Help! I'm a Cyberchondriac!

Group Information
Group Name
 * The Cyberchondriacs

Group Members
 * Jordyn Troyer
 * Martina Park
 * David Trautman
 * Brenna Ortynsky

Contact Information Name
 * Jordyn Troyer         - jltroyer@ucalgary.ca
 * Martina Park          - mpark@ucalgary.ca
 * David Trautman        - dktrautm@ucalgary.ca
 * Brenna Ortynsky       - bjortyns@ucalgary.ca

Project Statement
For our project we will discuss the recent increase in self diagnosis on the internet. Websites including Google, Wikipedia, Yahoo, search engines, blogs, chatrooms and particularly health specific websites such as Web MD among other examples are often used in order to obtain health and wellness information and even self-diagnose. This practice, although convenient, often results in misdiagnosis which in turn could greatly affect ones health. We will discuss some outcomes of internet diagnosis, accounts of similar experiences, statistics and general information.

Introduction
What is a Medical Reference Site? A medical reference site is a site where people can look up health symptoms. These websites include sites such as WebMD, DrugInfoNet, and MedicineNet among others. The website will usually give visitors a list of certain illnesses that correspond to their symptoms. It also usually provides information on each illness including what it is, general information, symptoms, treatment, who is most at risk, and frequently asked questions. Medical Reference Sites can provide forums in which people can post their personal experiences and treatments. They will often contain other general health information, including proper nutrition and information about common illnesses. Medical reference sites are popping up all over the internet, especially in the past couple years.

Why Do We Use the Internet for Self Diagnosis? There are many reasons why one would become a “cyberchondriac.” Multiple sources have spoken about having chronic illnesses. They believe that they are forced to become “cyberchondriacs” because of disbelief and dismissal from the medical community. These people often suffer from ‘embarrassing’ ailments, in which they do not want to go to a stranger to speak of their humiliating symptoms. These people will then turn to the internet for answers. Websites such as WebMD and blog websites often have answers for every ailment in the book. Blog websites can help calm a person down when they find they are not the only ones suffering from these embarrassing conditions.

Argument
If personal wellness sites are used cautiously then they can be helpful to pinpoint minor illnesses. However, the negative aspects of self diagnosis through the Internet, outweigh the positive aspects. People who visit medical professionals for help are more likely to be better off than those who rely on the Internet.

What is a Cyberchondriac?

 * [[image:Table1.jpg|350px|left]]:According to the book Medical Myths That Can Kill You: And the 101 Truths That Can Save, Extend, and Improve Your Life by Nancy L. Synderman, MD, “[Cyberchondriacs are] people who are convinced they've caught every disease on the Web. They feel a symptom, look it up on the Internet, and diagnose themselves." Cyberchondriacs fervently believe they are ill and will often believe they have symptoms that they do not actually have.
 * When a doctor dismisses their problem, “doctor-shopping” often results. This is when the patient will go to multiple doctors until they find one that tells them what they want to hear.
 * A cyberchondriac will do either that, or proceed to treat the condition themselves, using online medial references and pharmacies.
 * A cyberchondriac will do either that, or proceed to treat the condition themselves, using online medial references and pharmacies.



Pros and Cons
Web MD contains both positive and negative aspects. The positive include the symptoms feature it provides. This feature is beneficial because of its easy accessibility and the way it matches symptoms of possible sicknesses, many people use it. The symptom feature is great for new parents who don't know much about their child/children's health. People who don't have medical insurance often find the site helpful to avoid costly medical treatment such as visiting the doctor or going to the hospital. Web MD can be extremely useful to recognize and even treat illness without going to the doctor or seeking help. Web MD has negative aspects as well which include people relying on the website to diagnose a medical problem rather than receiving professional medical care. The Web MD site may not provide accurate diagnosis, resulting in misleading information. Inaccurate diagnosis can lead to unhealthy medical treatment and can result in becoming more sick or even death in extreme cases. Web Md is a site designed to help people over the Internet, but it can not be compared to seeing a professional doctor and therefore is not as professional and precise. People can become frustrated, overwhelmed and paranoid by the amounts of sickness and diseases that their symptoms are similar to, and therefore they live an unhealthy life style.

Accounts and Experiences
Example 1

This is an example of bloggers giving ratings to the drugs/medicines that they’ve been using.

Other bloggers can read the ratings before purchasing the drugs/medicines to find the most effective ones. These are reviews for benadryal oral medicine.

Condition: Chronic Trouble Sleeping

Drug Reviewer: Vickie, 55-64 Female on Treatment for 2 to less than 5 years (Caregiver)

Effectiveness

Current Rating: 3/5

Ease of Use

Current Rating: 4/5

Satisfaction

Current Rating: 3/5

Comment:

I've been using this drug to help me fall asleep for several years. I have no side effects. However, I do wonder about the long term effects of using this drug regularly. So, on the week-ends, I'll abstain.

