Suffering from Cyberchondria? Why Googling Symptoms Might Not Be As Bad As We Thought

A study published in JAMA Network Open suggests that online research about symptoms tends to be diagnostically more helpful and less likely to generate health anxiety than previously thought.

That's encouraging news for the estimated 80 percent of adult internet users who search online for health and medical information. But for nearly as long as the internet has been around, many healthcare professionals have discouraged people from relying on medical information gleaned online to diagnose an ailment. Their argument was that typing symptoms into a search engine could steer internet users to sites providing inaccurate or incomplete information. The result, they said, was that individuals might dismiss signs of potentially serious health issues such as cancer, come to the wrong conclusions about their health or worry unnecessarily about their medical future.

Online symptom checkers can provide users with a wide range of possible diagnoses. A check for worsening abdominal pain, for example, may lead to a list of results ranging from constipation to colon cancer. Fueling health fears through frequent online searches is known today as "cyberchondria."

To explore whether such concerns are well-founded, researchers from Brigham and Women's Hospital and the Harvard Medical School Department of Health Care Policy investigated the role internet searches play in a person's ability to make an accurate diagnosis. Study author Dr. David Levine of the Division of General Internal Medicine & Primary Care at Brigham says hearing his patients reveal their own cyberchondria motivated him to learn more about online symptom searches.

In the study of 5,000 participants, researchers provided each volunteer with a case vignette describing symptoms and then told the participants to imagine a loved one was experiencing those symptoms. Participants were asked to make an initial diagnosis and then research the symptoms online in order to make a second diagnosis. They were also asked to select a triage level, ranging from "let the health issue get better on its own" to "call 911." Participants also recorded their anxiety level.

After analyzing the results, Dr. Levine and his team found that people were slightly better at diagnosing the cases correctly after their online research. The cases involved common conditions, such as a virus, heart attack or stroke. It's less likely that an online symptom search would be as helpful for more complicated conditions, such as cancer, diabetes or cardiovascular disease. However, thinking and learning more about any type of symptoms will be helpful when you do see a doctor. And, of course, if you’ve been diagnosed with cancer, you should be in constant contact with your treatment team of medical professionals.

The participants also reported no change in anxiety after learning more about the condition. However, there was also no improvement in how they triaged the cases.

The key to making symptom research a worthwhile exercise, Dr. Levine says, is to view your online research as a preliminary diagnosis, requiring an examination, tests and evaluation from a healthcare professional for final confirmation. "A quick browse of the internet is a reasonable thing to do, but that medical advice from medical professionals still is necessary," he says. "Hopefully in the future new tools will make Internet search an even more powerful practice."

What to Do After the Diagnosis

For many internet users, searches for health information don't stop once an official diagnosis is made. Indeed, searches for treatment options, prognosis, clinical trial availability, and other factors can often dwarf the time spent pondering symptoms.

"It is of course natural for most people to search online for additional health information, most especially after they’ve received a new diagnosis of a serious health condition, like cancer," says Dr. Amin Azzam, a professor with the University of California, San Francisco's Department of Psychiatry and Behavioral Sciences.

Understanding the volume of health-related internet searches globally, Dr. Azzam established a program to boost the accuracy and depth of information on one of the internet's most-visited sites: Wikipedia. He established the first for-credit course for medical students to update and improve the information on 725 health-related Wikipedia pages, which have since garnered more than 62 million views, Dr. Azzam says

How to Find Quality Information

One of the encouraging findings in Dr. Levine's study was that, by and large, internet users were steering clear of sites with poor or misleading health information. Dr. Levine said much of the credit goes to the search engines that are guiding users to reliable sources. He also notes that users are becoming more discerning about the sites they pursue for important health information.

"In our study we found that the overwhelming majority of Internet searchers used only a search engine or higher quality health websites," Dr. Levine says. "I think this is new and preliminary evidence suggesting that folks are more often using higher quality sites. Of course, there are still plenty of websites yielding poor information to Internet searchers."

That's not to say that online research should be avoided because it may produce results that don't pan out in real life. The key is to be a discerning judge of health information found online.

"I think that it’s increasingly important for health providers to help teach their patients how to more accurately assess the quality of online information resources," Dr. Azzam says. "In my own practice, when I discuss health conditions and diagnoses with my patients, increasingly I type in the Google search term myself and then show my patients how I’m vetting the quality and accuracy of my Google search hits. If we empower our patients to be more informed consumers of online health information sources, then we are doing right by teaching our patients how best to care for the health of their minds and bodies."

Tips for Healthy Internet Research

Rather than type in symptoms and let a search engine do the work, go to reliable sources of medical information, such as major research institutions, the National Institutes of Health, Centers for Disease Control and Prevention, the American Cancer Society, and medical societies (American Academy of Dermatology, American Board of Internal Medicine, etc.).

Other tips to avoid falling down a rabbit hole:

• Use internet search results as the starting point for a conversation with your healthcare providers, rather than a definitive answer to your questions.
• Go to several high-quality sites and compare your results, rather than rely on the first thing you read. Think of it as getting a second opinion.
• Keep an open mind about what you read and understand that making a proper medical diagnosis usually involves a physical exam, labwork and other tests, a review of your medical history, and other information that a professional healthcare provider can evaluate thoroughly.

Learn more about SurvivorNet's rigorous medical review process.