Google Used To Diagnose Disease

dptalia writes "About 20% of all diseases are misdiagnosed, a percentage that has remained steady since the 1930s. However, scientists have discovered that by inputting the key symptoms into Google they can get the correct diagnosis about 58% of the time. For rare and unusual diseases, this provides doctors the information they need to get a correct cure. Of course, Google is only as good as its knowledge base, and its users, so this isn't a cure for everything."

Comments

20% error compared to 42% error of Google?

[epsalon]

What the blurb doesn't say, how much of the 58% google gets right overlaps with the 20% doctors get wrong, if at all.

Re:20% error compared to 42% error of Google?

[Anonymous Coward]

What the blurb doesn't say, how much of the 58% google gets right overlaps with the 20% doctors get wrong, if at all.

The blurb isn't much to begin with - it is only 28 cases that were difficult to diagnose.

Even so, there isn't much information about the 28 cases. Were those 28 cases all misdiagnosed at one point, or were only 20% of them were issues? Also, how accurate are search engines on correctly diagnosed diseases?

The internet is useful in picking up diseases with a unique symptom, but is less effective if the disease's most prominant symptom matches with anthoer common disease. As an example, Vomiting and Diarrhea may seem like something simple that can be waited out for a days. However, I turned out to have something a bit more serious - IIRC, it was Gastroenteritis, but it was a long time since I had it.

I'd post using my nick, but this is a bit into my medical history.

Re:20% error compared to 42% error of Google?

[snarkh]

Don't get too excited about these numbers. The whole study is based on 26 examples.

Since we're using famous websites

[mnmn]

There should be a global wiki for medical professionals searchable by symptoms.

The contribution weight of better/senior/more respected doctors should be higher compared to new graduates. The wide open public should not be allowed to write, but should be allowed to read it.

This way better healthcare will be available in poor countries with Internet access, people will be able to double-check their diagnosis online and better doctors will be able to make a name for themselves the way CowboyNeal has.

Re:Since we're using famous websites

[Anonymous Coward]

It's called http://pubmed.com/ and I use it all the time in exactly the same way. Google is my second choice. You can't practice medicine without internet access now.

ASO, MD
Neurology

Re:Since we're using famous websites

[espressojim]

A few of my friends and I (are we're all in the biology field in some degree, as researchers) refuse to use doctors who don't know what the internet is. I'm glad you do, but it is sad when you talk to a doctor about some large issue you have, and the doctor doesn't know about/use the internet to make sure they're aware of all the treatment issues.

One of the most interesting cases in our group was a friend who had osteonecrosis in one of his knees. Some of the doctors he went to weren't keeping up with modern practice, and they recommended full knee replacements. He finally found a younger doctor who was up to date, and the surgery he had involved boring small holes into his knee, so that blood would enter those areas and rebuild the bone there.

The surgery was a complete success, my friend didn't need an artificial knee (at age 30!), and now he's perfectly healthy. The recovery time for the new surgery was much lower, and it was an all around good solution.

Re:Since we're using famous websites

[InternationalCow]

A mistake that patients and other laypeople commonly make is to think that their search is just as good as the doctor's. It isn't. An untrained individual (patient, curious person, whoever) using Internet resources to gather information about their real or perceived diagnosis usually ends up barking up the wrong tree. I see it all the time in my patients. I warn them about it and still they make this mistake. I deal with rare diseases, the 20% that are usually diagnosed wrong. Trust me, Google by itself or any other internet resource doesn't do you any good if you don't know EXACTLY what the key symptoms are. And selecting those is not something an amateur can do. So you can go on and tell me about how you corrected your doctor and beat the medical establishment and crap like that, but at least for the kind of disorder discussed here (IPEX and family) you as an amateur would not arrive at that diagnosis. And oh, Google is not the best resource for medical type searches. Try Pubmed, or OMIM, or if you're really serious (IPEX is an X-linked disorder caused by FOXP3 mutations) use the London Dysmorphology Database (LDDB). Amateurs should NOT, I repeat NOT, try to diagnose their own diseases. They simply lack the background to judge their own symptoms.

I would prefer

[Timesprout]

If there was a publically available performance/competency grade for doctors online so I could just google for a good doctor in my area rather than hoping some med student hits paydirt with an 'I feel lucky search'

Good luck

[Shados]

Good luck finding any cure for anything even remotly related to female anatomy. "Hi miss. I currently can't help you diagnose your symptoms right now, as I left my credit card at home and its required to validate that I am old enough to access my.....references...."

Gives you ideas

[16K Ram Pack]

The key thing is that Google gives you ideas on how to solve the problem.

