Microsoft Researchers Study "Cyberchondria"

Slatterz introduces us to the first major study on "cyberchondria" by Microsoft researchers (abstract, paper [PDF]). The news that it can be a bad idea to search the Internet to see if you have a terrible disease should come as no surprise. According to the NYTimes article, the syndrome has been known as "cyberchondria" since at least the year 2000 (we discussed it a few years back). It refers to increased anxiety brought on when people with little or no medical training go searching for answers to common medical complaints on the Web. The article compares cyberchondria with a phenomenon well known among second-year medical students, called "medical schoolitis." The researchers note that Web searchers' propensity to jump to awful conclusions is "basic human behavior that has been noted by research scientists for decades."

Same rules apply...

[Z80xxc!]

The problem might not be the use of the internet for information, so much as how people are going about getting and using that information. Just like one wouldn't trust some random person off the street or even some unknown doctor-like person in a white coat walking down the hall at the hospital, one can't blindly trust information on the internet. Getting a second opinion, (and a third, and a fourth) might help people to get a better idea of what's truly happening. They should still talk to a doctor, rather than relying solely on their internet diagnosis, but they might be able to at least get a general idea of what might be wrong. Using medical information on the web as one's only source is irresponsible; it should be common sense to get a balanced opinion and also to see a real medical professional.

It's not new, just easier

[girlintraining]

The web hasn't made this behavior any less prevalent, it's just made it easier for people to fall into the trap. There are two camps in the medical community right now; Those who think that medical knowledge should be contained to those who are properly licensed, and those who think knowledge is power (but hope people use it responsibly). If this sounds familiar, it should -- our community (the technical and engineering disciplines) have had the same debate. We've all had our share of "technocondriacs" -- people who insist there's something wrong with their computer, even when we've scanned it with everything, reloaded the operating system, and defragged the drive five times... They somehow think it should run faster, or that there's a button somewhere to do X when there's never been X in that application. And no sniggering about literacy or operating system of choice here -- it happens to users of all backgrounds.

One example is pharmaceutical advertisements. Five years ago, using the words "Erectile Dysfunction" would have left people giggling on the floor. These days, it gets an eye roll and a remembrance of those commercials. It's undisputed some people have a problem rising to the challenge and may not have known there was a treatment for it, but the unintended consequence is a lot of people are taking medications that aren't medically necessary because of self-esteem problems, obesity, or a plethora of other causes that can be treated without a pill. Which of course leads to the "Solve everything with a pill" attitude that our society seems to enjoy, but that's a topic for another day.

I have to side with the idea that knowledge should be out there. My friend just got a horrible ear infection that resulted in extreme pain and puss coming out of her ear because the doctor misdiagnosed it as "swimmers ear"; She needed strong antibiotics and he prescribed drops, and so for three days she's been laid out on a couch screaming and crying every few minutes. She only went back to ER after researching out what else it could be besides swimmers ear, and an ear infection turned up -- there was no difference in the symptoms list, except the pain level. And her mother is a registered nurse who works in a hospital -- she didn't find anything wrong with the diagnosis either. My friend's access to the internet may very well have just saved her some hearing loss this week!

So which side is right? Both. And neither.

Zebra syndrome

[st0rmshad0w]

Yeah this sounds like classic zebra syndrome.

Zebra Syndrome is immediately jumping to the rare possibility when given a piece of evidence. When you hear hoofbeats you should think "horses", not zebras.

Someone gets an ache or pain and hops on Google and suddenly they have Schistosomiasis or something else equally as absurd.

Re:hm

[rhyder128k]

This was the first thing that leapt to my mind as well.

Basic scenario: Patient is able to spend six or seven hours carefully searching message boards and the web for something exactly matches their symptoms. In all fairness, patients aren't always brilliant at specifying their symptoms clearly and exhaustively. Next day, patient goes to see doctor and points out something that the doctor has missed. Doctor thinks, "Who the hell does this guy think he is? I'm God!". Patient gets a telling off for causing a nasty case of cognitive dissonance in the mind of the doctor.

I think that things are perhaps worse in the UK as we have a state healthcare system. As a result, Doctors don't always treat patients with the same respect that they would a paying customer. I've had some private dental care, and the attitude was like night and day. In contrast, a doctor once told me off for having read the the little leaflet that came inside a packet of pills.

It Has A Medical Counterpart, Too

[Wandering Wombat]

Because doctors know that people can often search for stuff like this on the internet, many medical professionals will IMMEDIATE ignore any and all such comments or queries. I've come to three doctors now with information I found in medical journals and on the internet which match my symptoms (migraines, blackouts, audio and visual hallucinations, seizures, fugue states... basically, every facet of certain kinds of epilepsy). All three doctors have told me, in various ways, that since I found this information myself, it's clearly NOT what I have.

I continue to have blackouts and seizures, and continue to go untreated, because unless I have a seizure in my doctor's office, he'll just assume I'm trying to get medication out of him.

I call it "Smug Superioritis".

Re:It's not new, just easier

[lxs]

but the unintended consequence is a lot of people are taking medications that aren't medically necessary

What makes you think this is an unintended consequence?

critical thinking

[bcrowell]

Most people -- including, I suspect, doctors -- have trouble with critical thinking, and one area that tends to be a particular problem is critical thinking about probabilities and cause-and-effect relationships. I'm a community college professor in California, and recently there was a big state-wide earthquake drill, which they made into sort of a media event. The day before, I heard my students before class talking about it. "There's gonna be an earthquake tomorrow at 10 o'clock." "Huh? They can't predict earthquakes, can they?" "I heard it on the news." "Really?" Most people just accept information without thinking about it critically. Obama won't say the pledge of allegiance? Oh, okay.

I don't think medicine is different from any other field where people gather their own information, and I don't think health-care professionals are always much better than anyone else at this kind of thing. For example, I had a certain foot problem, and my G.P. prescribed physical therapy. One of the things the physical therapist did was to use ultrasound on my feet (therapeutic ultrasound, not ultrasound for imaging). I checked on the web later, and it turned out that the only controlled scientific studies on the topic had shown that ultrasound had no effect on my condition.

I think it's telling that "evidence-based medicine" is a term that even needs to be used. If it's not evidence-based, what's it based on? Wishful thinking? Voodoo? The placebo effect?

Re:Personal experience

[BorgDrone]

The first doctor also thought that I had it and scheduled me for surgery. However, the surgeon said to wait for a while.

That's the thing that bugs me the most about the whole medical pseudo-science. They just try something and hope it works, they never actually try to get to the bottom of it and find the real problem. High blood pressure ? Here, have some medication that artificially lowers it. They don't bother to find out WHY it's high and correct that.

It's a good thing these guys didn't go into the programming business because I bet they would be awful at debugging.

The Singularity

[Anonymous Coward]

Does anyone else find it mildly encouraging that the Internet is bringing the general population up to the level of second-year medical students?

Ray Kurzweil is smiling somewhere.