ShareThisThe computer and the Internet are great healthcare tools, but they can also do a lot of medical harm.
Researchers are only beginning to appreciate how information on the Web can be used to help inform and guide patients in ways that augment, rather than replace, actual consultations with doctors, nurses and pharmacists.
There is a fine line. The tradition of docs jotting notes in a chart has largely evolved to typing the same notes on a computer screen. Most are not touch typists, and eye contact can suffer. But the notes are more legible and can roll over into an electronic medical record that can better be shared with other caregivers.
Many doctors of a certain generation resist electronic records because the systems are expensive and difficult to learn. And there are still plenty of docs around who roll their eyes, at least mentally, when a patient comes in with a fist full of printouts from the Web about their condition, or worse, what MIGHT be their condition.
About 7 of 10 Americans have regular access to the Internet and, according to a 2006 Harris poll, 80 percent of adults have looked up medical conditions online. About 60 percent searched on health issues five or more times a month.
Experts say when medical searches start consuming hours of each day, the patient might be addicted to Internet symptom diagnosis -- a cyberchondriac. Psychiatrists say up to 90 percent of patients diagnosed with hypochondria -- debilitating distress over imagined illness -- also obsessively search the Web for information on symptoms and illness.
A couple of Microsoft researchers, Eric Horvitz and Ryen (cq) White, last year reported an analysis of online health searches that found about 25 percent of surfers sought health information, but also looked at how they used what they searched.
They found a marked tendency to only look at the first few results and to focus on the worst case scenario -- as in brain tumor versus brain freeze for a headache -- in whatever entries they perused.
The Microsoft team hopes to use the findings to better refine how search engines cough up health advice, and to give users some sense of the likelihood that what they're experiencing is really a serious medical problem.
A report published last year by British analysts on future use of Internet search technology in public health monitoring noted, "if the number of patients turning to online services for a diagnosis increases, we see a growing demand for intelligent technology that can identify psychosomatic diseases" -- that is, a cyberchondria filter.
Even commercial Web engines specifically geared toward narrowing symptoms down to a limited number of possibilities often leave readers with a long list that is unranked by how common the ailments are, critics have found.
What is not yet clear is how the Web can positively impact health outcomes. The Harris survey, for instance, found that only 45 percent of health surfers looked up information about a medical problem after it had been diagnosed by a doctor -- which is the point when many physicians might actually want the patient to get better informed by reading pamphlets, watching a video or going to well-vetted Web sites.
Still, it appears that Web searches do influence treatment for at least some patients.
A new analysis to be published in an upcoming issue of the journal Cancer shows that colorectal cancer patients who seek out information from the Internet and media are more likely to be aware of and receive the latest treatments. Other studies have shown that about 4 of 10 cancer patients search for information about cancer online.
Dr. Stacy Gray of the Dana-Farber Cancer Institute in Boston and researchers at the National Cancer Institute center on cancer communications at the University of Pennsylvania looked at what treatments 633 patients received compared with how active they were in seeking out information.
They found that aggressive information seekers were nearly three times more likely to have heard about two new front-line drugs for cancer treatment (Avastin and Erbitux) than patients who did not seek information and more than three times more likely to receive the therapies.
The association held true both for patients with advanced disease, for whom the drugs are approved by the Food and Drug Administration, and for those with earlier stages of disease, for whom use is not recommended.
On the Net: http:\\www.cancer.org
(E-mail Lee Bowman at bowmanl(at)shns.com)
The Medical Journal
