Friday 4 September 2015

The Rise of Dr Google and the Dangers of Self-diagnosis

Health app image from Shutterstock

We've all done it, there is no use pretending you haven't, in fact I was at it last night and what does it do? Cause worry and stress of course. I can't give you even one example where a friend has goggled their health ailment or symptoms and come up with a good and reassuring answer. There is even a name for this nowadays - cyberchondria, the anxiety and fear created when you search the internet and come up with a worrying diagnosis for yourself. If I'd been the sort to readily believe the internet then I'd be sat here this morning thinking I had COPD (Chronic obstructive pulmonary disease) especially as my Mum has this disease. But I don't, I have a cough. Yes one that I need to get checked with the doctor as it has been hanging around a while but until a doctor tells me otherwise I refuse to be worried by it (just annoyed!). I firmly believe that for a lay person like me self-diagnosis is not the way to go.

As well as searching the internet there are now also hundreds or even thousands of health apps and a new one literally appears each day. I was amazed to watch a short video on the Telegraph web pages which showed new developments in health apps. A handheld device that you could hold to your forehead and it reads your temperature, heart rate and blood oxygen level and then it sends this data by blue tooth to your smart phone. Also a scanner attachment to go on your smart phone camera that can take a picture down the ear canal and then you can send that image to your doctor and potentially get an antibiotics prescription without even leaving home. Now I'm not sure about you but that level of involvement in my or my child's health feels like a big responsibility and pretty scary.

By far the scariest thing for me is that all these apps are not regulated, there is no industry body making sure that the information they provide is accurate and medically correct. All the experts agree that the best thing any of us can do if we are unwell is visit our GP to have a conversation and allow them to see and hear our symptoms for themselves. Yes, if you really want to you can take some information with you gained from your health app or the internet but chances are that will lengthen your appointment and it is no secret that doctors generally don't have enough time already.

Legal and General have written a really good piece on this subject and to quote them - "GPs and medical practitioners have reason to be concerned about health apps. They’re causing increasing problems for GPs and patients. Dr Des Spence, one of the most vocal critics of health apps, argues they lead to unnecessary and often “extreme anxiety”. What’s more, this anxiety leads to more work for doctors and medical practitioners. One in five (21%) GPs have seen an increase in patients presenting data generated from health apps and ‘smart’ devices. This information takes up more of GPs’ time to read and digest. Three out of four GPs think it could soon overwhelm the present medical system." That is a frightening situation.

Furthermore, advise from Srini Pillay for Psychology Today is that if you do not agree with your doctors diagnosis to be upfront with them and to tell them why and ask for a second referral. Do not be tempted to walk out and consult the internet and then self- diagnose and potentially medicate, this can be so dangerous. Of course we all know our ourselves but it is very easy, especially with psychological disorders to kid ourselves and miss symptoms or to overplay them. Our doctor can be the mirror we need to see ourselves truthfully and without bias.

Are all health apps a bad idea? No of course not, some are actually becoming invaluable. I love wearing my Fitbit and finding out about my activity levels, this spurs me on to beat my bests and to do more the next day. A number of studies have shown that mobile strategies lead to better patient outcomes. In one study, participants lost an average of 3.9 kg more than the standard group using a paper-based weight loss plan (*). Research. I've also recently found a water balance app very useful and my intake of water has improved, whilst my awareness of the effect of caffeine has also been heightened, both positive outcomes.

Please do not hurry off and delete all your health based apps but I wouls day to do some robust research and see where the information has come from. If it is an activity tracker you are using then great you are probably not hurting anyone, but if it is a self-diagnosis tool and you know you are the kind of person to feel anxious then why not call NHS direct instead. They are available at the end of the line if you know that you are the kind of person who worries at the slightest thing and just needs a bit of reassurance. At least the person who advises you there has been trained by the NHS and we can have a level of confidence in them.

(*) Spring B, Duncan JM, Janke EA, et al. Integrating technology into standard weight loss treatment: a randomized controlled trial. JAMA Intern Med2013;173:105-11 

All other sources have a hyperlink to the relevant webpage.

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