Houston Chronicle

Understand­ing pros and cons of online medical symptom checkers.

- DRS. MICHAEL ROIZEN AND MEHMET OZ Drs. Oz and Roizen Contact Drs. Oz and Roizen at youdocsdai­ly@share.com.

You’re grumpy, and you wonder why. So you enter the word in a symptom checker online and find out you may have one of 82 disorders or diseases, ranging from a middle ear infection or menopause (and you’re a guy!) to dementia or a subarachno­id hemorrhage between your brain and the tissue that covers it.

Try again. You also have achy joints. Ah, that leads you to a list of 101 causes of joint pain. Maybe it’s ulcerative colitisrel­ated. Who knew it could make your joints hurt? Or from infectious mono? That wasn’t a good date!

But you cannot find any condition that shows up on both lists. So maybe you have two different illnesses at the same time!

That can bean informatio­n seeker’ s nightmare. Yet hundreds of millions of times a year people turn to online and appbased symptom checkers to help figure out what’s ailing them, and if they should call the doctor or if it’s time for a visit to the emergency room pronto! You might as well ask a crystal ball. It’s anybody’s guess.

That’s the conclusion­of a new study published in The Lancet that examines both the promise and reality of symptom checkers. The researcher­s looked at a wide range of studies on diagnostic direct-to-consumer digital tools and concluded: “Overall, the current evidence base on direct-to-consumer, interactiv­e diagnostic apps is … uneven in the informatio­n provided and inconclusi­ve with respect to safety and effectiven­ess.” Buyer beware, for sure.

This reinforces findings from earlier studies: While misdiagnos­is by human doctors happens about 5 percent of the time, affecting about 12 million U.S. adults annually, according to a 2014 study in BMJ Quality & Safety, misdiagnos­is by digital symptom checkers happens, on average, about 50 percent of the time!

In another study published in BMJ in 2015, researcher­s tested 23 symptom checkers by having them evaluate symptoms derived from 45 clinical vignettes that are used to teach and test medical students. Overall, the symptom checker listed the correct diagnosis first in only 34 percent of cases and put it in the top three diagnoses 51 percent of the time. And another study published that year in Diagnosis concluded, “research suggests that they (medical apps and online tools) should be used with great caution. … The lack of verifiable informatio­n provided about the evidence or expertise used to develop these apps is of major concern.”

How to be a smart digital health info consumer

You’re not going to stop checking out online health info — and shouldn’t. It’s only human to go to what’s right at your fingertips (literally). But all symptom-checker digital health sources are not created equal.

1. The best one (it’s ours, we are biased) was developed for the Department of Defense and is available on the Sharecare.com app. (It’s a free download.) It has the best questionna­ire(s) and data, and is most likely to offer correct diagnoses. Plus, it will send you to a nearby doc (or telemedici­ne connection), if you want one.

2. Telemedici­ne can provide personaliz­ed medical advice reliably: Dr. Mike and Dr. Oz’s hospitals both have their own services — Cleveland Clinic Express Care Online and NYP On-Demand. Chances are your local medical intuition has similar services.

3. Don’t let online results make you think you can determine your own treatment. You know the expression “a lawyer who represents himself has a fool for a client”? Well, a patient who has him- or herself for a doctor is foolish, too! Get your online info, then call your local or telephysic­ian for a consult and/or an appointmen­t.

4. As for online health info: We hope you’ll use it to help you stay healthy so that you don’t need a symptom checker. RealAge.com and DoctorOz.com are highly trustworth­y zones where you can get the support, encouragem­ent and advice you need to be your healthiest self.

 ?? Fotolia ?? Digital diagnostic apps are a good starting point. But don’t try to determine your own treatment using the online results.
Fotolia Digital diagnostic apps are a good starting point. But don’t try to determine your own treatment using the online results.
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