{"id":26259,"date":"2013-05-08T09:42:51","date_gmt":"2013-05-08T08:42:51","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=26259"},"modified":"2013-05-08T11:14:58","modified_gmt":"2013-05-08T10:14:58","slug":"david-kerr-signals-from-the-crowd-making-a-diagnosis","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2013\/05\/08\/david-kerr-signals-from-the-crowd-making-a-diagnosis\/","title":{"rendered":"David Kerr: Signals from the crowd\u2014making a diagnosis"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" alt=\"David Kerr\" src=\"http:\/\/www.bmj.com\/site\/blog\/icons\/david_kerr.jpg\" width=\"160\" height=\"126\" align=\"left\" \/>For very many years making a medical diagnosis was based loosely on the application of the principle of <a href=\"http:\/\/en.wikipedia.org\/wiki\/Occam's_razor\">Occam\u2019s Razor<\/a> otherwise known as diagnostic parsimony\u2014look for the fewest possible causes to explain a patient\u2019s symptoms. However, with the increase in longevity of the background population, Occam\u2019s Razor was eventually superseded by the <a href=\"http:\/\/en.wikipedia.org\/wiki\/Hickam%27s_dictum\">Hickam\u2019s Dictum<\/a> which states that \u201cpatients can have as many diseases as they damn well please.\u201d Here the idea is to consider that multiple symptoms are more likely explained by a collection of common diseases rather than a single rare one.<!--more--><\/p>\n<p>Hickram\u2019s Dictum has since been extended even further due to the pervading influences of health consumerism and fear of litigation. The modern doctor is much more likely to order a number of investigations to rule out multiple conditions irrespective of whether they are common or very rare. This can result in patients undergoing repeated painful and expensive tests leading to frustration for both the sufferer and the healthcare professional. It is also expensive and in principle bad medicine.<\/p>\n<p>Nowadays we have a growing number of so-called ePatients. These are \u201chealth consumers\u201d who use the Internet to gather information about a medical condition. The e in ePatient apparently stands for \u201cbeing equipped, enabled, empowered, engaged, equal, emancipated, and expert\u201d and, according to Wikipedia, e-Patients report two effects of their online health research: &#8220;better health services, and different relationships with their doctors.&#8221; This group are also calling for \u201cmedical education to take the <a href=\"http:\/\/en.wikipedia.org\/wiki\/E-patient\">e-patient into account and to prepare students for medical practice that encompasses the e-patient.<\/a>\u201d<\/p>\n<p>So in terms of the art and science of turning a collection of perplexing symptoms into a diagnosis we will also soon have \u201ccrowdsourcing diagnostics.\u201d According to a <a href=\"http:\/\/mobihealthnews.com\/21835\/crowdmed-gets-1-1m-to-crowdsource-diagnosis\/\">recent report<\/a>, a technology start-up has received more than $1 million in seed funding to develop the idea of using the \u201cwisdom of crowds\u201d for making medical diagnoses. On this particular site you can \u201cuse your personal experience, intuition, and online research skills to help solve the world\u2019s most difficult medical cases\u201d and \u201cnot only win cash, prizes, and status, but also save lives.\u201d Reassuringly the idea is not to make a diagnosis per se but to make \u201cdiagnostic suggestions\u201d about rare and unusual conditions that can be discussed with healthcare professionals. On the site, users can sign up to be either a patient or a medical detective (otherwise known as an \u201cMD\u201d). All the information about a medical quandary: symptoms, family history, and test results are uploaded and cases are then presented to the MDs, who can suggest a diagnosis and bet on the likelihood of their diagnoses being correct.<\/p>\n<p>Whether crowdsourcing diagnostics will ever catch on remains to be seen. It will probably be of more value for detecting side effects from recently introduced new medicines or for <a href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/01\/16\/david-kerr-crowd-sourcing-clinical-research\/\">suggesting topics for clinical research<\/a>. When it comes to the personal experience of seeking a diagnosis most individuals are probably still keen on seeking the views of a well-trained, experienced, and caring professional and in confidence.<\/p>\n<p><em><strong>David Kerr<\/strong> wears many hats, sometimes at the same time\u2014diabetologist, editor of <\/em>Diabetes Digest<em>, researcher, and founder of VoyageMD.com, a free service for travellers with diabetes. You can follow him on Twitter (@GoDiabetesMD) and Linkedin. He holds a small amount of stock in CellNovo (a new insulin pump company) and Axon Telehealth.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>For very many years making a medical diagnosis was based loosely on the application of the principle of Occam\u2019s Razor otherwise known as diagnostic parsimony\u2014look for the fewest possible causes [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/05\/08\/david-kerr-signals-from-the-crowd-making-a-diagnosis\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2253],"tags":[],"class_list":["post-26259","post","type-post","status-publish","format-standard","hentry","category-david-kerr"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>David Kerr: Signals from the crowd\u2014making a diagnosis - 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