Why is asking Google about your health a bad idea?

I asked Google to diagnose my symptoms. That mistake cost me a lot of unnecessary stress.

The Internet is like a labyrinth of knowledge. It’s easy to get lost among pseudo-experts spreading fake medical news. The algorithms determining search results can manipulate the way people interpret reality. You can fall into a trap of inadequate information, and you probably already have many times. Just like me.

The art of misleading data

It was just another winter evening. Something had been bothering my back for several days. The slight itching was not annoying enough to visit a doctor, but I still felt that I should check what was going on. In the mirror, I saw a mole about a centimeter in diameter. As a health-conscious person, I understood that I should show it to a dermatologist. But then something went wrong in my decision-making process. I knew I would have to wait weeks for an appointment. Weeks of uncertainty. But immediate help was within reach. On the Internet.

Illustration by Tomek Tuz

There was no real reason to worry – I had the impression that the mole had always been there, and it didn’t look suspicious. But I wanted a clear answer today – not tomorrow – to the questions spinning in my head. The idea that it was something serious was intensifying, arousing negative emotions. I sat down at my computer to ask Google. Even then it was clear to me that I was making a big mistake. How many times had I read that Dr Google was unreliable? How many articles had I written about the negative consequences of checking symptoms on the Internet? But in moments like this one, there is no place for rational thinking. The highest priority is to discover the truth as soon as possible, and nothing else matters. I typed in the keywords “itching mole” and entered a labyrinth of random information and advice.

The photos that came up suggested a clear answer: cancer. The articles described cases of melanoma, along with prognosis and treatments. I’d fallen deep into the trap – it was too late to separate the scientific, evidence-based medical knowledge from patients’ stories that were not even relevant to my case. I clicked the links for all the suggested search results -of course the ones at the top of the list.

Google gave me the worst possible diagnosis without knowing anything about my case. Even worse, it left me alone with a load of data that was hard to understand. I could rightly blame myself for having been fooled, but I, like millions of other Internet users, have no tool to navigate through the mix of information displayed on the computer screen. Since the Internet has become a reliable source of daily knowledge, why shouldn’t we trust Google when it comes to medical advice?

Disinformation engine

After a sleepless night, early the next morning I found myself in the emergency room feeling scared. A few minutes later, I felt both angry and cheated. The search engine had been wrong. The algorithms had shown me the most popular results, based on numbers of clicks, rather than the most relevant ones. Google, Bing, Yahoo! and Baidu all pretend they can diagnose diseases, when in fact they tempt us with information that is sensational, not rational. And unfortunately, most of us don’t realize it. This not only misleads those who are looking for help, but also threatens the credibility of medical knowledge and doctors’ expertise.

When objective knowledge lands in the same pot as fake medical news, it’s hard to draw a line between truth and falsehood. Paradoxically, the mechanism used to classify information on the Internet makes expert opinions less accessible than medical conspiracy theories.

With over 90% of the overall search engine market share, Google receives about one billion health questions each day. Every minute Dr Google answers 70,000 inquiries. No healthcare organization in the world serves so many patients. Despite this, its impact on patients’ health has never been investigated. We can only guess the scale of the adverse effects, as well as costs, when health-related decisions are based on Google searches.

The problem goes much further than merely checking symptoms online. Medical lies spread quickly on the Internet: patients at high risk of heart disease may discover that statins are harmful to their health, parents looking up vaccines are confronted with lies about how life-threatening they are for children. Ads for super diets, miracle herbs or unknown alternative therapies are playing with our emotions, trying to discredit medical facts. Doctors keep warning against seeking answers on the Internet, but false healthcare-related theories continue to spread.

Dr Haider Warraich, a cardiologist from Duke University, writes in The New York Times article “Dr Google is a Liar” that “fake news threatens our democracy and our lives.”

“There is no doubt that search engines can be precious, not only for patients but physicians as well,” told me Dr Warraich.

“Searching for symptoms through search engines, while valuable to some, can often mislead others since they don't cover the entire context of the patient's health. The practice could either unnecessarily alarm patients or give false reassurance, both outcomes being dangerous.”

Google has for years faced massive criticism for the methods behind how the results of a patient’s search are presented, which allows the spread of misleading information. In response, the Silicon Valley tech giant is attempting to introduce a few changes. For example,“knowledge panels” should give patients access to reliable information. To help fight the opioid crisis, Google Maps now displays local drug disposal locations. These initiatives are only a tiny drop in the sea of needs.

AI brings enlightenment

The evening I allowed myself to be misled has taught me a lot. To be clear, there is nothing wrong with seeking information about health-related topics online. On the contrary, the Internet has democratized access to information. Patients are becoming empowered and are sharing responsibility for their own health with their doctors. The worldwide shortages of medical staff require more engagement from society. The Internet is also a vast library of useful and helpful information. But medicine is a science, not guesswork. Meanwhile, Google’s algorithms don’t favor scientific evidence.

Illustration by Tomek Tuz

Fortunately, thanks to technological progress, things are changing for the benefit of patients. Artificial Intelligence systems study hundreds of thousands of pages in medical books and research results to provide accurate answers. For example,“symptom checkers” can then provide a reliable health evaluation. These AI-based solutions focus exclusively on evidence-based medicine. Instead of entering a phrase in a search engine, patients describe their symptoms and answer syndrome-related questions. The health assessment includes possible causes of the symptoms, options what to do next, and suggested lab tests. Of course, symptom checkers evaluate the state of the patient’s health based on the information provided; they can’t see, hear, touch or examine the user.

Nonetheless, symptom checkers have an undeniable advantage over search engines. They are created in cooperation with doctors and are equipped with scientific knowledge – the same that medical students acquire. They absorb data from reliable sources, and machine learning guarantees constant improvement. They offer the best possible AI-driven help online to guide patients. Development in this area is rapid. The first symptom checkers entered the market only a few years ago. Today, national health systems and health insurers use them to help patients navigate their own health or find the right doctor, to distribute health services online, and to make quick health assessments. The goal is challenging, but worth the effort: to pull patients out of the information chaos and strengthen digital health literacy, and thus the capability to navigate through information available online to manage one’s health in the best possible way. If people have the knowledge necessary to find, classify and use health-related information, they can protect themselves from disinformation.

No online health assessment can replace a doctor’s consultation. But sometimes you want to know what’s wrong as soon as possible, before a doctor’s appointment is available. In that case, remember to navigate wisely through advice found online. Otherwise, you’ll fall into a sea of random information and diagnoses.