Wednesday, November 08, 2006

The patient side of web-based diagnosis

Dr. Marla Shapiro of The Globe and Mail discusses the patient side of diagnosing using the Internet in a recent article, "Self-diagnose off the Web at your peril"

A recent article in the medical journal The Lancet reported the case of a 64-year-old woman who diagnosed herself with chronic fatigue syndrome and then proceeded to self-medicate with oral steroids that she had purchased over the Internet, rather than being prescribed medication by her physician. She had been taking the medication in varying doses over a four-year period. She developed dense cataracts in both eyes and glaucoma (high pressure in the eye), both of which were induced by the steroid use. These side effects of steroids are well known to physicians. It is clear that the patient was unaware of the dangerous side effects and had gone unmonitored, putting herself in this serious situation.
The Lancet reference: Severn PS, Fraser SG. Bilateral cataracts and glaucoma induced by long-term use of oral prednisolone bought over the internet. Lancet. 2006 Aug 12;368(9535):618. (PubMed record)

Related article: There's also been a lot of talk this week about a study published in the British Medical Journal, "Googling for a diagnosis--use of Google as a diagnostic aid: internet based study," an experimental study that examine the utility of Google searches for diagnosing 26 cases from the New England Journal of Medicine, noting "Google searches revealed the correct diagnosis in 15 (58%, 95% confidence interval 38% to 77%) cases." (lots of blog commentary on this article available via a quick Google BlogSearch)

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