When Self-diagnosis Goes Wrong, Harvard Study Concludes that Self-Diagnosing Tools are Only Correct Half the Time

07/29/2017 10:42 pm ET Updated Jul 29, 2017

In the age of WebMD and Healthline.com, when we get sick, many of us flock to these websites to self-diagnose. And although we may only have the symptoms of a cold, in some cases self-diagnosing does not always work out in our favor. A recent first of its kind study released by Harvard Medical School found that online symptom checker tools were only correct about half the time.

Self-diagnosing, symptom checker tools allow patients to entire their information into the system by answering a a series of multiple-choice questions, checking off a list of symptoms, or typing free form texts. The software analyzes the answers and provides a list of possible illnesses and treatment recommendations based on the symptoms provided.

In the study, published in the British Medical Journal (BMJ), researchers assessed the accuracy of general-purpose symptom checkers and received some surprising results. The researchers tested 23 different online symptom checkers using 45 brief clinical descriptions; a combination of indicators were entered into the symptom checkers to determine the accuracy of each diagnosis. In all, researchers found that:

  • 34% of symptom checkers accurately listed the correct diagnosis as the #1 possible illness
  • 51% listed the correct diagnosis within the top 3 possible illnesses
  • 58% listed the correct diagnosis within the top 20 possible illnesses
  • 58% of the time, the correct triage advice was provided
  • 80% of critical care diagnoses accurately advised patients to seek urgent care

In some cases, the overly cautious, conservative advice provided by symptom checkers resulted in patients potentially seeking unnecessary medical treatment. One of the most interesting conclusions from the study cited that the results of using online symptom checkers were comparable to the accuracy of telephone triage.

In an article published by the Harvard Gazette about the study, Dr. Ateev Mehortra, the study’s senior authors states that although the tools can be useful in helping patients to learn more about their condition; the information provided by online symptom checkers should not be taken as gospel.

As patients, it can sometimes be much quicker for us to Google our symptoms than to schedule a doctor’s appointment and online symptom checkers are not going away anytime soon.

So, what do doctors have to say about this growing trend?

According to Dr. Kyrin Dunston, you should not have to attend medical school to effectively communicate with your doctor, online tools can be useful in helping you to communicate your symptoms and receive an accurate diagnosis. Dr. Dunston does warn, however, against over reliance on online research and tools: “Great danger can occur from relying on Dr. Google to assess symptoms and depending on it as the definitive answer. A false sense of security can be obtained (some of us are wired to minimize discomfort and seek reassurance on the internet) or cause for unnecessary alarm (others are wired to believe the worst based on an array if information located on the internet) by relying on Google MD.”

Dr. Dawnmarie Risley shares her story about how one patient was affected after reading information from an online site:

I actually bought this mug and have pleaded with my patients to ignore forums and such for medical advice. I am thorough and truthful with my patients regarding their diagnosis, treatment, side effects, risks and benefits of the medications I prescribe to them. Recently, I prescribed Lithium to a very manic woman who was spending lots of money and had served jail time for physical altercations while manic. Lithium is the gold standard, tried and true, for the treatment of bipolar illness. I warned her about toxicity and the most problematic problems that can occur with the drug. She came back two days later refusing to take it because of all the bad stuff she read about it on the internet. I showed her my mug and we had a good laugh. She still refused to take it and I had to discuss alternative therapies with her.

Dr. Risley advises that patients should allow their doctors to provide an actual diagnosis and from there the provider and patient can work together to develop a plan of treatment. She states, “Let your doctor present to you your diagnosis. Your google search of symptoms does not provide those innuendos that we as physicians have been trained to find. There are nuances about a person’s affect and physical exam that one won't find in a google search.”

Tips for Preparing for Your Doctor’s Visit

Online websites can be helpful tools to help you learn more about your symptoms and diagnosis, but below are some steps that you can take to help you prepare for your visit to the doctor’s office:

1. Understand how your body works

2. Write down your symptoms

3. Identify your primary concerns

4. Prepare your questions ahead of time

5. Know your medication history

According to Casey Calamusa, Communications Manager for the Washington Health Alliance, “First, pay attention to what your body is telling you. When you experience symptoms, take a moment to make note of them in detail. Be as specific as possible about the symptom and when it started. Next, create a family health history. Your health history can play a role in what tests your doctor recommends. Finally, prepare a list of questions for your doctors, outlining any concerns you have or areas where you would like more clarification.”

The Washington Health Alliance operates the Own Your Health Washington website, which provides patients with tips on how to better talk with their providers. The site has dozens of articles and resources to help patients better prepare for their doctor’s visits.

In addition to the tips listed above, some additional tips are below:

6. Be aware of your allergies

7. Know your family history

8. Arrive early to complete your paperwork

9. Understand how your insurance works

10. Be prepared to talk openly with your provider

11. Do not be afraid to let your doctor when you do not understand

Patients and their families now feel more empowered because of the amount of information and options available. To merge these two worlds, Dr. Leigh Bradley, a representative of the Healthcare Experience Foundation, believes that the doctor-patient relationship should be a collaborative partnership between the provider, the patient, and their family. Dr. Bradley recommends 3 simple tips for patients using online sources:

  • First, seek information from reputable sources and approach the conversation with your provider as you would with any trusted expert. We want you to know, to be informed, and to use the information you bring as a springboard for discussion, being open for hearing the reasons this may or may not explain your condition.
  • Second, in addition to doing some reading, write down and organize your questions; do bring them with you.
  • Finally, answer your provider’s questions as accurately as possible; for instance, when asked what brings you in, help your provider by really describing what’s going on with you, how you feel, and how often the symptoms occur.

Author, Dr. Kristy Taylor, is the founder of Heka Healthcare Consulting, LLC, and healthcare training and performance company. She has 15+ years of experience in healthcare and education.

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