For second opinions, Dr Google
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By Dene Mackenzie on Tue, 7 Oct 2008
Try typing in "online medical" into Google and you find more than 44 million references.

You can narrow down the search if you add the word "diagnosis" to a mere 1.11 million references.

But a note of warning, it does not pay to start reading the symptoms found in the sites too closely if you are of a nervous disposition.

Because, within 5min I was off to see my boss about time off because I had discovered a rare disease, the symptoms of which were sure to be floating around in my body.

But for Terri Nelson, online diagnosis has been a bit of a saviour.

When she learned she had a large fibroid tumour in her uterus, she went online.

She started with straightforward information-gathering, checking articles about fibroid tumours on various sites.

By the time she went into the consultation with her surgeon, she knew that the old-school way of dealing with her grapefruit-size tumour would probably have been a hysterectomy.

But she found several doctors preferred abdominal myomectomy, which left the uterus intact.

During the surgery and recovery, her husband used Twitter, the short-message communication service, to keep friends and family appraised of her condition.

Friends contributed, and in one instance Ms Nelson's medication was changed because a friend correctly identified a potentially hazardous side-effect was caused by an anti-nausea drug.

There is nothing much new in that because the intrepid and the adept were going to the web for health information as long ago as the 1980s before Google and other search engines made it accessible to a wider audience.

According to the Pew Internet and American Life Project, at least three-quarters of all Internet users look for health information online.

People with a high-speed broadband connection are more likely to search online.

One in nine searches on a typical day.

About 75% of online patients with a chronic problem told researchers their last health search affected a decision about how to treat an illness or conditions.

Reliance on the Internet is becoming so prevalent that Google had become the "de facto second opinion" for patients seeking further information after a diagnosis.

The author of the report, Susannah Fox, the associate director of Pew, said paging Dr Google could lead patients to miss a rich lode of online resources that might not yield to a simple search.

Sometimes just adding a word made all the difference.

Searching for the name of a certain cancer will bring up the Wikipedia entry and several information sites from major hospitals, drug companies and other providers.

Add the word "community" to that search and "it's like falling into an alternative universe" filled with sites that connected patients, she said.

As a result, patients were learning from each other rather than websites.

PatientsLikeMe.com is a site that allows patients to track and document their conditions and compare notes with other patients.

With a growing online population, it becomes possible to research highly specific conditions - such as being a 50-year-old man with multiple sclerosis who has leg spasms and is taking a certain combination of drugs.

There are so many sites today, and the landscape is changing so rapidly, that it would take an encyclopedia rather than a newspaper to list them.

But the New York Times online site has identified five broad, often overlapping, categories:General interest: webmd.com, health.discovery.com and nytimes.com/health provide information about disease, news and lifestyle advice, as do medical institutions like the Mayo Clinic (mayoclinic.com).

Medical research sites: These sites offer access to the published work of scientists, studies and a window into continuing research.

They included ncbi.nlm.nih.gov/pubmed, clinicaltrials.gov, apa.org/psycinfo for psychological literature, and nccam.nih.gov for the National Centre for Complementary and Alternative Medicine.

Patient sites: These sites are booming, so much so that they are increasingly used by researchers to find patients for studies.

Cancer resources are on acor.org and e-patients.net and trusera.com and PatientsLikeMe.com provide a Facebook-style social connection for patients to share their stories in clinical, data-laden detail.

Disease-specific sites: These focus on particular conditions and are often sponsored by major organisations.

Look at americanheart.org, cancer.org and diabetes.org.

Web Tools: These sites help people manage their conditions - sugarstats.com for diabetes, drx.com for comparing drug prices and YourDiseaseRisk.com that helps patients determine their risk for various problems.

Changes to the Internet and the ways people use it might help explain why people are engaging more with their own doctors when they seek professional medical advice.

But it is also making health care more democratic and allowing people to make informed choices about their treatment.

dene.mackenzie@odt.co.nz

http://www.odt.co.nz/blogs/dene-mack...ions-dr-google