Example 2

This is an example how internet users write down about their own experience to help answer the question.

Instead of going to the doctors to find precise conditions, the internet users rely on the answers that they get. The answer might not be 100% precise, but many people prefer this way since it’s more convenient.

How long did the symptoms of your abdominal pain last? Was there anything in particular that helped with pain/symptom relief? My abdominal pain starts in the morning and increases throughout day. Milk of Magnesia and anti-acid/anti-gas OTC liquids take the edge off during periods of hunger when stomach pain worsens. It feels like a burning and inner-writhing of spasms at its worst and strange noises can be heard within. I'm thinking that less food throughout day may result in less trauma at night trying to relax. It feels under pressure then and especially sensitive.

I am 40years with a history of severe abdominal pains, as a result, I underwent three surgeries (closed colonoscopy) with no success. This has been going since 1996. Sometimes I feel as if I am constipated, bloated and my stomach will be distended, however, at the same time I will be having a running stomach. several medication have been prescribed which I feel they are not assisting at all because when the pains begins, just becomes worse which might last from one day to several days.

Recently, I had another attack which was worse. According to my doctor after performing another colonoscopy, after many times, said the problem might be caused by the narrowing of the colon as a result of the three surgeries (scars which cannot heal). My concern is that before those surgeries, the pain was there, which presupposes that something is causing the pain. According to my doctor, he is very reluctant to perform the fourth surgery because it cannot guarantee less pain for me in future. Please, can anyone advise me what to do, any dietary plan to follow, etc, or is there any solution to manage my condition.

I experienced the mild abdomen pain at around 3 inches left and around 2 inches down from the navel and I also got a frequent feeling of thirst and also observe a mild change of colour of my stool that is slightly brown, the colour is usually in the present in the starting stool. And from about six months I also got stress in my mind due to bad dreaming which I consider serious. The Doctor prescribed me 1)L-cin and 2)Dyoflux and he told me that I might have an infection in my upper GI.

Example 3

This is an example which is very similar to example 3.

6 months pregnant and stomach pain?

I'm 26 weeks pregnant and have been having intermittent pain right below the middle of my rib cage. Haven't been too worried since your rib cage is supposed to expand during pregnancy and there can be some soreness with it. However, today I was crouching down to look at gift cards in the store, and when I started to stand up, I got this terrible stabbing pain in that same spot. It felt almost like something had ripped. I'm still extremely sore in that spot and it hurts when I move certain ways, but the pain is dull, not sharp, and I am not bleeding or anything. I think it must be a pulled muscle but obviously with it being near my stomach I'm a little worried. Has anyone experienced something similar? Please don't just tell me to go to the doctor because it is Saturday. Obvioiusly I'll go if it gets worse, but the pain has been better since the initial cramp. Thanks in advance!

• everything is stretching and growing,so there will be some aches and pains im 26 weeks with my first,i think it could be round ligament pain,i get a sharp pain if i move in a certain way 2 quickly,doc put it down to round ligament pain or as u say yourself it could be a pulled muscle,i wouldnt worry to much as long as your not loosing any fluid or spotting, if it does not improve though call your doc just to be on the safe side :)

• well Hun thing is you never know what the pain could be or if its serious i suggest maybe calling a heath link nurse im sure she will be able to tell you what to do

• yeah i get a pain like that but only if i stand up or get up too quickly and im 24 weeks pregnant =) but if there is no bleeding it might jus be normal

Content Control
While the free nature of the Internet is desirable for fostering open debate and information without censorship, this very quality is one which poses a serious problem regarding the issue of medical information. Without censorship, the quality of the information available comes into question, which is a serious concern when the information provided is being used for medical purposes. Often, self-diagnoses made by    use of medical reference Web Sites can be detrimental to one’s health when a professional should have been consulted.

The lack of accuracy and assessment of the information posted on medical sites can cause many problems for a variety of reasons. The main problem with this is if information on the Web Site is incorrect or not well represented, one attempting to diagnose their problems alone can result in an incorrect conclusion. Additionally, our limited medical knowledge further causes us to be unable to understand ad apply the knowledge presented, accurate or not. Achieving a self-diagnosis may be motivation enough not to seek professional help.

The ability to access medical information on the web can improve the transfer of knowledge from medical professionals to the general population, which in turn can help people maintain and improve their health. At the same time, this technology can create several problems, some of which being the possibility of incorrect medical information, which could cause harm to the patient, or difficulties in understanding and applying the information found on these sites. These problems can be addressed through the involvement in the medical community in the development and evaluation of medical information sites.

