The Doctor is ... YOU! Online Medical Symptom Checkers Examined
My take: This is probably the most popular health-related site on the Web. Google ranks it No. 1. But I found some of that aforementioned absurdity here.
Upon landing on the symptom checker page, I was presented with a list of 76 possible symptoms or an interactive map of the human body that lets you select the bothersome part with a mouse hover.
After answering questions about age and gender (with optional questions about ZIP code and e-mail address, just in case you want another newsletter in your in-box), I eventually found the path to plantar fasciitis by clicking on the map's back view, then "leg" and then "sole."
I was then given a list of 21 possible conditions. A series of questions ensued, designed to zero in on the most probable cause.
Question No. 1 was the first of my problems -- how to describe the pain. I had a hard time deciding if it was:
- sharp or stabbing
- dull or achy
- burning or stinging
Is "sharp" that much different from "stinging"?
It turns out it didn't make any difference what answer I chose -- the end result was the same for every path I took through the process.
Not yet knowing that, I pressed forward through seven questions (although each one offered the option to "finish") and ended up with a list of 15 "conditions associated with the selected symptoms," with plantar fasciitis as No. 8 -- not that there was any indication that the ordering meant anything. (See the video below to track how I navigated through WebMD's symptom checker.)
Starting over and choosing the option to "finish" after the first question -- the pain description question mentioned above -- I was immediately rewarded with a list of the same exact 15 possibilities, but in a different order.
I started over yet again and chose "don't know" or "none of the above" for every single question, and yes, I got the same exact 15 possibilities.
So after choosing "sole" and "pain or discomfort," there was apparently no result possible other than the 15.
Except for one. The only way the list changed was if I indicated that I had suffered a catfish sting.
That's right, question No. 6 was:
Choosing option No. 2 added -- you guessed it -- "catfish sting" to the list of possibilities.
So if your sole hurts and you recently tangled with a catfish, you're told that the cause of your pain could be a catfish sting -- or 15 other things.
Excuse me? I mean, how many people have even seen a catfish? I can't figure out why "catfish sting" was one of the options and "stepped on a nail" wasn't, or maybe "walked over hot coals on a bet."
Conditions rounding out the 15 ranged from multiple sclerosis to poorly fitting shoes. Gee, thanks for narrowing it down. If you decide to click on each of the 15 items to get detailed descriptions and try to pinpoint your problem, I hope yours isn't No. 15 on the list.
WebMD does contain plenty of good information and services and looks like it could be quite useful, as do all the other sites. But for quickly and easily figuring out your specific problem through the symptom checker, not so much.
Dr. Beaty's take: She found WebMD and MayoClinic.com (below) to be very similar. Specifically, "they were literally too inclusive."
Her first test ailment of choice was a urinary tract infection. Going through the WebMD process, she ended up with 16 possible causes. "And then when you increase the number of symptoms -- which obviously in medicine helps you to better isolate the condition -- for these sites, it actually increases how many conditions they are including. So I went from 16 to 21 just by adding a few more symptoms. I thought that was kind of all over the map."
Dr. Spooner's take: He liked the way WebMD used a "Bayesian logic calculator" that lets users add multiple symptoms and tailored its results so, for example, the symptoms "cough and fever" would have a different result than "cough and wheeze." However, the results "are still very narrow. Clearly, these are small databases."
Physicians use a similar tool, he noted, that might come up with 200 possible causes, compared to the much smaller number offered by WebMD and some of the other sites. That helps him consider diseases that he might not otherwise have thought of. He said the professional tool also makes it easy to add many different symptoms and combine them in various ways to reach this large number of possible conditions.