Cyberchondriacs

By DEIRDRE FULTON  |  July 22, 2009

Combine sensational search results with an anxious populace — not to mention a few stories (some urban legends, some apparently true) about people who actually do figure out their own health mysteries online after their symptoms stump doctors — and you have fertile ground for cyberchondria. Thus, a headache becomes a brain tumor (rather than, say, caffeine withdrawal), muscle twitches are almost certainly multiple sclerosis (not fatigue, which is much more likely); and absolutely everything is cancer.

Solid sources:Where to go to avoid cyberchondria
Based on their affiliations, information sources, motives, advertisers, design, accuracy, and tone, Consumer Reports WebWatch ranked several health Web sites in 2002. The top four sites were:

1) The National Institutes of Health
2) MayoClinic.com
3) WebMD.com
4) InteliHealth.com (associated with Harvard Medical School)

The most important factors in deciding these rankings were transparency of sources (authors and credentials are listed for most, if not all, articles on these sites), and the extent of possible commercial interests/biases. Sites that fared worse in the Consumer Reports study (such as Health Bulletin, HealthWorld, or Oxygen Health) did so because of their commercial focus ("too many ads" was a prominent complaint) or lack of academic rigor and original content.

Rule of Thumb: If you're perusing a health Web site and feel like you're getting a sales pitch, it's time to look elsewhere.

Misusing, and misinterpreting, online medical information "can lead users to believe that common symptoms are likely the result of serious illnesses," Microsoft researchers Eric Horvitz and Ryen White wrote in their 2008 study, "Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search," published through Microsoft's research and development arm. The study was the first to attempt to quantitatively analyze cyberchondriac tendencies. "Such escalations ... may lead to unnecessary anxiety, investment of time, and expensive engagements with healthcare professionals," they wrote.

The Microsoft study found, among other things, that Web searches of common symptoms are just as likely (and in some cases more likely) to turn up serious explanations as non-threatening ones. For example, if someone enters "bug bite" into a search engine, she might see just as many results referencing poisonous spiders as those dealing with infected mosquito bites — despite the fact that the latter justification is exponentially more probable. Some people, the scientists say, equate prevalence in search results with diagnostic likelihood — the closer to top of the pile, the more realistic it seems as a medical explanation. Obviously, that's bunk. But the Microsoft study found that rank order of search results made one in 10 subjects more anxious.

"Despite how tempting it is to believe that it's the worst thing on the list, the important thing is not to panic," says obstetrician and gynecologist Roger Harms, the medical editor-in-chief for MayoClinic.com, one of the Internet's most popular medical Web sites. Harms points out that some health-related sites, especially those targeted to sufferers — or potential sufferers — of certain diseases, are not good sources of medical facts. "They almost have a tone of recruiting people to the disease," he says. (Indeed, "cyberquackery" might be a topic for a whole other article.)

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