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For Docs Stumped for a Diagnosis, Google May Be the Cure

Study suggests physicians could benefit from world's most popular search engine

THURSDAY, Nov. 9, 2006 (HealthDay News) -- Everyone's using it, so why not your doctor?

That's Google, of course, the Internet search engine now so popular, it's a verb in several different languages.

According to a new study in the Nov. 11 British Medical Journal, a quick Google search could help doctors diagnose difficult cases.

In fact, it already seems to be happening.

"It's a reality," said Dr. Robert Schwartz, professor and chairman of family medicine and community health at the University of Miami Miller School of Medicine.

Schwartz didn't know how many doctors at his facility, which includes the nation's largest public hospital, were turning to cyberspace but stated, "Absolutely, people are using the Web."

And perhaps more doctors should try.

"We can't know everything. I think docs should use search engines like Google more often if they are stuck with a difficult diagnosis," said Dr. Hangwi Tang, lead author of the study and a respiratory and sleep physician at Princess Alexandra Hospital in Brisbane, Australia. "It's quick, and has no harm, and is usually educational."

According to the study, doctors carry two million facts in their heads needed to help them diagnose different illnesses. But as medical knowledge continues to expand, this may not be enough.

"There has been a dramatic explosion of information," Schwartz verified. "Doctors, medical students, residents and faculty struggle with it every day, so any kind of a tool that's going to help you look at the data is welcome."

According to a New England Journal of Medicine paper, one doctor correctly diagnosed IPEX (immunodeficiency, polyendocrinopathy, enteropathy, X linked) syndrome, a rare immune system disorder, thanks to Google. Her colleagues were astonished.

Patients also use Google to diagnose their own problems. One father used information gleaned from Google to instruct his son's doctors on the symptoms and treatment of Paget-von Schroetter syndrome, another rare disorder, this one often linked to sports. The son played water polo.

The authors of the British Medical Journal paper chose 26 difficult-to-diagnose cases published in the New England Journal of Medicine in 2005, then Googled three to five search terms from each case. The people doing the searches did not know the correct diagnosis.

Google found the correct diagnosis in 15, or 58 percent, of the cases.

Conditions included cat scratch disease, Cushing's syndrome, Creutzfeldt-Jakob disease and tuberculosis (Google identified these correctly), and "hot tub lung" and brain abscess (Google misdiagnosed these).

"The potential benefit is that Google is good at finding documents with co-occurrence of words (i.e. symptoms), and this can be very helpful when there is a set of unusual symptoms and signs," Tang said.

On the other hand, the age of information has some potential drawbacks.

"To some degree, the only downside is the ability to interpret the information that you're getting," Schwartz said. "You have to be careful about the information that you're getting. It would have to be corroborated with further testing and exams."

Tang added: "The most obvious drawback is believing everything one reads, therefore, doctors need to have skills in critical appraisal of stuff they find on the net." Similarly, "patients doing a search should use common sense, so if something is too good to be true, then... Another potential drawback is self-diagnosis by patients. I don't think search engines can ever replace a good clinician who has plenty of common sense."

More information

Need information about diseases or illness? Try the U.S. National Library of Medicine.

SOURCES: Hangwi Tang, M.B.B.S., respiratory and sleep physician, Princess Alexandra Hospital, Brisbane, Australia; Robert Schwartz, M.D., professor and chairman, family medicine and community health, University of Miami Miller School of Medicine; Nov. 11, 2006, British Medical Journal
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