The pros and perils of online symptom checkers

Your child has a fever and a stomachache. You’re not sure what to do. So you reach for—your laptop?

kidsdocsymptomchecker
The AAP just launched the KidsDoc Symptom Checker, which helps look up specific symptoms by body part.

More and more, that’s what many parents are doing. Over the past few years, the amount of health information available on the internet has skyrocketed, and many sites offer to help you make diagnoses, whether it’s through specific health information, quizzes, or a “symptom checker” that allows you to look specifically at what might be causing the fever or stomachache—or rash, or whatever.

The American Academy of Pediatrics recently launched their own “symptom checker,” called the KidsDoc Symptom Checker, available at healthychildren.org (there’s an iPhone app too!). It’s very straightforward: you run the cursor over the part of the body where there’s a problem, and you get a menu of possible symptoms in that area. For example, I ran the cursor over the abdomen (pretending I have a child with fever and stomachache), and it gave me Abdominal Pain and Constipation as possibilities. So I clicked on Abdominal Pain, and it gave me information on possible causes of abdominal pain, advice on when to call the doctor and some home care instructions.

There are some great things about this application. It gives you quick access to really useful information. It does help you figure out when you should put down the laptop and call the doctor, which (as a doctor) I appreciate. And the application, along with the whole healthychildren.org web site, has all sorts of wonderful health information to help you take better care of your child.

CM_pullquoteBut there are also some things that aren’t so great. There are real limitations to reaching for the laptop instead of the phone. Medicine, especially making diagnoses, can be complicated. It’s easy to head off in the wrong direction, especially if you don’t have medical training. For example, I can’t tell you how many parents come in to our clinic saying their child has chickenpox when what they actually have is a different virus, or impetigo, or an allergic reaction. If you were one of those parents, and you were using KidsDoc, you’d click on chickenpox and get information on what to do for that. There are pictures, but they aren’t that great; you may or may not realize that your child doesn’t have chicken pox at all.

And sometimes it’s easy to get fooled by a symptom. I once had a mother bring her child in because of a skin irritation between her legs. Using KidsDoc, if she were my child I would click on skin conditions. Based on the fact that the rash had only been present for a couple of days and wasn’t very painful, the symptom checker would have me put cool compresses on it and maybe cream and call the doctor if it didn’t get better or I got worried. The little girl actually had diabetes; the skin irritation was from urinating all the time, which happens when your blood sugar gets very high.

Or another example: fever and stomachache, the symptoms I picked, can sometimes be pneumonia. Usually there is cough, but sometimes the stomachache is bad enough that parents think of it as the major symptom. The Abdominal Pain section of KidsDoc doesn’t mention pneumonia. And it doesn’t allow me to add symptoms like fever or cough. The symptom checker on WebMD does allow me to add symptoms. When I put in abdominal pain, fever and cough for a 3 to 6 year old, it gives me a list of 20 possible conditions—which is, really, my point. It takes a health care provider to sort through the possibilities.

These symptom checkers assume that the person you are checking about is generally healthy. But if your child has a chronic health problem, like sickle cell disease or asthma, or a problem with their immune system, the advice you need may be very different from what a symptom checker will give you.

So here’s my advice when it comes to reaching for the laptop for health help:

  • Talk to your doctor about using the internet for health information. Get some advice about good sites (there are a lot of bad sites out there) and how you should use them. This is especially important if your child has a chronic health problem.
  • Think of the internet as the place to go to get and keep informed about health. Use it for general health information, stuff like nutrition advice, parenting help, safety tips, health news. It’s a great place to find out all those things you always mean to ask at the doctor’s office but forget to, or those things you feel like you shouldn’t bother the doctor about (although most doctors are happy to be bothered by parents wanting to learn about health!).
  • If your child is sick or injured, and the illness or injury is anything more than mild, call your doctor. I don’t mean to diss the internet (especially as someone who writes for it), but it can’t ask all the necessary questions, and it can’t do a physical examination. Both are necessary to make a diagnosis—and give the best advice.

That’s the thing: as wonderful as the internet is, it can’t give the personalized attention your child deserves—and sometimes really needs.

One thought on “The pros and perils of online symptom checkers

  1. My pre-mommy career was in sports medicine (I work from home in the health information industry now that I have children), so I worked with a lot of head injuries. I worked with a few colleagues and had our research on head injuries published in our professional journal once upon a time, actually. So when a friend called me and casually mentioned her son’s head injury I natrually asked questions about it. He had a severe headache with vomitting and blurry vision and I remember her saying “one eye just don’t look right.” Having recieved her M.D. from the University of Google, she decided he did not need medical attention and it would pass. I told her to disconnect from the internet and go to the hospital. Within about an hour he was in the ER having a bur hole placed. I just happened to be in the right place at the right time with the right knowledge to tell her she was interpretting the information wrong. Not only do we have to find the right information, but then parents also have to interpret what they read correctly. Unfortunately, not all parents do this. Find websites that are geared for the casual reader to understand. It is not wise to read through the New England Journal of Medicine if you’re a parent trying to decide if that injury is worthy of an ER visit.

    I think the very worst thing patients do is to go online to forums and ask other people like themselves. People mean no harm in giving answers, but just because their child received a certain treatment for a condition that sounds the same online does not mean your child will receive the same treatment. I moderate a health and fitness forum where I am constantly having to stop people from giving out medical advice. Just because your back injury was treated this way, does not mean another person’s will be. Don’t let anonymous people online diagnose anything!

    On the other hand, I have found my own children’s pediatricans appreciate that I already know what they need to know. Between education in the medical field and being an obsessive researcher, I can present my doctors with a concise medical history that I know they need. I know they don’t need to hear about that hang nail back in 2003 when I bring my daughter in with a petechiae rash, but they DO need to know about that fever of unknown origin last week.

    Knowledge is power, as long as you know the limits of your power. That old saying “a little bit of knowledge is a dangerous thing,” is quite often very true. This was a great article, and one I hope parents will take to heart.

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