Posts Tagged ‘Biases’

Suffering from Cyberchondria? Then you should know this –

November 18, 2009

“Chondria what? What did you say?” I can literally hear you saying! “All I had always heard was about hypochondria!”.

This week Washington Post staff writer – Carolyn Butler – posted an interesting article titled “A glut of Google can give you a virtual fever” (registration may be required to read) in which I for the first time came across this term – cyberchondria. Yes, I somehow had missed on that! Wikipedia defines cyberchondria as –

“Excessive preoccupation or worry about having a particular disease based on medical information gleaned from the Internet”

Cyberchondria - Escalation of Medical Concerns (img src -

Cyberchondria - Escalation of Medical Concerns (img src -

Seems like this word (derived from the word hypochondria) was keyed around at the start of this decade but got into prominence after two Microsoft Researchers – Eric Horvitz and Ryen White – released this study titled – “Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search” and New York Times carried a follow-up article about the same. This paper from Microsoft Research studied various patterns of web searches associated with healthcare information and found that people’s medical concerns got escalated because of the kind of results shown by the web search engines. These researchers concluded this when they saw that the online healthcare information searchers started searching for and reviewing content on serious and more rare conditions that were linked with their symptoms in the same web surfing session. The paper is an interesting read and I would recommend you all to read it. I am also capturing some of my learnings from the paper below –

  • Majority of us tend to miss out on checking key quality indicators for any online health information – As I had mentioned in my presentation about Healthcare from Consumer Perspective too, this paper also confirms that substantial number (more than 70%) of internet users search for healthcare related information on the web. However more than 75% of these searchers also fail to check for the key quality indicators such as validity and creation date of such information. (Some additional studies have pointed out that more than 70% of the healthcare content on the internet may not be of appropriate quality)
  • Online search results tend to over-exaggerate possible causes based on symptoms –  The probability of a cause for a particular symptom based on what seems to be implied from web-based search results and the probability of occurrence of the same cause in real world seem to be differing dramatically. Sounds slightly confusing? Let me simplify it. For example – as the paper points out – for a symptom such as headache if you were to search it through a search engine – you might feel that there is a 3% probability of you having a brain tumor. Whereas the actual occurrence rate for brain tumor is possibly less than 0.001%. This over-exaggeration due to coarse linkages done by the present-day search engines between the symptoms and the content tends to increase unwarranted anxiety among the web searchers.
  • Cyberchondriat’s trust in Doctors is minimalistic – Studies have shown that Cyberchondriats – assuming that they suffer from hypercondria – typically tend to express doubt and disbelief in their physician’s diagnosis and typically are not easily satisfied by their doctor’s reassurances.
  • Mapping a disease online based on symptoms is inherently flawed – Having hung around a family of doctors and seen them practicing – I personally had always been skeptical (and thought it was risky too) about the increasing number of healthcare websites which have mushroomed on the “you tell us your symptoms” and “we will tell you what you suffer from” information model. Diagnosing (will be blogging more on this in future blogs) as done by doctors requires intricate probing and building an hypothesis around the subtleties of the symptoms and various findings – along with giving enough consideration to characteristics of the patient (typically done face-to-face). This is not feasible with the web-based search. Well, atleast the ones which are available today!  Almost all of the search engine or querying mechanism today are not designed to perform coherent diagnostic or probabilistic reasoning (a key tool for medical diagnosis). Cyberchondriates need to be aware of this.
  • Individuals themselves have core biases while pursuing for online medical diagnosis – The authors of the paper point to studies in Cognitive Psychology wherein they had presented evidences that humans tend to employ heuristics or speculative approaches in determining likelihood of a particular theory when presented with large amount of possibilities. Authors believe that this tendency of human beings plays a big role in cyberchondria too. Because of this habit – human beings tend to be biased towards certain medical content – which in turn drives their assumptions of what they suffer from.
  • Lastly, there seems to be more online information on Rare Diseases than to Common ones – The authors believe that for the sake of garnering more attention (nothing wrong in that though), there is a lots of literature and online discussions devoted to rare disorders than to common ones. However, the flip side of this is that this abundance of information may lead to biasing the search engines and ultimately the online searchers towards the possibility of they getting diagnosed with a more critical or serious disease.

Personally, I have always been vary of the potential use of the abundant healthcare related information which is available freely and easily on the internet today. My challenge is not against the content part – but on the context part! How does that content or the information apply to the individual himself/herself? This article clearly alludes to my fears – that increasing amount of healthcare information on the internet while needed can also bring in side-effects too.

Thoughts and/or comments are most welcome!