A glut of Google can give you a virtual fever

[Guest guest]

Carolyn

Washington Post Staff Writer

Tuesday, November 10, 2009

It always starts out innocently enough -- for example, with an eye twitch.

It's just a little tic, but it keeps coming and going over the course of a

few weeks, and so I decide to do a little medical investigation online. I

plug " recurrent eye twitch " into my friendly search engine and, after

several hours poring over a range of health-related Web sites -- skimming

over likely explanations such as fatigue, stress and too much caffeine in

favor of dozens of worst-case scenarios, and growing increasingly panicky

all the while -- I am utterly convinced that I have multiple sclerosis, at

the very least, and quite possibly Lou Gehrig's disease.

But what really ails me? Cyberchondria, loosely defined as the baseless

fueling of fears and anxiety about common health symptoms due to Internet

research, or, as I like to think of it, Googling oneself into a state of

absolute, clinical hysteria over every last pain, itch and strange freckle

on your body.

Apparently, I'm not alone. Last year, Microsoft researchers Horvitz and

Ryen White documented the growing trend in " Cyberchondria: Studies of the

Escalation of Medical Concerns in Web Search, " which included a survey of

515 Microsoft employees and Web-search tracking of hundreds of thousands of

consenting Windows Live toolbar users.

The report showed that about 2 percent of all the Windows Live searches were

health-related. Of the 250,000 or so users who engaged in at least one such

query during the study, roughly one-third " escalated " their subsequent Web

surfing to focus on far more serious -- and much less common -- conditions.

In addition, the employee survey showed that this type of escalation

interrupted the everyday life of more than half the respondents at least

once.

Of course, it's important to acknowledge that there is a lot of high-quality

health content on the Internet that has helped a lot of people, both on

respected, vetted Web sites such as WebMD and Medstory, and also within the

myriad online support groups for particular illnesses, where people can seek

information, encouragement or a shoulder to cry on. In addition, Horvitz and

White's follow-up study found that while two in five people report that

surfing the Web for health-related information has made them feel more

nervous about a perceived medical condition, just over half of folks say

that it reduces anxiety.

The problems arise when people turn to a broad Web search to diagnose their

ills, says Horvitz, whose professional credentials include an MD degree.

" People have come to look at search engines as question-answering systems, "

he explains. " We now see [the Internet] as a general oracle, in our pockets

and desktops, that we can just ask questions to, and people think it's going

to answer all questions in a quality manner; therefore, people turn to the

system and say, 'Diagnose me; here are the symptoms.' "

Horvitz notes that medical diagnostics requires taking in sets of symptoms,

reflecting, having an interactive dialogue with a patient and then

converging on a list of likely conditions. " It's a relatively sophisticated

task that's quite different than information retrieval, which is what search

engines are good at. They do not have a good sense for how to reason under

uncertainty, or for probabilities. . . . The Web is really great at finding

out who played the role of Gilligan on 'Gilligan's Island,' but not so good

at weighing the evidence to give you good information about concerning and

unconcerning health situations. "

Instead, Web search rankings are often based on such things as relevance and

click-through rates, which skew the results you see. For example, Horvitz

and White use the example of headaches, which are just as likely to be

associated with " brain tumor " as " caffeine withdrawal " in search, although

the annual U.S. incidence rate of brain tumors is about 1 in 10,000, and

missing your daily cup of java is one of the most likely explanations for a

common headache. Yet the research also shows that the vast majority of

people have interpreted the ranking of search results as a list of likely

ailments, in order of probable diagnoses.

