Think twice before consulting Dr. Google, researchers say

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Eye twitching? Weird stomach pain? Leg cramp? Is it a symptom of a serious disease? Beware the temptation to ask Dr. Google.

A recent study suggests internet health searching could make you feel worse. It could leave you even less informed. And you're also potentially revealing private health information.

It's part of a growing body of research into the potential side-effects of consulting the internet about health issues — something that creates a risk of "cyberchondria."

University of Waterloo computer scientist Amira Ghenai decided to investigate this phenomenon for her PhD thesis in part because she was being bombarded with internet health advice from her mother.

I had a feeling this topic has a huge impact on people's lives.- Amira Ghenai

"She gets messages from her friends, she looks online for information and then she forwards it to us," said Ghenai, who worried about the potential for harm if people chase unproven treatments. "I had a feeling this topic has a huge impact on people's lives."

To determine how people are influenced by internet health searches, Ghenai designed an experiment that presented artificial search results for a series of health questions. For example, one question asked whether cinnamon would treat diabetes. (It won't.)

The study found that people were confused by the search results, and they ended up having the wrong impression more often than if they'd just guessed based on what they already knew.

'They were convinced they had cancer'

Part of the problem is that Dr. Google's answers hinge on the words in the question.

"People use search engines but they're not aware of how they work," said Ghenai.

If the query is phrased "Does cinnamon help diabetes?" the search engine displays documents that contain the words "cinnamon," "help" and "diabetes."

Anything matching those words will show up high in the results, a mix of true and false information from various sources, but people will take away an impression based on whatever the consensus of the results seems to show. People may then make decisions "regardless of the truth," Ghenai said.

That ability to get an instant diagnosis has turned many people into cyberchondriacs.

University of Georgia communications researcher Carolyn Lauckner saw her friends doing it.

"Whether it was a headache or some strange abdominal pain, and they Googled it and they were immediately convinced they had cancer," she said.

In 2013, Lauckner designed an experiment to see if she could see this happening in real time, manipulating the results people saw in an internet health search and then monitoring their moods. 

She discovered that people formed a quick impression just from scanning the search results, without even following the links.

"They were more likely to feel frightened or overwhelmed based on how we manipulated the search results," said Lauckner.

"So the way that things appear on a search results page are really important — maybe even above and beyond what the actual web pages say."

As a new mother, Lauckner said she had to stop doing internet health searches.

"I was Googling every symptom she was experiencing — and of course it's always the worst thing possible could be happening to your baby, so I had to say enough is enough. It was causing too much anxiety."

'The web is not your doctor'

Not only can you end up freaking yourself out when you visit Dr. Google, you could also be unwittingly revealing personal information.

Oxford University researcher Tim Libert cautions that Dr. Google will not respect privacy.

"The web is not your doctor. People treat the web like a doctor, but the web is not taking the Hippocratic oath," said Libert, whose paper "What web browsing reveals about your health" was published in the BMJ in 2015.

"You should treat it like talking to a guy in a park with a megaphone."

He said every time you visit a web page seeking information about a health condition there is a chance that data is being collected by third parties.  

"The number of companies tracking you online is really huge," he said. "Some of those companies make lists of people and sell that."

Health information can be sensitive, yet there is little regulation over how this information is collected, how long it's kept and how it's used, he wrote in the BMJ.

Canada's privacy watchdog ruled in 2014 that Google's use of sensitive health information violated Canada's privacy laws after it allowed advertisements to be directed at a consumer who had searched for devices to treat sleep apnea.

"Our office is of the view that that personal health information (i.e. online activities and viewing history of health-related websites) is sensitive," said Anne-Marie Cenaiko, spokesperson for the office of the Privacy Commissioner of Canada. "Advertisers should avoid collecting sensitive personal information, such as individuals' health information, for the purpose of delivering tailored ads."

Dr. Eric Cadesky, a B.C. family doctor, gives patients his email and encourages them to consult him before they check with Dr. Google.

"I find a lot of my patients will actually come to me first by email with questions or an early complaint," he said.

He also tries to direct them to reliable sites, run by governments or medical societies, usually ones with web addresses that end in .gov or .edu.

If you are looking for possible treatments for diabetes, just write 'treatment for diabetes.'- Amira Ghenai

Cadesky said sites with a lot of advertising tend to be less reliable."The information sometimes has bias or sometimes can be out of date."

Ottawa cardiologist Dr. Andy Wielgosz says he spends a lot of time correcting the misinformation his patients bring him.

"Sometimes it's something they've picked up because a celebrity has talked about an issue ... and we have to deal with that."

But there are occasions when internet searches unearth new information.

"Sometimes they educate us, and that's fair too," he said. "I've had patients who point out something and I hadn't considered it."

Wielgosz developed a website for the College of Family Physicians of Canada that curates online health information about chronic diseases, linked only to reliable Canadian, non-commercial sources.

Another way to increase the chances of getting reliable information, says Ghenai, is to think carefully about the way the query is phrased.

"If you are looking for possible treatments for diabetes, just write 'treatment for diabetes.' And if you didn't find cinnamon then maybe cinnamon is not helpful."