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Mining the Net for information needn't be a one-dimensional affair. The real charm of the Net is its interactive nature. |
Dial up a Doctor For those with a medical problem, information is the best prescription. Modern technology, in the form of the computer and Internet, has now made it possible to access the latest medical research and educate yourself about a particular medical problem. Dr Aniruddha Malpani tells you how to ensure you get the best medical care. Take two aspirins and look it up on the internet'' is fast becoming the standard prescription for anyone facing a new or major illness in the West. In India, when it comes to a medical problem, we tend to behave like, well,....a mouse. Successful executives, who make decisions involving crores of rupees daily, are often paralysed into inactivity when confronted with a medical crisis. We all know that information is power, but when it comes to collecting information about our own medical problems, and then making an intelligent decision after analysing this information, most patients behave like village bumpkins and leave everything to the doctor. The Internet is the ultimate information resource: it is a library which is open 24 hours and provides a wealth of information on every possible health and medical topic. In fact, medical journals, textbooks, encyclopaedias, research papers, and huge international databases once available only to doctors are now just a mouse click away. Savvy patients can even learn about a breakthrough before their doctor does, and the Internet has given birth to a new group of informed, empowered patients who want to make medical decisions in partnership with their doctors, instead of just blindly following the doctor's advice. While everyone knows that there's a wealth of medical information on the Net, why are most patients in India still so reluctant to make use of this? A major problem is that there are still very few sites about health and medicine in India (most websites are American in origin) with the result that a lot of the information on the Net is irrelevant to Indians. However, you can use the Internet intelligently to find out more about your medical problem. Many people still take a perverse pride in the fact that they know so little about their own bodies. Many intelligent people are also worried that a little knowledge is a dangerous thing and are worried about becoming half-baked doctors or hypochondriacs. However, remember that the point of this search for information is not to turn you into a doctor--it's to make you more aware of your own problem. One warning: It is unwise to try to diagnose yourself--don't try to play doctor! If you have a medical problem I strongly recommend that you seek a qualified medical opinion from your own doctor, who can see you, conduct tests if necessary, and diagnose properly. Once you have a diagnosis, your search for information can become focused and productive. If you possess a computer, you can use CDs to research your problem. Two invaluable CD-ROMs are the American Medical Association Family Medical Guide and the Mayo Clinic Family Health Encyclopedia. One advantage of CDs over books is that they provide you with computer graphics and even video clips. Searching for information on the Net is very similar to looking up a book. You turn to the index to look for a particular topic, and on the Net you can use one of the many search engines available, such as hotbot.com, altavista.com, excite.com or infoseek.com. The trouble is that these engines are unintelligent, so that a search usually retrieves thousands of websites--the majority of which are completely irrelevant to your query and it's hard to separate the wheat from the chaff. Search engines are most useful when you are looking for information on a rare problem, or very specific information only. Be sure to try several different search engines when looking for information since each one can have different listings included in their database. You also need to double check your spellings--an error can mean you may not retrieve any useful information at all! Try to be as precise as possible in order to retrieve relevant information. It's easy to get lost in the flood of garbage which a standard search produces, which is why many patients often despair of ever being able to find anything useful or understandable on the Net. In order to make their life easier, experts have put together evaluated subject gateways or medical search engines, to make directed searching for relevant information easier. As their name implies, these search services provide the user with a gateway to medical resources on the Internet. These gateways are produced by medical libraries, doctors and other organisations, and are useful to both new Internet users--who may be unsure where to begin--and experienced surfers who are frustrated with ploughing through the inevitable volume of irrelevant dross when using any of the more general search tools. Examples of such gateways for patients include: www.healthatoz.com; www. achoo.com; www. medhelp.org, and HealthyWay at http://www.ns.sympatico.ca/ healthyway/health.html . If you are a novice, it can be helpful to have a friendly doctor (or medical student) or a librarian to guide you with your first few searches, to teach you how to search efficiently. If you want a comprehensive search of the Internet you must be prepared to search multiple gateways and search engines--the much sought after 'one-stop information medical source' has yet to appear. Medical Databases: Databases such as MedLine are by far the most effective way to find references, although some effort is required to learn how to use these resources intelligently. You can carry out MedLine searches free on the Internet (for example, at www.healthgate.com). The huge size of these databases with millions of references and abstracts from thousands of journals means that if the information you seek has been published, the references are there. The ability to focus your search on keywords that interest you allows you to extract the specific references that pertain to these words. The biggest drawback with regard to these databases is that you are swamped with too much information, not too little! It is important to determine beforehand how much information you actually need to make yourself comfortable with your diagnosis and treatment options. Some 'insatiable gluttons' need as much information as they can possibly gather! Others find that less information, or information with a specific focus, is the most appropriate for them. Some patients find it helpful to hear only the good news; others want the whole picture, including the negative possibilities. Again, let your doctor know what precisely your needs are. He or she can provide you with printed matter or other sources of information, as well as point you towards other potential resources that can help you gather whatever information you find necessary. Do not accept the contents of any single journal article or book as definitive. One should bear in mind that all scientific inquiry involves human fallibility and could be prone to errors. Also, many conclusions are false and many reports flawed. Even research conducted and reported over many years may eventually be proven to be false, which is why you need to seek your doctor's help to make sense of the wealth of medical information available to you. He or she can explain to you how the information you have unearthed applies to you as an individual. In other words, you need to form a partnership with your doctor, but such a partnership should be one between well-informed equals, which is why you need to do your homework thoroughly first!