I had a long term and quite painful medical problem to do with the eustation tube in my ear being blocked. The doctors, and even the ENT specialist didn't really have much of a clue. We tried steroids (that helped a little), pinching the nose and blowing, decongestants and all sorts.

What Google did for me was to keep going back to doctors with "would xxxx work?". It got me prompting them. Eventually, I tried out some massage, which someone had recommended on groups (that Google found) as a way to relieve the tension. And met a massage therapist who applied some Bowen Technique which solved the problem (the jaw alignment was out after dental work).

I wouldn't use Google alone, but sometimes, doctors don't think of everything. Some of their suggestions were little more than "switch it off and on again".

Another great medical breakthrough!

[Sippan]

"For the past 70 years, we used to be wrong only 20% of the time, but now we've discovered a new exciting method which allows us to be wrong 42% of the time!"

Apostrophe abuse

[Alioth]

Zonk, this summary abuses apostrophes badly.

As Dave Barry said, "An apostrophe doesn't mean - Yikes! Look out! Here comes an S".

Tip: It's means "it is".

Don't trust things like this 100%... not even 58%

[pan-y-vino]

I hope this doesn't get modded "Funny" 'cause I assure you it wasn't... I've got irritable bowel syndrome, and I'm a bit of a hypochondriac. OK, so not a "crazy thinking I'm ill ALL the time hypochondriac", but I'm very apprehensive. About a year or so ago I had some symptoms (which I won't describe here for obvious reasons...) and decided to Google for them. I spent about 1 week crying (yes, really crying) thinking I had Colon cancer, and about 1 year more to live or so. It took 3 doctors and all sorts of horrible tests (which I won't describe here either .... for obvious reasons...) for me to realize I was being silly and there wasn't anything wrong with me. I can't imagine what my state of mind would've been if, prior to searching for the symptoms, I'd read this on slashdot... I woulds been even MORE sure that there was a 58% chance I had colon cancer and I might've killed myself... So, if you're even a little apprehensive don't EVER google for your symptoms!

No...

[tkrotchko]

The write-up is a bit funny and misleading.

It's saying of the 20% that's mis-diagnosed, Google correctly identified 58% of those.

However, what no one has brought up is that when something is misdiagnosed, no one knows until they do the autopsy, so you can't just do simple math to lower the error rate to 8%. As you suggest, while google does better when the doctor is wrong, Google is worse than the doctor when he's correct. I'm not sure it's even correct to assume that if the doctor used Google the diagnoses would be better or worse, since there is an element of human judgment in medical practice.

What is does suggest is that doctors and patients should consider using Google to do a check on their patients and themselves for diagnosis and treatment options.

Well google saved my fiancee's life

[syousef]

Specialist put her on a drug that caused her ever increasing grand mal seizures. He kept uping the dosage despite seizures being a contra-indication. She started with occassional seizures and progressed to a couple a day. She'd had previously had brain surgery to remove an araknoid cyst some time before and was experiencing petite mal (blank staring) seizures and narcolepsy. (I now suspect that carbonmonoxide poisoning due to a faulty car exhaust was partly to blame and not the brain injury, nor subsequent treatment but the truth is I won't know). Anyway the drug was also killing her personality and making her moody and erratic. Unfortunately coming off the drug immediately leaves patients prone to being suicidal so we had to bring her down over a period of weeks.

Did the doctor work out what was going on? No the arrogant son of a bitch didn't bother to give the fact that his patient had developed seizures a second thought. Fucker wanted her to stay on the medication. I had googled it, and after we pointed out to him that it was a contraindication and asked to have her come off it for a while, he said okay. Again I'm the one who looked up the fact that suddenly stopping would have made her suicidal.

Three things were re-enforced for me:
1) Yes Google is only as good as the researcher. Using Google to find a specialist site is probably one of the better ways to go. Thing is you have to learn some of the lingo and understand what you're seeing. Takes a bit of plugging away to do that.

2) The medical profession is full of arrogant tossers. The only less practical, more corrupt systems I know of are our legal and political systems. Some doctors are good despite the system. However the system encourages self serving educated idiots who take no interest in themselves (not to mention overworked perpetually tired doctors making life and death decisions). Most doctors don't take kindly to being second guessed, think they know best even when they haven't considered something properly, and think themselves above using technology to diagnose a patient. In the 21st Century the medical profession remains very 16th Century.

3) Get a good doctor and they make you better. Get a bad one and they'll take a minor problem you have and kill you with their incorrect treatment. It is entirely possible to know better than your doctor. In that case you still do need someone medically trained. Get a second or third opinion. Your life can depend on it.

She was deteriorating so quickly that I have no doubt whatsoever that had I not worked out what was wrong with my fiancee she'd have been dead within about 6 months from the time I did work it out (if not sooner). Having a search engine there to be able to research her condition was literally a life saver. Google happened to be king of the hill at the time.

