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Why you should not self-diagnose based on online information

SINGAPORE — A 40-year-old businessman, who was diagnosed with early rectal cancer and had a good chance of survival, went online to search for an alternative therapy. He found one — touting wheatgrass juice as a natural cure for cancer — and paid a high price for it.

Why you should not self-diagnose based on online information

SINGAPORE — A 40-year-old businessman, who was diagnosed with early rectal cancer and had a good chance of survival, went online to search for an alternative therapy. He found one — touting wheatgrass juice as a natural cure for cancer — and paid a high price for it.

“By the time we saw the businessman, his cancer had become as large as a fist. He died a few months later with plenty of wheatgrass juice in his belly and thousands of dollars poorer,” said Dr Peter Edelstein, chief medical officer of global information solutions provider Elsevier.

“We’ve seen some horrible outcomes from unreliable online information by the time patients get to us for treatment,” said the US cancer expert, who was in town last month for the Healthcare Information and Management Systems Society AsiaPac15 conference.

The wealth of online health information has become a double-edged sword for the healthcare industry today, said doctors TODAY spoke to. The right information can provide useful insights into medical conditions. Used wrongly, however, it can place lives at risk.

“It can be difficult for patients to differentiate between what is reliable and what is not,” said Dr Daniel Chan, co-founder and deputy CEO of Fullerton Healthcare Group.

SELF-DIAGNOSING OFTEN RISKY

One example is symptom checkers. These computerised tools, which produce a diagnosis after users enter information about their symptoms, are fast gaining popularity among web users.

One free symptom checker app, iTriage, reports over 12 million downloads and a 4.5-out-of-five-star rating from over 100,000 reviews, according to its description on iTunes. One review posted by user Anne P claimed the app helped her discover she had deep vein thrombosis after a long plane trip.

But a new study by Harvard Medical School published in medical journal BMJ in July has found that many symptom-checker sites tend to misdiagnose patient’s health issues.

The researchers tested 23 online and mobile apps, and found that the apps offered a correct diagnosis on the first try only about one-third of the time. The symptom checkers missed one out of every five cases requiring emergency treatment.

On the other hand, in two-thirds of patient evaluations where medical attention was not necessary, symptom checkers encouraged medical care.

This prompted the researchers to note that “some patients researching health conditions online are motivated by fear, and the listing of concerning diagnoses by symptom checkers could contribute to hypochondriasis and cyberchondria, which describes the escalated anxiety associated with self-diagnosis on the Internet”.

Anxiety arising from information overload is something Madam H Fong can relate to. The 54-year-old manager worked herself into a panic after an online search about the numbness in her left shoulder came up with several possible life-threatening conditions of the kidney and heart. She saw a specialist and did an MRI scan.

“When the scan revealed it was only due to wear and tear from ageing, I actually shed tears of relief. My doctor later chided me for worrying myself needlessly,” said Mdm Fong.

Dr Edelstein said even minor ailments can be magnified when a person who is not medically trained is faced with unfiltered information.

He explained: “You can get really frightened over a cold, which can have similar symptoms to a more serious condition like lymphoma. But what worries me more is that symptom checkers can also downplay symptoms, which is risky.”

DON’T DOWNPLAY URGENT SYMPTOMS

There are certain scenarios where you should not waste time searching online for medical advice. They include certain red flags which would require urgent medical attention, such as severe chest pains, vision problems and persistent high fevers, said Dr Chan of Fullerton Healthcare Group.

He warned: “For instance, chest pains, if ignored, can sometimes be fatal as it may be a symptom of an undetected and underlying condition such as a heart attack. Likewise for recurrent headaches; in rare cases, this can be a sign of a serious condition, such as a stroke or a brain tumour.”

Neither should pain be taken lightly. Ms Sylvia Ho, principal physiotherapist at Core Concepts, advised seeking immediate medical attention in instances when pain becomes progressively worse, or is so severe that the person is unable to put any weight through the affected limb, starts losing strength and sensation in the limb, or loses control of bladder and bowel functions.

Dr Snehal Patel, co-founder of MyDoc, a digital healthcare platform where patients can consult doctors online, said: “There is nothing better than a personalised consultation with a real doctor who can assess a patient based on his specific symptoms and conditions. While minor conditions like a sore throat can be self-managed, it is hard to argue that getting personalised advice from a professional would not be the better way to go.”

Mr Victor Khoo, managing director for Core Concepts, pointed out that a knowledgeable patient is likely to work better with his healthcare partner. The local private musculoskeletal healthcare group provides a symptom checker on its website developed by its physiotherapists.

“No symptom checker for the consumer will ever be 100-per-cent accurate. Rather, it is meant to open minds to new possibilities. This trend only becomes a problem when patients become fixated with a condition that they read about and think it fits them to a T,” said Mr Khoo.

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