Clearly, psychology is just as much at play as technology.

phson, a clinical associate professor of psychology at Weill Cornell

Medical College in New York, says that a lot of the health concerns people

have fall broadly under the category of anxiety, which can prompt compulsive

behaviors such as constantly cruising the Web for information. He explains

that it's well-proven that people are prone to selectively attend to

negative information -- like the fact that a mole might be melanoma -- and

to ignore the actual low prevalence of dire diseases,

" It's a paradox: The more you read in an attempt to reduce your fear, the

more you try to figure things out, the more anxiety peaks. Very few people

know how to navigate the Internet and evaluate information when they're

anxious, and yet that's when they tend to go online. "

Microsoft's Horvitz says the challenge for the Web is to improve health

content so it more accurately reflects probability and likelihoods, and to

adapt search engines to factor in many more complexities, such as family

history, to be able to properly diagnose an ailment and then intervene when

people are escalating inappropriately. Take, for example, someone younger

than 35 with no family history of cardiac trouble who plugs " chest pain "

into a search. Right now " heart attack " will pop up the most frequently,

about 37 percent of the time, says Horvitz. " But if the system just knew

their age and family history, it would say, 'Just take it easy; don't run to

the hospital,' " because it would be extremely unusual for a young person

with no history to be having a heart attack.

In the meantime, fellow cyberchondriacs, try to keep everything in

perspective and seek out credible information. The Medical Library

Association has some great tips for evaluating health research online.

Oh, and about that twitch? Eventually I asked my doctor about it, and he

helped me figure out that I'm actually allergic to a new eye cream I bought

to stave off the effects of aging -- not in need of pricey and invasive

tests for a rare tropical disease.

[Guest guest]

While this is a great article, I have a personal feeling I wish to express. I have horrible health care coverage. There have been several occasions where I leave an appointment terribly frustrated with the "cattle call" mentality of the busy doctor offices. I feel the need to "do it myself" because I am literally "on a conveyer belt" and shuttled in and out of the office in the blink of an eye. I need to arm myself with research/education so I can guide the doctor properly in the short amount of time I am allotted. I think the internet is a wonderful tool for people in situations like me.From: Francesca Skelton <fskelton@...>Subject:

[ ] A glut of Google can give you a virtual fever"support group" < >Date: Tuesday, November 10, 2009, 10:58 PM

 

Carolyn

Washington Post Staff Writer

Tuesday, November 10, 2009

It always starts out innocently enough -- for example, with an eye twitch.

It's just a little tic, but it keeps coming and going over the course of a

few weeks, and so I decide to do a little medical investigation online. I

plug "recurrent eye twitch" into my friendly search engine and, after

several hours poring over a range of health-related Web sites -- skimming

over likely explanations such as fatigue, stress and too much caffeine in

favor of dozens of worst-case scenarios, and growing increasingly panicky

all the while -- I am utterly convinced that I have multiple sclerosis, at

the very least, and quite possibly Lou Gehrig's disease.

But what really ails me? Cyberchondria, loosely defined as the baseless

fueling of fears and anxiety about common health symptoms due to Internet

research, or, as I like to think of it, Googling oneself into a state of

absolute, clinical hysteria over every last pain, itch and strange freckle

on your body.

Apparently, I'm not alone. Last year, Microsoft researchers Horvitz and

Ryen White documented the growing trend in "Cyberchondria: Studies of the

Escalation of Medical Concerns in Web Search," which included a survey of

515 Microsoft employees and Web-search tracking of hundreds of thousands of

consenting Windows Live toolbar users.

The report showed that about 2 percent of all the Windows Live searches were

health-related. Of the 250,000 or so users who engaged in at least one such

query during the study, roughly one-third "escalated" their subsequent Web

surfing to focus on far more serious -- and much less common -- conditions.

In addition, the employee survey showed that this type of escalation

interrupted the everyday life of more than half the respondents at least

once.

Of course, it's important to acknowledge that there is a lot of high-quality

health content on the Internet that has helped a lot of people, both on

respected, vetted Web sites such as WebMD and Medstory, and also within the

myriad online support groups for particular illnesses, where people can seek

information, encouragement or a shoulder to cry on. In addition, Horvitz and

White's follow-up study found that while two in five people report that

surfing the Web for health-related information has made them feel more

nervous about a perceived medical condition, just over half of folks say

that it reduces anxiety.

