The Dangers of Being Second-guessed by a Smartphone

May 18th, 2017

SAN DIEGO — In the worst cases, parents are tapping their cellphones before leaving the examining room to check your diagnosis, but, in general, pediatricians — and other physicians — are aware that many of them use online healthcare sites to second-guess diagnoses and treatment plans.

Now, a new study says that trend might also be delaying treatment for children whose parents are less likely to trust their doctor’s advice based on what “Dr. Google” says.

The study abstract, "Paging Dr. Google: The Effects of Online Health Information on Parental Trust in Pediatricians' Medical Diagnoses," was presented in early May at the Pediatric Academic Societies Meeting in San Francisco.

Presenters, led by researchers from Cohen Children's Medical Center in San Diego, employed the Mechanical Turk online research platform to recruit 1,374 parent participants. The researchers described a situation to them involving a child who "has had a rash and worsening fever for three days."

Participants, all parents with children under 18, were divided into the following groups:

• parents who received screen shots of internet information describing some symptoms of scarlet fever, which can lead to serious complications such as rheumatic fever and heart damage if not treated with antibiotics;
• participants who received screen shots listing select symptoms of Kawasaki disease, which requires treatment with anti-inflammatory drugs to prevent life-threatening complications such as aneurysms;
• the control group, the third division, received no internet screen shots.

All participants were told that the physician had diagnosed the child with scarlet fever. Based on that, 81% of the control group and 90.5% of parents receiving information about scarlet fever said they trusted the doctor. In fact, only 21.4% of the first group seeing scarlet fever screen shots said they were likely to seek a second opinion, compared to 42% of the control group.

Confidence in the physician was much lower in the group receiving information about Kawasaki disease, with only 61.3% saying they trusted the diagnosis. Even more — 64.2% — said they would obtain a second opinion.

"The internet is a powerful information tool, but it is limited by its inability to reason and think," said lead author Ruth Milanaik, DO, an associate professor at the Hofstra Northwell School of Medicine. "Simply entering a collection of symptoms in a search engine may not reflect the actual medical situation at hand. These computer-generated diagnoses may mislead patients or parents and cause them to question their doctors' medical abilities and seek a second opinion, thereby delaying treatment.

"Parents who still have doubts should absolutely seek a second opinion," Milanaik added. "But they shouldn't be afraid to discuss the result of internet information with the physician."