Medics find cure for Dr Google 'addiction'

With millions of people now turning to Dr Google in a bid to overcome long healthcare waiting times the search engine has inadvertently created a world of worriers. It is 25 years since Google launched and it presently deals with 70,000 searches about medical concerns every minute. Researchers from Imperial College London estimate it costs the UK's National Health Service £56 million a year, because one in five appointments result directly from people googling their symptoms and jumping to the wrong conclusion. Peter Tyrer, emeritus professor of community psychiatry at Imperial College, told The National it is a major issue in the Middle East and recent research revealed 88 per cent of people in Saudi Arabia search medical conditions online. It has led him and his team to develop a cure to “cyberchondria” – a neologism to describe googling the symptoms of your ailment and fretting over what you read. They discovered by using a specially developed form of psychotherapy, cognitive behavioural therapy, it could effectively help patients overcome health anxiety, fuelled by googling their symptoms. He told The National he is working closely with NHS Trusts to offer treatment in this “neglected” area which could be rolled out internationally and save millions on unnecessary medical treatment. “We are very close to getting the NHS to provide a service for people who worry about their health rather than them going through repeated tests,” he said. “We found when people did have treatment for cyberchondria they improved and the people who didn’t were just as bad as they were eight years earlier because they had gone on consulting doctors unnecessarily and had all these unnecessary tests so had all their fears reinforced by that. We know our treatment for it works, it’s highly cost effective.” He said the cost of unnecessary appointments and scans are costing health services millions. “A lot of the information on Google is good but it’s not filtered so people can actually find a tremendous amount about a condition,” he said. “Increasingly I find that GPs say the first part of their interviews are taken up with patients repeating something they have printed out from Google and want to know answers to and it maybe relevant and it maybe completely irrelevant. "The trouble is Dr Google is a useful source but you need to have knowledge in advance before you interpret it. Increasingly people who haven’t got anything seriously wrong with them will find something on Google that suggests something is seriously wrong with them. They come repeatedly for tests and consultations to be reassured and this is where cyberchondria comes in. “One of the consequences is that it’s not just the appointments that are expensive but it is the unnecessary investigations. Some doctors can be bullied into doing things like MRI scans which are expensive just because Dr Google has suggested something unusual to a patient. "The actual cost of cyberchondria can be quite high. In our research we found over the course of five years the frequency with which people presented with worry about their health doubled so we are in danger of this becoming an epidemic, that might be too strong, but it is certainly becoming more common.” The concept of cyberchondria led Dr David Levine, of the division of general internal medicine and primary care at Brigham & Women's Hospital in Boston, Massachusetts, to conduct a study. He found that many patients were coming to him worried they had cancer after searching their symptoms on Google. “I have patients all the time, where the only reason they come into my office is because they googled something and the internet said they have cancer. I wondered, 'Is this all patients? How much cyberchondria is the internet creating?'” Dr Levine gave 5,000 people a series of symptoms which they had to imagine someone close to them was suffering. He asked them to provide a diagnosis based on the given information then look up the symptoms on the internet. Cases ranged from mild to severe, but described illnesses that commonly affect people every day, such as viruses, heart attacks and strokes. In addition to diagnosing a given condition, participants each selected a triage level, ranging from “let the health issue get better on its own” to “calling an ambulance”. Dr Levine and co-author Ateev Mehrota, from Harvard Medical School, found that people were slightly better at diagnosing their cases correctly after performing an internet search. Participants demonstrated no difference in their abilities to triage. “Our work suggests that it is likely to be OK to tell our patients to 'Google it’,” Dr Levine said. “This starts to form the evidence base that there's not a lot of harm in that, and, in fact, there may be some good.” Dr Rahila Anjum, from the College of Health Sciences in Chennai, India, has found 50 per cent of studies into the effect of Google have concluded that patients researching their symptoms might not be a bad idea. “Many physicians are not big fans of Google, or internet sites, or search engines that might be causing a negative impact on their patients,” he said. “Patients who Google search their symptoms come to physicians with fear and queries that might not even be related to what they might have, but (they) would still doubt the physician’s diagnosis because what they have searched might be something else. “But 50 per cent of the studies have concluded that searching symptoms on the internet before consultation with their physicians might not be such a bad idea. “When individuals search for their symptoms, does Google give them a full review of what they have? Why do they have it? And what are the aftermaths? “Google fails to say what exactly they have. If you search a common symptom, for example, a skin rash, Google will show you almost all the possibilities of that rash. “From the simplest cause being itchy clothes to the most hyper cause being an immune system disorder, people who do not have medical knowledge will tend to assume the worst in most cases. And deeper research on this topic will lead them to believe that they might even have cancer,” Dr Anjum said. “This leads to cyberchondria, where repeated internet searches on their health might lead to anxiety. “But not all is wrong – Google searches have also given some physicians positive feedback. Some physicians state that, searching symptoms before consultation gives their patients a sense of understanding of their symptoms and prepares them for the worst, which helps the physicians to be open and clear with their patients.” Since its launch, Google has expanded and developed tools and now deals with more than 93 per cent of worldwide online search requests. Started from a dormitory by two Harvard students, Google was the brainchild of Larry Page and Sergey Brin. It began with 26 million web pages and has come a long way in the past 25 years. It now holds an index of more than 40 billion web pages which it searches in less than half a second. The search engine now deals with 8.5 billion searches each day. With Google continuing to push the boundaries of new technologies, its latest developments are firmly cementing Dr Google’s place as a health resource. Last month, Google announced in the journal Nature that it is developing an AI programme called Med-PaLM. The company claims AI can perform as well as a doctor when answering questions about ailments. Its technology processes language similar to ChatGPT and it is able to answer a range of medical questions with 92.6 per cent accuracy, Google said. Last year, Google used the AI technology to answer the US medical licensing exams and it scored a pass mark of more than 60 per cent. “This model not only answered multiple choice and open-ended questions accurately, but also provided rationale and evaluated its own responses,” Google said. “Recently, our next iteration, Med-PaLM 2, consistently performed at an expert doctor level on medical exam questions, scoring 85 per cent. This is an 18 per cent improvement from Med-PaLM’s previous performance and far surpasses similar AI models.” The team at Google Research believe it will be the foundation of the next generation of healthcare systems. General biomedical AI systems that learn multi-mode medical data and adapt are likely to be the foundation of next generation learning health systems, making healthcare more accessible, efficient, equitable and humane, Google Research said. “While further development and rigorous validation is needed, we believe Med-PaLM represents an important step towards the development of such generalist biomedical AI,” it said. Prof Tyrer is in support of the use of AI and believes it will help with cyberchondria. "The big advantage with AI technology is that it filters out the rare illnesses and emphasises the common ones," he said. "I think the problem with looking at Google at present is that you do not actually get that filter operating and with an AI you do and you can obviously reinforce that and say the chances of getting these other problems are extremely rare. I think AI has a definite role in helping people with cyberchondria." So, it looks like Dr Google is here to stay and may become the next generation’s household first aid directory.

Medics find cure for Dr Google 'addiction'

Doctors say they recognise Google as a health resource but some patients need to take a little sugar with its 'diagnoses'