Cyberchondriacs

By DEIRDRE FULTON  |  July 22, 2009

Another problem with online medical detective work is that neither the computer or Google has any information about the searcher — their age, gender, genetic history, and other pertinent facts remain unknown.

"[R]ich sets of symptoms and detailed background information are rarely provided to search engines," the Microsoft researchers pointed out. "[T]he subtleties in interpretation and implication that come with expertise are lost in web content," they continued.

This lack of specificity can lead searchers to conclude that they have a condition for which they are barely at risk. Consider this anecdote, from a 32-year-old Portland woman, who "had a roommate once who did nothing but sit around on her ass all day surfing the Web and eating crap. When she then felt sick — who wouldn't on a diet of junk food and 8 hours of computer time a day? — she would search online to find out what 'disease' she had. Her mouth hurt ... so she convinced herself that she had thrush, which normally occurs in infants, and is basically a yeast infection in your mouth."

(The roommate did not have thrush. It remains unclear whether or not she had any diagnosable condition, apart from Lazy Bum Disorder.)

Any reputable health Web site is plastered with disclaimers, like this one at MayoClinic.com (emphasis added): "This site and its services are for consumer educational use only. Nothing contained in this site is or should be considered, or used as a substitute for, medical advice, diagnosis or treatment. The services provided on this site are here to educate consumers on health care and medical issues that may affect their daily lives. This site and its services do not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment."

But no one reads those. A better cure for cyberchondria might be smarter symptom-searching technology. Already, based on user research, big health-info sites like MayoClinic have retooled their home pages to focus more on symptom identification, Harms says. The next steps would be developing "techniques for recognizing health-related queries" within search engines, the Microsoft researchers proposed, responding to those with "de-biased" results that display incidence rates, and filtering serious conditions that produce more hits but are also more rare.

Of course, one of the most obvious ways to counter cyberchondria is to encourage people to see their doctors before letting their imaginations run wild. This isn't a missive about health insurance, but it's worth noting that for those who have no doctor to call, what they find online might be their only information. And even for the insured, going to the doctor can be inconvenient and expensive — people want to know whether something is serious enough to bother. Those people often call their doctor's office and chat with a nurse, and that's where online cyberchondria, in small doses, can be helpful.

Harms points out that surfing unbiased, trustworthy online health clearinghouses like his and WebMD.com can have positive effects. "The Internet is a very, very powerful tool ... to help you make the most of your physician visit," he says, helping Web surfers know what questions to ask, and familiarizing them with terminology. But even here, there are problems. If someone is convinced they have a certain condition, what's to stop them from playing up or down appropriate symptoms when describing their condition to a doctor to ensure they get their "desired" diagnosis?

Which suggests, when it comes to our health and the Internet, perhaps we're all better off playing by this 38-year-old Portland man's rules: "I avoid WebMD at all costs."

Deirdre Fulton can be reached atdfulton@phx.com.

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