Baffled GPs urged to try diagnosis by Google

http://www.timesonline.co.uk/article/0,,3-2446250,00.html

Baffled GPs urged to try diagnosis by Google
By Nigel Hawkes, Health Editor


If in doubt, Google it, doctors puzzling over a diagnosis have been
told.

The internet search engine used by millions of people to find a plumber
or discover what their house is worth is also pretty handy when it
comes to putting a name to unusual ailments.

Embarrassing as it may seem to professionals trained for many years in
medicine, Google can often come up with the right answer.

In one case described in The New England Journal of Medicine, a doctor
astonished her colleagues, who included an eminent professor, by
correctly diagnosing Ipex (immunodeficiency, polyendocrinopathy,
enteropathy, X-linked) syndrome.

It just "popped right out" after she entered the salient features
into Google, she admitted. Two Australian doctors have now put Google
to a sterner test, using 26 cases from the case records section of the
journal.

This is a regular feature in which the symptoms of a tricky case are
described and readers are asked to come up with a diagnosis.

Hangwi Tang and Jennifer Hwee Kwoon Ng, doctors at the Princess
Alexandra Hospital, in Brisbane, simply entered words from the case
records into Google. The words reflected the symptoms described, and
for each case they picked between three and five.

They then looked at the first three pages of the Google output -
thirty items - and chose what seemed to be the most plausible of the
diagnoses offered. In 58 per cent of the cases, Google came up with the
right answer, or at least the same answer as given in the journal.

For example, when the case involved a 48-year-old man with multiple
spinal tumours and skin tumours, the doctors searched Google by
entering the words "multiple spinal tumours" and "skin
tumours". Google responded with items suggesting the man had
neuro-fibromatosis type 1, the correct diagnosis.

In another case, a man lost consciousness while jogging. A search under
"cardiac arrest", "exercise", and "young" produced the
diagnosis of hypertrophic obstructive cardiomyopathy, which was also
right.

Other conditions that were diagnosed successfully included
Creutzfeldt-Jakob disease, gastrointestinal bleed, amyotrophy (a
neurological disorder) and encephalitis (inflammation of the brain).

There were some errors. A condition deduced to be graft versus host
disease turned out to be West Nile fever - quite a big difference.
But the two doctors conclude that Google is well worth trying.

"Useful information on even the rarest medical conditions can now be
found and digested within a matter of minutes," they say. "Our
study suggests that in difficult diagnostic cases it is often useful to
'Google for a diagnosis'.

"Web-based search engines such as Google are becoming the latest
tools in clinical medicine, and doctors in training need to become
proficient in their use."

Irritating medical television series such as House, in which a grumpy
know-it-all physician played by Hugh Laurie astonishes his colleagues
by his remarkable diagnostic skills, will never seem quite so
impressive. How long before he is upstaged by Google?

And GPs who grumble when their patients turn up with printouts from the
internet claiming that they have some obscure disease will have to be
more circumspect. Having access to Google, the patients might just be
right.

The doctors started their research after examining a 16-year-old water
polo player with a blockage in a vein, and explaining that the cause
was uncertain.

His father immediately interrupted to say: "But of course he has
Paget-von Schrötter syndrome." He had successfully Googled the
symptoms and proceeded to give the doctors a mini-tutorial on the cause
of the condition - huge neck muscles compressing the axillary vein
- and the correct treatment.

*************

TC

.

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