Internet (possibly) Saved My Life

[dannydawg5]

This happened Feb, 2003.

2 months after finishing college and starting a new job in a new area, I woke up one morning with an odd stomach pain. I didn't think anything of it, so I went to work. By lunch time, the pain did not relax at all. It didn't get worse... just a steady piercing pain. I told a co-worker I was taking a half day. By 5pm, I was starting to get really worried because this was not a normal feeling stomach pain, and it was still there.

I went to Google and typed in stomach pain, and that's when I was starting to really get worried. Several websites started directing me to Appendicitis. After reading more, I had all the Appendicitis symptoms except "nauseated". I called a friend, and he said, "Nah, man! It's probably just something you ate! You said you aren't feeling nauseated, right? I'd wait until you were nauseated."

I had crappy insurance. I didn't want to go to the hospital unless I needed to, but since everything I read online was pointing to Appendicitis, I eventually decided that peace of mind was worth an out-of-pocket exam, so I jumped in the car and drove myself to the ER.

I went to the front desk, and he asked, "What do you think is wrong?"
I said, "I think I have Appendicitis."
"All right, fill this out and sit over there."

When I got to finally see a nurse, I said, "I think I have Appendicitis."
"Does this hurt?" "Yes."

When I got to finally a doctor, I said, "I think I have Appendicitis."
"We'll run some tests."

They ran a blood test. Came back positive.
They ran some x-ray type test. Came back positive.

By 10pm, the doctor came and said, "You have Appendicitis." By 5am, they were operating on me.

After one flaming bag of pus removed, and ~$5,000 worth of medical debt, I spent the next week on disability leave playing Final Fantasy X in my apartment. Good game, btw.

self diagnosis = fun!

[yulek]

while at work one day back in 1997 i got these weird blisters on my face. they got worse quite quickly. a fever came. sweats. sitting in my cube i started panicking and typed a search string containing my various symptoms into the search engine of the day at that time, prolly hotbot (!)

the search engine told me that at best i had herpes but more likely leprosy.

my doctor finally returned my call, had me come over, and told me it was chickenpox... ...

can you imagine what a hypochondriac's google search logs might looks like?

I am a doctor and I use Google

[Invicta{HOG}]

But not for this purpose. It's a good resource for handouts explaining diseases in layman's terms. It's also good for diagrams to show patients. And occasionally I'll fire it up if I don't recognize a trade name for a new medication.

But for diagnosis, no. Here are the limitations of this study as I see them. The New England Journal cases are weird, uncommon diseases. They often feature a constellation of uncommon symptoms, such as the example used in the article - IPEX (immunodeficiency, polyendocrinopathy, enteropathy, X linked). If you search for just immunodeficiency and polyendocrinopathy, you will get the answer. This is because those are rare symptoms and their combination is even rarer. You would get the same result on any of the well-traveled medical professional sites. If you had a patient with more common symptoms such as with fatigue, weight loss, and night sweats, the prospects of a successful search are low. Another problem with the study is that diagnosis requires a determination of which symptoms are important. If you search for "immunodeficiency polyendocrinopathy hangnail" you don't get IPEX. The researchers in the study got to choose which features of the disease to include and made sure to search for them in medical language. If they had searched for "immunodeficiency low thyroid" they would get an article about greyhounds. It's the same symptom, but not searched medically (polyendocrinopathy). A final issue is that one of the reason these cases are so hard (they all come from Massachusetts General Hospital, where I've cared for a few of them) is that they take awhile to unfold. Usually by the time they are written up nicely, they are far easier than when only one or two symptoms have developed or when the bloodwork is only half finished. When a case appears in the New England Journal, you start thinking rare things immediately. When it appears in your clinic, you should think of common things first.

Anyway, I definitely think that google (or more likely other diagnostic algorithms) has a role in the future of diagnosis. I don't think that it is anywhere near that point yet. I think the study actually supports that (58% is pretty poor!)

That's actually not been shown to work

[spineboy]

These lesions usually spontaneously resolve, or can be treated with bisphosphonates (osteoporosis meds) and a bone stimulator. Surgical drilling has not been shown to affect the outcome. The fact that your friends knees became better probably had nothing to do with the surgery. Knee replacements are indicated when the osteonecrosis leads to collapse of the knee joint, usually in large lesions. Since your friend is young, a total knee replacement would not be the preferred treatment - an osteotomy (cutting the bone to change the knee alignment and weight bearing area) would be the preferred treatment.

-Francis C. MD
Dept. Musculoskeletal Oncology, Orthopaedic Surgery.