'Googling' aids difficult diagnoses

Tags: Choice England Google iS Quality

13 Nov 2006

Doctors puzzling over a difficult diagnosis might do well to try “googling” their patients’ symptoms, according to research published by the British Medical Journal.

The researchers, from Australia, reached their conclusion after “googling for a diagnosis” using the Google search engine on 26 cases records published in the New England Journal of Medicine in 2005.

They arrived at the correct diagnosis in 15 cases – a success rate of 58% (95% confidence interval 38%-77%). During the online research they were “blind” to the correct diagnoses.

The research was prompted by an incident in which the researchers were treating a 16 year old with an acute subclavian vein thrombosis. As one of them explained that the cause of the thrombosis was uncertain, the patient’s father blurted out: “But he has Paget-von Schrötter syndrome.” He had reached the diagnosis by “googling.”

Discussing their results, the researchers acknowledge that the role of diagnostician remains one of the most challenging and fulfilling roles of a physician. “Physicians have been estimated to carry two million facts in their heads to fulfil this role. With medical knowledge expanding even this may not be enough.

“Search engines allow quick access to an ever increasing knowledge base. Google gives users ready access to more than three billion articles on the web and has far exceeded PubMed as the search engine of choice for retrieving medical articles.”

Google Scholar, currently in beta form, is likely to be even more useful as it searches only peer-reviewed articles, they say.

They conclude: “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.”

Connecting for Health is also tapping into Google’s expertise. The agency confirmed to E-Health Insider that its director of clinical knowledge, process and safety, Sir Muir Gray, recently visited Google in the United States to have discussions about their searching techniques and our knowledge quality standards.

“He was also discussing this in the context of the World Health Organisation global health library,” a spokesperson added.

Readers Comments

I have been doing this for years!

13 Nov 06 20:36

I think that Google has been the most useful addition to my clinical skills in recent years. I have solved several very difficult cases in seconds, by entering key words - the clinician's skills are in choosing the correct words, and spellings. Using USA spellings e.g. thrombocytopenia not thrombocytopaenia gets more returns. Try this "What was the cause of rhabdomyolysis in a patient taking fusidic acid and simvastatin with high creatine kinase levels?" or "What was the cause of acute renal failure in a patient with pneumonia on X ray, and hypophosphatemia on the blood test results?", or"Llist the common causes of hepatitis in a patient returning from a Nile cruise", or "Why did the patient with myasthenian gravis treated with azathioprine develop pancytopenia when gout was treated with allopurinol?". One still needs to be a clinician to identify the abnormal pattern in an illness, enter the correct search terms and spot a reliable website. I have found information at weekends and nights that has made major difference in clinical outcomes - and sometimes makes my juniors think that I am smart!

Use Google Scholar

13 Nov 06 20:41

Google Scholar is even better - go to Google and "more" and choose Scholar - this accesses peer reviewed journals etc. If for example you know an expert's name, you can find all his or her publications in no time - and maybe an email address for more personal advice!