The problems arise when people turn to a broad Web search to diagnose their

ills, says Horvitz, whose professional credentials include an MD degree.

"People have come to look at search engines as question-answering systems,"

he explains. "We now see [the Internet] as a general oracle, in our pockets

and desktops, that we can just ask questions to, and people think it's going

to answer all questions in a quality manner; therefore, people turn to the

system and say, 'Diagnose me; here are the symptoms.' "

Horvitz notes that medical diagnostics requires taking in sets of symptoms,

reflecting, having an interactive dialogue with a patient and then

converging on a list of likely conditions. "It's a relatively sophisticated

task that's quite different than information retrieval, which is what search

engines are good at. They do not have a good sense for how to reason under

uncertainty, or for probabilities. . . . The Web is really great at finding

out who played the role of Gilligan on 'Gilligan's Island,' but not so good

at weighing the evidence to give you good information about concerning and

unconcerning health situations."

Instead, Web search rankings are often based on such things as relevance and

click-through rates, which skew the results you see. For example, Horvitz

and White use the example of headaches, which are just as likely to be

associated with "brain tumor" as "caffeine withdrawal" in search, although

the annual U.S. incidence rate of brain tumors is about 1 in 10,000, and

missing your daily cup of java is one of the most likely explanations for a

common headache. Yet the research also shows that the vast majority of

people have interpreted the ranking of search results as a list of likely

ailments, in order of probable diagnoses.

Clearly, psychology is just as much at play as technology.

phson, a clinical associate professor of psychology at Weill Cornell

Medical College in New York, says that a lot of the health concerns people

have fall broadly under the category of anxiety, which can prompt compulsive

behaviors such as constantly cruising the Web for information. He explains

that it's well-proven that people are prone to selectively attend to

negative information -- like the fact that a mole might be melanoma -- and

to ignore the actual low prevalence of dire diseases,

"It's a paradox: The more you read in an attempt to reduce your fear, the

more you try to figure things out, the more anxiety peaks. Very few people

know how to navigate the Internet and evaluate information when they're

anxious, and yet that's when they tend to go online."

Microsoft's Horvitz says the challenge for the Web is to improve health

content so it more accurately reflects probability and likelihoods, and to

adapt search engines to factor in many more complexities, such as family

history, to be able to properly diagnose an ailment and then intervene when

people are escalating inappropriately. Take, for example, someone younger

than 35 with no family history of cardiac trouble who plugs "chest pain"

into a search. Right now "heart attack" will pop up the most frequently,

about 37 percent of the time, says Horvitz. "But if the system just knew

their age and family history, it would say, 'Just take it easy; don't run to

the hospital,' " because it would be extremely unusual for a young person

with no history to be having a heart attack.

In the meantime, fellow cyberchondriacs, try to keep everything in

perspective and seek out credible information. The Medical Library

Association has some great tips for evaluating health research online.

Oh, and about that twitch? Eventually I asked my doctor about it, and he

helped me figure out that I'm actually allergic to a new eye cream I bought

to stave off the effects of aging -- not in need of pricey and invasive

tests for a rare tropical disease.

[Guest guest]

The information that you can get from Google can be a mixed bag of useful and

questionable information. There is a new search engine for health that allows

you to search trusted sources, like the Mayo clinic, or expand your search to

the web or even blogs. This is the link:

HealthMash

http://www.healthmash.com/

Tony

>

> While this is a great article, I have a personal feeling I wish to express. I

have horrible health care coverage. There have been several occasions where I

leave an appointment terribly frustrated with the " cattle call " mentality of the

busy doctor offices. I feel the need to " do it myself " because I am literally

" on a conveyer belt " and shuttled in and out of the office in the blink of an

eye. I need to arm myself with research/education so I can guide the doctor

properly in the short amount of time I am allotted. I think the internet is a

wonderful tool for people in situations like me.

>