There are many doctors and health professionals on the Internet who will respond to medical questions. These responses are meant to educate the questioner and the public and cannot be a method of rendering personal medical care. Occasionally a response might be directly by e-mail, but most sites use the bulletin board forum and archive all the responses (what are called FAQs or frequently asked questions) so that everyone can search, view, and benefit from the information. Remember that there's a lot more on the Net than just tonnes of textual information on thousands of websites--you can admire anatomy in three dimensions thanks to virtual reality, and even watch video clips of surgery on-line. However, mining the Net for information need not be a one-dimensional affair--the real charm of the Net lies in its interactive nature, so that you can get a response to your queries. There are also a few live question-and-answer chat sessions. If you can't make the scheduled chat time, then at many of the sites you can post your question ahead of time and return later to view the transcripts of the chat and see if your question was answered. During the live discussion sessions, you need to ask your question through a moderator and whether or not your question gets answered depends on the number of participants and their questions. Newsgroups, which are also called Internet Discussion Groups, function like electronic worldwide bulletin boards. In a newsgroup you can post or view messages or reply to someone else's. There are thousands of newsgroups open to the public, and you can use Deja News (www.dejanews.com) to find the one of interest to you. LISTSERVS, also called mailing lists, are a way of communicating with others via e-mail on various topics of interest. To search for a particular LISTSERV topic go to www.liszt.com. You'll find there's a support group in cyberspace for just about any medical problem, and instead of being limited to a few local patients, you can communicate with dozens of people going through the same things you are. The Internet also provides a cloak of anonymity, and this is particularly important with illnesses that carry a social stigma, such as infertility or AIDS. If you have been able to identify an expert on your problem, it is also possible to send him an e-mail directly, and he may then reply to you. You can find e-mail addresses of doctors through a little bit of lateral thinking. Many leading clinics, hospitals and medical colleges have websites which list the names, addresses and e-mails of their faculty members. Another option is to use an e-mail search engine, such as four11.com. Also, many authors of medical journal articles now include their e-mail addresses along with their institutional address. Once you've found the information, how do you evaluate it? This is still the most difficult part of searching for medical information and, unfortunately, many patients become misinformed thanks to the Net. The problem, of course, is anyone can publish on the Net--and it's not easy to make out whether the information being presented is credible or not. You need to be aware of the fact that not all the medical information available on the Net is reliable; you need to assess it critically (this is true for all information, whether it comes from a book, your neighbour, your stockbroker or your doctor!). A good website should be accurate, useful, credible, readable, up-to-date and have useful links to other sites--but the most useful guideline is to find the source of the information! Websites built by well-respected medical institutions and government health agencies such as the US Government's Healthfinder (www.healthfinder.gov), Mayo Clinic's Health O@sis (www.mayohealth.org), Johns Hopkins' InteliHealth (www.intelihealth.com), Dr Koop's Community (www.koop.com) all provide consumer-friendly health information and are reliable sources. Remember that a lot of the medical information on the Net is designed for the doctor, and this can be quite complex to understand, because it is primarily written for medical professionals. However, this is usually the most reliable, and many leading medical journals now available on the Net, such as the British Medical Journal, the Lancet, New England Journal of Medicine and the Journal of the American Medical Association, only publish studies after they have been carefully reviewed by leading doctors. Though these may look intimidating, you don't need a medical degree to read them--each one has a conclusion and a summary that contain most of what you'll need to know. Once you have found as much information as you need about your problem, you then need to process it so that you can understand what treatment options are open to you. Your doctor (or a friend or relative who is in the medical profession) can be very helpful in explaining to you exactly which portions of the information you have unearthed are applicable to your particular problem. You then need to decide which treatment option is the best for you. For example, for patients with infertility, the options will include: adoption; child-free living; or taking medical treatment. Remember that there are always going to be choices--you need to be able to choose intelligently among them. In USA, a new group of professionals has come into being, called 'medical information consultants', who specialise in helping patients carry out this type of analysis. However, if you look upon this activity as a business exercise, it is really very similar intellectually to a SWOT (strengths, weaknesses, opportunities, threats) analysis. It is absolutely critical that you actually do make a timely decision. If you don't, you may end up without any treatment, rather than getting the best treatment! (You may also find that most of the options are equally promising. If this is the case, then just pick any one of them!) Too much information can also often leave you feeling confused. It's obviously much easier to remain passive and to allow the doctor the freedom to do what he wants: ''Why break your head over something you will never fully understand anyway'' is a common rationalisation many patients resort to. However, it is far better to be confused because you know too much, rather than because you don't know enough. After all, there is little to be gained in complaining about shoddy medical care after a problem arises because of your ignorance! You may also be worried that your doctor may become upset if you ask too many questions. Suppose he turns around and asks: ''Who is the doctor here?'' However, such a mindset reflects an archaic paternalistic attitude, and if your doctor refuses to help you find and analyse information about your medical problem, you should consider looking for another doctor! Having a medical problem is bad enough, but the real tragedy is having a medical problem which can be treated, and not getting the right treatment! The ultimate reward of doing your homework will be a peace of mind coming from the knowledge that you did the best you could! |
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