Diagnosing with Dr.Google and Health 2.0

Hangwi Tang and Jennifer Hwee Kwoon Ng, a physician and rheumatologist from Brisbane, Australia, wonder how often Google searches lead doctors to correct diagnosis after a father of their patient got correct diagnosis and treatments by searching the most popular search engine.

They did an experiment study by picking search terms from dianosis cases published in the New England Journal of Medicine (NEJM). After searching on Google by using the combination of the terms selected in each case, they used three most prominent dianoses and compared with the correct diagnoses as in NEJM.

The result found 58% of the diagnoses found on Google are correct (95% confidence). Personally, I think it is quite low rate, especially with the terms selected by physicians (as the terms would be more specific and relevant). This would yield less accuracy rate for patients’s searches inevitably. However, the paper rather points out the optimistic side as physicians could use Google for formulating a differential diagnosis in difficult cases.

One of the concerns of this study is the “search terms” which regularly reflects searchers’ experiences. Thus, the authors point out that:

“Patients doing a Google search may find the search less efficient and be less likely to reach the correct diagnosis. We believe that Google searches by a “human expert” (a doctor) have a better yield, as Google is exceedingly good at finding documents with co-occurrence of the signs/symptoms used as search terms and human experts are efficient in selecting relevant documents.”

However, the paper does not indicate if the study was done when Google health is available or not. If so, would the Google health architecture improve the efficiency?

The article is published in British Journal of Medicine (Vol. 333., No. 7579).

Moreover, the quotation of one of the author, Dr.Tang, in the interview in Courant is interesting.

“In cases of mystery illness, doctors usually discuss it with other doctors,” Tang says. “We may use PubMed or Medline, or go to the library. We are advocating using the Web as another resource.”

This points out to the importance of community of practice as web 2.0 could well facilitate the diagnosis. Dean nicely introduces the web2.0 sphere in medical area, in particular highlighing blogophere and RSS feed. In the recent AMIA conference in Washington DC, there was a session dedicated to web 2.0 opportunity in health/medical education (rather than for diagnosis or communication between physicians and patients as I expected).

The role of web 2.0 is particularly enhancing the communication of a community which could be used for different purposes. Dianogsis is only one of benefits that we could obtain from web 2.0. By looking at community’s point of view, one can find three benefits that Web 2.0 could provide to a community.

Communication among health professionals

Among health professionals, up-to-date information can be shared easily by blog, podcast, feed, Flickr, and wiki-kind applications. Also in responding to the case by the Google study, social software, such as LinkedIn, is probably another alternative source to find an “expert” as a reference for diagnosing difficult or mysterious cases.

Communication among patients/health care consumers

This type of community is obviously existing everywhere. The Web 2.0 applications primarily facilitate social networking and seeking preliminary information prior to seeing a doctor. For example, by browsing different kinds of topics in Lumpini room in Pantip.com, a Thai health specific topic webboard, the members of community can share their experiences about symptoms, health care products, treatment and even health care providers. In many cases, people post messages to ask where they could get the best health care service for particular symtoms/diseases which I think it is valuable.

However, the pertinent issue which becomes classic in online world is the creditability. Therefore, from public health perspective, having physicians as members/moderators would be add reliability to the community which leads to the last benefits.

Creation and maintenance of relationship between health professionals and patients/consumers

As we believe that the good relationship between doctors and patients could lead to more accurate diagnosis, there are a number of medical/health informatics folks trying to make a system to facilitate that idea into practice, e.g. Telemedicine or Personal Health Records (PHRs). Web 2.0 applications, especially social networking software, apperently could also help on this matter. People may think that social software like MySpace or Facebook can only work for leisure purposes. However, I think leisure can be merge with “seriousness” that means there is a chance where health is the matter for the Web 2.0 business as well. Even with virtual community, for instance, a number of health professionals (also health librarians) have been participating in Second Life. However, the creditability or trust in the community would highly depend on the sources (e.g. whether or not they have authority or are actual doctors).

By thinking about this last group, I wonder about the current use of social software by health care professionals. Such questions may include:

  • how many health professionals participate in those networks? (In another word, how many doctors have profiles on social networking websites?)
  • Who are their “friends”? (school friends, work colleagues, patients(?))
  • What role are they representing? (Do they reveal their actual identity? Do they tell that they are a doctor? or in health care professions?)
  • What activities they do on those websites?

Let me know anyone work on this topic.

[via Library Stuff and Courant; Additional reading: How Google is changing medicine]



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