from the and-your-dr.-is-always-right-first-time dept.
For your typical hypochondriac, online symptom checkers are a rabbit hole of medical information and the anxiety that comes with it. But according to a new study led [PDF] by researchers at the Harvard Medical School, most of these sites are so inconsistent and inaccurate that patients shouldn't rely upon them for correct diagnoses.
In the study, which was published in the British Medical Journal, the researchers looked at 23 web sites from around the world that claim to offer information for diagnosis and triage (assessing how urgently a condition needs to be treated). They used 45 patient vignettes, about half of which were common conditions, to assess the sites' accuracy.
They found that the correct diagnosis came up first only 34 percent of the time. Half the sites had the right answer in their top three results, and almost 60 percent had it in the top 20. Triage advice fared a bit better, with accurate suggestions coming up first 57 percent of the time. The sites in which the right answer came up as the first result most often were: DocResponse (50 percent), Family Doctor (47 percent), and Isabel (44 percent).
What has been the experience of SN Members? Do they rely on online medical diagnosis?
[Also Covered By]: http://commonhealth.wbur.org/2015/07/self-diagnosing-health-websites-study
Original Submission
(Score: 3, Insightful) by Anonymous Coward on Tuesday July 14 2015, @03:33AM
You have 15-minute consultation. Educate yourself before seeing your physician - help her help you.
I found Mayo Clinic's website informative.
(Score: 2) by Common Joe on Tuesday July 14 2015, @04:11AM
Agreed. Personally, I let the doctor make the diagnosis of my problems and then I do a scrutinizing follow up (i.e. study the condition on the internet) to make sure they got it right and are doing the right things to treat me. This seems to work best for me. Even if the doctor has my best interest in mind, the regulations they have to follow by the government / insurance companies do not.
(Score: 0) by Anonymous Coward on Tuesday July 14 2015, @12:06PM
Especially if your doctor is on one of those "death panels"! Soylent, it's not always news!
(Score: 3, Insightful) by Thexalon on Tuesday July 14 2015, @11:54AM
The best way to help your doctor: Be able to fully and accurately describe your symptoms and your own medical history.
So instead of "my tummy hurts", you are able to say "I have no history of food allergies or major stomach problems, but I've been feeling nauseous, and there's severe pain near where my appendix used to be. If it's relevant, I tried borscht for the first time in my life yesterday."
That makes good use of your 15 minutes, because your doctor is able to skip a lot of the questions that otherwise would be part of the standard diagnosis.
"Think of how stupid the average person is. Then realize half of 'em are stupider than that." - George Carlin
(Score: 5, Insightful) by Frost on Tuesday July 14 2015, @03:45AM
That's OK, your professional medical doctor's diagnosis is probably wrong too.
34% accuracy is about what I've come to expect from real doctors.
(Score: 4, Interesting) by MrGuy on Tuesday July 14 2015, @11:17AM
So, while this is pithy, it raises a serious question. For these specific patient profiles, how much more accurate ARE real physicians? Failure to include that means they can't disprove what is apparently their null hypothesis (online sites are as accurate as human physicians). After all, if humans were similarly inaccurate, all it means is diagnosis is hard. Or, more correctly, that diagnosis is hard for these specifically chosen/crafted profiles (which, of course, are NOT a real patient).
Yes, there are other stories out there about how accurate physicians are at a first diagnosis, but you can't get an apples-to-apples comparison unless you let humans diagnose these same facts.
(Score: 1) by shrewdsheep on Tuesday July 14 2015, @11:31AM
It is intruiging you mention that 34% figure again. I was always suspecting they were just clicking through the web-sites when doing the interview.
(Score: 1) by unzombied on Tuesday July 14 2015, @04:00AM
Say doctors get the diagnosis right 80% of the time [nytimes.com], or at least 72% of the time [ncpa.org]. Autopsy analysis suggests heart failure diagnosis is right some 50-80% of the time [sma.org] (depending on how you interpret the stats). This study says the 1st search hit is correct 34-57% of the time? Looks like inconsistency and inaccuracy are serious problems for everyone, not just web sites.