Health on the net foundation
Recently, the Internet has become the most frequently used median for communication. This, combined with the fact that censorship policies do not exist on all Web Sites, has created a need to assess the quality of circulating information. For this very purpose, the Health On the Net Foundation (HON) was formed. Since its formation in 1996, HON has become one of the most trusted portals to medical information on the Internet, and is used by both the general public and medical professionals to find reliable medical information.

HONcode
The main concern of HON has always been the assessment of the quality and accuracy of the information provided on medical reference sites. HON created a code of conduct, called the HONcode, in order to help standardize the reliability of medical information on the web. The code holds Web Site developers to basic ethical standards in the presentation of information and helps make sure readers are aware of the source of the data they are looking at, as well as the purpose it was meant to serve. The HONcode is a voluntary certification system which allows sites who have formally submitted an application and been approved to display the HONcode seal. This seal allows users to identify sources of credible information. Even with the credibility the seal brings, not all information presented is necessarily accurate. There is no substitute for one-on-one consultations and diagnoses with a medical professionals.

HON code principles
1. Authoritative - Indicate the qualifications of the authors

2. Complementarity - Information should support, not replace, the doctor-patient relationship

3. Privacy - Respect the privacy and confidentiality of personal data submitted to the site by the visitor

4. Attribution - Cite the source(s) of published information, date and medical and health pages

5. Justifiability - Site must back up claims relating to benefits and performance

6. Transparency - Accessible presentation, accurate email contact

7. Financial disclosure - Identify funding sources

8. Advertising policy - Clearly distinguish advertising from editorial content

Statistics
Approximately six million people per day, within the USA alone, use the internet to research unknown symptoms. The American Medical Association has estimated that the number of people that visit a medical center in the United States is much lower. According to survey results in 2007, 71% of all people were considered cyberchondriacs.
 * More than 50% of youth, between the ages of 13 and 24, research ailments online. The most common source, according to respondents, is the website “Web MD,” having over 15% of the youth using this site. [[image:Table3.jpg|350px|right]] Youth also use blogs to anonymously discuss their problems, using blogs 17% of the time, while anonymous hotlines provided by the government are used only 10% of the time. Of these bloggers, 54% were male and 46% were female, suggesting an equal attraction to anonymous posting in youth.  This changes in adulthood as adult women are typically more likely to research a symptom online. Surveys show that 71.7% of adult women research possible symptoms online, while only 60.5% of men do.  Age within adulthood is not considered as large a factor in determining differences in likeliness of researching, however, the data shows an increase in research with age, as there is a direct correlation between age and amount of heath concerns.
 * Amount of education affects a person’s likelihood of researching online, with post-secondary students and graduates seeking personal wellness information 67.9% of the time, while high school graduate’s likelihood of researching personal wellness online remains at approximately 59.5%. 36.5% female of respondents use sites such as “Wellness.com” or “Web MD”, while 34.6% of men use these websites.[[image:Table5.jpg|350px|right]]
 * Amount of education affects a person’s likelihood of researching online, with post-secondary students and graduates seeking personal wellness information 67.9% of the time, while high school graduate’s likelihood of researching personal wellness online remains at approximately 59.5%. 36.5% female of respondents use sites such as “Wellness.com” or “Web MD”, while 34.6% of men use these websites.[[image:Table5.jpg|350px|right]]
 * Amount of education affects a person’s likelihood of researching online, with post-secondary students and graduates seeking personal wellness information 67.9% of the time, while high school graduate’s likelihood of researching personal wellness online remains at approximately 59.5%. 36.5% female of respondents use sites such as “Wellness.com” or “Web MD”, while 34.6% of men use these websites.[[image:Table5.jpg|350px|right]]

Trends show that the 2008 numbers of people researching ailments online has decreased from the 2007 numbers, however it is estimated that 66% of adults use the internet to research health concerns, while 81 percent of all internet users check their concerns online. It is estimated that 86% of cyberchondriacs believe that the information they research is reliable, while only 47% of cyberchondriacs discuss these discoveries with their doctors. Amount of education affects a person’s likelihood of researching online, with post-secondary students and graduates seeking personal wellness information 67.9% of the time, while high school graduate’s likelihood of researching personal wellness online remains at approximately 59.5%. 36.5% female of respondents use sites such as “Wellness.com” or “Web MD”, while 34.6% of men use these websites.

Conclusion
A cyberchondriac abuses the use of the internet to self diagnose pain or illness. This trend is becoming increasingly common, often leading to self-diagnosis, and sometimes self prescription. It is a dangerous habit, encouraged by many websites for an increased number of hits. This increasing trend demonstrates the dissatisfaction of the general population with the modern healthcare system, as well as an overall lack of motivation to leave the home.