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.