Medical information on Web is mixed blessing Thursday, July 12, 2001 I'm not a medical doctor and I don't play one on TV. Yet, as a parent, a husband and a hypochondriac, I sometimes find myself acting as a medical sleuth, searching various health-related Web sites in search of explanations, cures or advice about a wide variety of ailments. Medical information on the Internet is a mixed blessing. On the plus side, there is plenty you can learn, but there is also much misinformation. A survey of health Web site visitors conducted in February and March by the Swiss-based Health on the Net Foundation (www.hon.ch) found that 83 percent of respondents questioned the accuracy of information on the sites they visited, while 72 percent found had trouble finding things. Yet, that same survey found that, despite the shortcomings, medical sites are generally helpful, with 72 percent of respondents saying the sites made them ``more knowledgeable.'' Some 61 percent said consultation with their health care providers is ``more constructive'' as a result of the knowledge gained. Seventy-eight percent of the medical professionals who responded said patient Internet searches were helpful because the patient ``becomes more knowledgeable and communication is improved.'' Of the 18 percent of professionals who considered patient Web searches to be not helpful, most cited ``risk of patient self-treatment.'' Dr. Andrew Newman, a Palo Alto internist and pulmonary specialist, worries abut the accuracy of Web-based information. ``People come in with Web clippings, TV ads, Family Circle,'' Newman said. ``The demand for information is there and it should be met, but it should be answered in a way that ensures that it's safe and accurate.'' Newman said the best-known consumer health sites are typically too general for many of his patients, who wind up searching deeper to find sites with specific information about their conditions that typically ``has not been through rigorous peer review like articles in refereed medical journals.'' One problem with doing your own medical research online is that almost any symptom can mean different things. The general health sites will usually focus on the most common causes of symptoms, but they don't spare you the possibility that it could be something worse. According to WebMD, for example, a headache can be caused by muscle tension or a brain tumor. A cough can be the result of a common cold or possibly lung cancer. Being a hypochondriac, I've had some sleepless nights contemplating all the things that might possibly be wrong with myself or family members. When I do find something alarming, I often print it out and bring it with me if I have a coming doctor's visit. Sometimes I'll e-mail it to my doctor. As it turns out, I'm not alone; 64 percent of the respondents to the Health on Net survey discuss their Internet findings with their physician and 14 percent use e-mail to consult with their physician. Dr. Judith Murphy, a Palo Alto pediatrician, estimates that the families of about a quarter of her patients have come to her armed with information they found online. ``Many people use it to learn about a specific condition. It's increased availability of information and it's very positive and helpful,'' she said. Still, there are patients who come to her with needless worries. ``People who are anxious or hard to reassure have a tendency to focus on small probabilities of something disastrous,'' Murphy said. ``Some parents have expressed worry over conditions that I've never seen in my 19 years of practice.'' Murphy does find the Internet extremely useful for people with very rare conditions or diseases. ``When someone does have something quite rare, the Web site can have lots of information that is useful to me and the patient and hooks them up to a virtual community of people who are dealing with something quite unusual.'' Despite my tendency to become alarmed about what I read online, I've generally found worthwhile information. A few months ago, my wife Patti was told by her doctor that she had a low iron count. So, I immediately started searching the Web for information on anemia. I went to all the usual health sites including www.DrKoop.com, Dr. Dean Edell's www.HealthCentral.com, www.WebMD.com and www.MayoHealth.org to get background information on her condition. Some of what I learned led to needless anxiety about terrible diseases that were consistent with her symptoms. Of course, Patti continued to get professional medical advice, including a consultation with a hematologist. The hematologist, as you would expect, knows a lot more about anemia than I do and immediately eased our fears. He recommended an intravenous iron infusion. But before Patti went ahead with the procedure, we spent some time on the Net exploring the benefits, risks and alternatives. Using www.Google.com, my favorite search engine, we found a Web site that let us calculate exactly how much iron she would need and how long the procedure would take, as well as the recommended safety precautions. Call me paranoid, but on the day of the procedure, I kept my eye on the nurse to make sure she followed all the procedures. The nurse did; Patti responded well and is now fine. In addition to finding out about conditions, symptoms and procedures, the Net is a great place to find out about drugs. Like most families, we have a lot of prescription drugs in our medicine chest and, in most cases, the pamphlet that came with the medication is nowhere to be found. Fortunately, you can find information about virtually any prescription or over-the-counter drug at most of the health Web sites. You can find even more if you enter the drug's brand name or generic name into Google. There are also government-funded medical databases, including PubMed and Medline Plus from the U.S. National Library of Medicine (www.nlm.nih.gov). Medline Plus (www.medlineplus.gov) is for most of us, a far more useful compendium of medical information. Aimed at both consumers and professionals, it has a database of prescription and non-prescription medicines, listed by both brand and generic names. You can also find information in forums and newsgroups. Www.Deja.com is a Web-based newsgroup search engine that makes it easy to locate information on virtually anything. But before you go off to newsgroups to learn about medical conditions, remember that anyone can post to a newsgroup, and you often have no way to determine whether the person actually knows what he or she is talking about.

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Larry Magid is a technology journalist and commentator based in Palo Alto. Contact him at larry@safekids.com .