symptoms, Hill said. “For people who lack health knowledge, they may think the advice they’re given is accurate or that their condition is not serious when it may be.”
The study, published in the Medical Journal of Australia, analyzed 36 international mobile and web-based symptom checkers and found they produced the correct diagnosis as the first result just 36 per cent of the time, and within the top three results 52 per cent of the time.
The research found that triage advice — when and where to seek care — provided more accurate results than for diagnoses.
“We found the advice for seeking medical attention for emergency and urgent care cases was appropriate around 60 per cent of the time, but for non-emergencies that dropped to 30 to 40 per cent,” Hill said. “Generally the triage advice erred on the side of caution, which in some ways is good but can lead to people going to an emergency department when they really don’t need to.
Go to the source
So what should a wise consumer do when confronted with health questions? The most obvious answer is to see your doctor, but that’s not always as easy as it sounds. It can be hard to get an appointment, hard to take time off work, arrange for child care and so forth.
Short of an obvious emergency — when you should always call 9-1-1 — a quick internet check can provide at least preliminary research on what might be going on.
The key is to disregard Dr. Google himself. After all, search engines today are basically advertising engines and many if not most of the most prominent search results are paid advertisements. They may very well be hawking unproven, untested, dangerous remedies.
It’s better to go directly to one or more of the credible websites maintained by leading health institutions. Many of these feature symptom checkers and all have medical and health information that has been reviewed by experts.
Here are a few of the most credible sites:
- Mayo Clinic
- National Institutes of Health
- Cedars-Sinai, Los Angeles
- Mercy Hospital, St. Louis
- University Health, San Antonio
There are plenty of others. In general, it’s best to avoid any healthcare information site that is trying to sell you something. Sadly, search engines used to provide a clear distinction between advertising and search results but consumers are now on their own and must work to ensure that the site they’re looking at is credible — ideally, managed by a large healthcare institution, government agency or respected non-profit organization.
The information contained in this story is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.