Internet health information can reduce parents' trust in doctors' diagnoses

The study abstract, "Paging Dr. Google: The Effects of Online Health Information on Parental Trust in Pediatrician' Medical Diagnoses," will be presented at the Moscone West Convention Center in San Francisco.

Using the Mechanical Turk online research platform, researchers recruited 1,374 parent participants who were presented with a vignette of a child who "has had a rash and worsening fever for 3 days." The participants, who averaged 34 years of age and had at least one child under age 18, were then divided into groups.

In the first group, participants received screen shots of internet information describing some symptoms of scarlet fever, an infectious disease linked to Strep throat that causes rash and fever. Unless treated with antibiotics, scarlet fever can develop into rheumatic fever and, in some cases, lead to heart damage.

The second group of participants received screen shots listing select symptoms of Kawasaki disease, a condition in which blood vessels throughout the body become inflamed. It also is accompanied by fever and rash. Prompt treatment with anti-inflammatory drugs is needed to help prevent life-threatening complications such as aneurisms.

A third set of parents, the control group, received no internet screen shots. All participants then read that the doctor had diagnosed the child with scarlet fever. Compared to the control group, in which 81.0 percent of parents reported trusting the physician, 90.5 percent of parents who had received scarlet fever symptom screen shots reported trusting the physician. Furthermore, fewer parents in the scarlet fever cohort answered that they were likely to seek a second opinion (21.4 percent), compared to the control group (42.0 percent).

Conversely, only 61.3 percent of participants who had viewed the screen shots listing rash and fever as symptoms of Kawasaki disease reported trusting the doctors' diagnosis, and 64.2 percent reported that they were likely to seek a second opinion.

Lead author Ruth Milanaik, DO, FAAP, an associate professor at the Hofstra Northwell School of Medicine, said that although there are many advantages of having easily accessible medical information available on the internet, the study's findings show that "internet-driven interpretation of symptoms" can compromise trust between a doctor and patient.

"The internet is a powerful information tool, but it is limited by its inability to reason and think," Dr. Milanaik said. "Simply entering a collection of symptoms in a search engine may not reflect the actual medical situation at hand. These computer-generated diagnoses may mislead patients or parents and cause them to question their doctors' medical abilities and seek a second opinion, thereby delaying treatment."

Pediatricians should encourage parents to share all concerns they have, Dr. Milanaik said, so they lead them through the differential diagnosis process, and why others diagnoses were ruled out.

"Parents who still have doubts should absolutely seek a second opinion," she said. "But they shouldn't be afraid to discuss the result of internet information with the physician."