Reaction to Googling for a diagnosis, a recent BMJ study

gballs.gif  I wasn’t going to write about the study published recently in the BMJ, mainly because everyone else has. So what I’m going to write about is some of the reaction to the study. First, here is the abstract; free full text is available online:

Tang H, Ng JHK. Googling for a diagnosis–use of Google as a diagnostic aid: internet based study. BMJ 2006; 333(7579):1143-1145.
Objective: To determine how often searching with Google (the most popular search engine on the world wide web) leads doctors to the correct diagnosis. Design: Internet based study using Google to search for diagnoses; researchers were blind to the correct diagnoses.
Setting: One year’s (2005) diagnostic cases published in the case records of the New England Journal of Medicine.
Cases: 26 cases from the New England Journal of Medicine; management cases were excluded.
Main outcome measure: Percentage of correct diagnoses from Google searches (compared with the diagnoses as published in the New England Journal of Medicine).
Results: Google searches revealed the correct diagnosis in 15 (58%, 95% confidence interval 38% to 77%) cases.
Conclusion: As internet access becomes more readily available in outpatient clinics and hospital wards, the web is rapidly becoming an important clinical tool for doctors. The use of web based searching may help doctors to diagnose difficult cases.   PubMed Record     Related Articles

One of my favourite alerting services, MedPage Today, wrote the following in a teaching brief:
- Explain to interested patients that for physicians search engines may be less helpful in diagnosing complex diseases with non-specific symptoms or common diseases with rare presentations.
- Caution patients that while Google is good at finding documents describing signs or symptoms, the judgment and clinical experience of physicians are still needed to determine relevance and make the diagnosis.
[It's interesting to note that after I suggested to the MedPage Today reviewers that they link to the abstracts of the papers they review, they sent me a lovely gift of fruit and cheese.]

The BMJ rapid responses to this article provide some fascinating reading. In an Authors’ Reply, the study’s authors write:
To state the obvious for those who seem to have missed the point, there is no danger of “Google misdiagnosing life-threatening disease” as search engines cannot make diagnosis. Only doctors are capable of making diagnoses (and misdiagnoses). If the probability of a diagnosis exceeds the testing threshold [10], then tests would be performed to prove or disprove the diagnosis. However the diagnosis has to be considered in the first place and search engines may act as a diagnostic reminder.

Google googling for a diagnosis and you will find huge numbers of responses. In the morning of December 10 there are about 10,700 hits. (!!)  Here are some more specialized hits, from Google News and Google Blog Search. (I wonder if I will show up here?)
Note: I wrote this post in the morning of December 10. Google picked it up about 12 hours later. Those are quick little spiders, eh?

See also A Google Primer

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