(Score: 1, Interesting) by Anonymous Coward on Tuesday July 14 2015, @03:11PM
The article on the same study on the CBC website had a phrase that had me laughs : Doctors are thought to have a diagnostic accuracy of 85 to 90 per cent.
http://www.cbc.ca/news/health/online-symptom-checkers-far-from-accurate-1.3143905 [www.cbc.ca]
(Score: 2) by MostCynical on Tuesday July 14 2015, @04:07AM
so if your doctor *doesn't* pick one of the top three, is the doctor or the web more likely to be wrong?
"I guess once you start doubting, there's no end to it." -Batou, Ghost in the Shell: Stand Alone Complex
(Score: 2, Disagree) by toygeek on Tuesday July 14 2015, @04:45AM
A medical student who graduates last in his class and barely scrapes by?
Doctor.
There is no Sig. Okay, maybe a short one. http://miscdotgeek.com
(Score: 2, Interesting) by Anonymous Coward on Tuesday July 14 2015, @05:20AM
I'd like to know id the sites are correlated or not. I expect they share a lot of info, but if they were actually independent (from a statistical perspective) using several of them could produce some more useful data.
(Score: 4, Interesting) by MichaelDavidCrawford on Tuesday July 14 2015, @06:07AM
Cancer of the adrenal gland will make you psychotic.
Going without sleep can make you either manic or psychotic.
Norman King [blastar.in] is a member of the McCoy Clan. The McCoy Hatfield Feud lasted IIRC thirty years, killed fourteen and I expect injured many others. Despite that the two clans are now the best of friends, the McCoys are genetically predisposed to an otherwise rare form of brain and spinal cancer that makes one irrationally angry.
A fellow patient in a psychiatric intensive care unit was catatonic. This is most commonly caused by severe depression or schizophrenia. In his case he had ammonia in his blood.
While not dead certain I havevreason to believe much of my own illnesses stems from inhaling mercury vapour when I was twelve.
The better psychiatrists refer me to neurologists to rule out non-psyciatric illnesses. I have had CAT scans, EEGs and neurological exams where I do silly things like roll my shoulders to determine whether one lobe of my brain is damaged.
Unfortunately not all psychiatrists seem to be aware of these other causes for what seem to be the symptoms of mental illness. I dont know why because its not like we dont know from cancer. I wrote the following to point out that you might not really be crazy:
If You Think You're Mentally Ill [warplife.com]
I know some people who are oermanently brain damaged. I myself have experienced quite severe concussion. While similar in some respects to mental illness it is not generally the same.
Yes I Have No Bananas. [gofundme.com]
(Score: 1, Insightful) by Anonymous Coward on Tuesday July 14 2015, @01:33PM
I think the ~30% rate is coming from people just being inexperienced at it.
If something new pops into my life I am not an expert. I will and do make wild assumptions. You have been living with a particular condition for a long time. So you know the jargon you know what is probably a rabbit hole and what might be worth looking at. If I came down with something today I would have no clue. There are many things out there which share many of the same symptoms. So it could be very easy to misdiagnose. There unfortunately is not a test for everything.
Some conditions are just not very well diagnosed, as to do so probably would mean cutting you into little bitty pieces (which I am sure you are not interested in at the moment). For example my long time friend has severe migraines. He has been thru at least 50 different doctors and dozens of cat scans. A couple of meds help for a short time but not long and are semi pricy. He started looking at external causes (because of the internet and it worked for some people). I think I have finally convinced him the external causes are not it. He comes to me every couple of months with 'it is XYZ' I always respond 'no its not'. I am unfortunately vindicated most of the time.
(Score: 5, Insightful) by wonkey_monkey on Tuesday July 14 2015, @07:18AM
Your Online Medical Diagnosis is Probably Wrong
And your headline is clickbait. Can we have a filter put in place to reject any headline that starts with "Your"? Or "This..."
systemd is Roko's Basilisk
(Score: 2) by lizardloop on Tuesday July 14 2015, @12:12PM
Yes. This is becoming an annoying trend on Soylent News and spoiling an otherwise great site. Stop the click bait headlines. They are utterly unnecessary on a site who's readership is primarily regular visitors who look at all stories anyway.
(Score: 2) by aristarchus on Tuesday July 14 2015, @07:37AM
Self-diagnosis! Self-medication? Sounds like you have a well-know condition!
Seen on a tombstone: "I told you I was sick!"
Besides, if you keep searching for all the stuff that might be wrong with you, only Obamacare will save you from being denied medical insurance for pre-existing conditions.
(Score: 4, Interesting) by bradley13 on Tuesday July 14 2015, @07:46AM
I've successfully diagnosed some things online - to the point of going to the hospital and insisting on the test that proved it. Once, after getting a diagnosis from a doctor that I just didn't believe (being sent home with a lung embolism, thanks, doc). If I may ramble a bit, I have the following thoughts:
If you have something new, i.e., you have no experience with the disease and don't just recognize it, it can be very difficult to describe your symptoms in an objective, measurable fashion. The online diagnosis sites, accordingly, cannot pose really discriminating questions, because two people with the exact same symptom may describe it differently. Hence, there really is no way for an online diagnosis site to have a high accuracy rate. A good doctor can work against this ambiguity by judging how the patient answers questions (is this a "whiner" or a "tough guy", for example), and posing follow-up questions.
What's useful is that the online sites provide a range of possible diagnoses, and you can visit multiple sites and see how well their lists match up. What I did was to then take the diseases they proposed, read the medical descriptions of the diseases (articles aimed at medical personnel, not at patients) and work backwards: If your patient has this disease, then they will have the following symptoms. Coming from this perspective, you can eliminate the diagnoses that make no sense, for example, because only some of your symptoms match up.
In the end, as an intelligent lay-person, it took a lot of hours of reading medical literature that was (as a non-medical type) barely understandable, plus a willingness to look at things as objectively as possible. Of course, none of this is going to help a hypochondriac, who wants the attention that goes with the worst possible diagnosis.
tl;dr: The diagnosis sites are a great starting point, but they are only a starting point. You certainly shouldn't rely on them alone for anything of critical importance.
Everyone is somebody else's weirdo.
(Score: 3, Insightful) by penguinoid on Tuesday July 14 2015, @10:16AM
tl;dr: The diagnosis sites are a great starting point, but they are only a starting point. You certainly shouldn't rely on them alone for anything of critical importance.
Like your health ;-)
RIP Slashdot. Killed by greedy bastards.
(Score: 2) by MrGuy on Tuesday July 14 2015, @11:26AM
There's an unstated assumption here when you throw around the term "accuracy." Specifically, that when a certain symptom is described, a physician will look primarily at the most common causes of that condition, and determine what's most likely.
I'm not certain (IANAD) that that's necessarily the way things work, especially early in the diagnostic process (where we have little information other than a few symptoms that COULD mean a lot of things). Rather than start with the most likely, we might want to ask questions to eliminate the most problematic or dangerous possible cause, rather than to try to confirm a somewhat benign or more common one. For example, if the three most likely causes of a given set of symptoms are (in order) irritation from airborne pollutants, a common cold, and lung cancer, I'd be more worried about making sure it's not lung cancer.
Given that online Q&A can only ask so many pre-determined questions, can't follow-up off-script, can't order tests, and can't consider nuances of the patient history, maybe the goal isn't strict likelihood.
Because the second question is what the patient will do with the follow-up information. If I present three possible diagnoses, with accompanying detailed description, do I expect the patient to read all of them and see if they apply? Or do I only expect they'll read the first one? Maybe the one I want them most to read is the lung cancer one, because if they feel like that actually fits, they'll seek a follow-up from an actual doctor who can run some tests. That might be a better result for the patient.
(Score: 0) by Anonymous Coward on Tuesday July 14 2015, @03:06PM
But I don't just look at one source, I explore many sites. It actually saved me from getting the wrong medication once. I questioned the Doctor about a medicine he wanted me to take, he grudgingly looked it up in the PDR and was surprised that I was right and he was wrong. Some Doctors are total assholes when you question them, so ymmv.