Cyberchondria: Studies of the escalation of medical concerns in Web search

The World Wide Web provides an abundant source of medical information. This information can assist people who are not healthcare professionals to better understand health and illness, and to provide them with feasible explanations for symptoms. However, the Web has the potential to increase the anxieties of people who have little or no medical training, especially when Web search is employed as a diagnostic procedure. We use the term cyberchondria to refer to the unfounded escalation of concerns about common symptomatology, based on the review of search results and literature on the Web. We performed a large-scale, longitudinal, log-based study of how people search for medical information online, supported by a survey of 515 individuals' health-related search experiences. We focused on the extent to which common, likely innocuous symptoms can escalate into the review of content on serious, rare conditions that are linked to the common symptoms. Our results show that Web search engines have the potential to escalate medical concerns. We show that escalation is associated with the amount and distribution of medical content viewed by users, the presence of escalatory terminology in pages visited, and a user's predisposition to escalate versus to seek more reasonable explanations for ailments. We also demonstrate the persistence of postsession anxiety following escalations and the effect that such anxieties can have on interrupting user's activities across multiple sessions. Our findings underscore the potential costs and challenges of cyberchondria and suggest actionable design implications that hold opportunity for improving the search and navigation experience for people turning to the Web to interpret common symptoms.

[1]  Tania Lewis,et al.  Seeking health information on the internet: lifestyle choice or bad attack of cyberchondria? , 2006 .

[2]  D. Heckerman,et al.  Toward Normative Expert Systems: Part I The Pathfinder Project , 1992, Methods of Information in Medicine.

[3]  W. Hersh,et al.  Factors associated with successful answering of clinical questions using an information retrieval system. , 2002, Bulletin of the Medical Library Association.

[4]  Alla Keselman,et al.  Term Identification Methods for Consumer Health Vocabulary Development , 2007, Journal of medical Internet research.

[5]  Thorsten Joachims,et al.  Accurately Interpreting Clickthrough Data as Implicit Feedback , 2017 .

[6]  L. Shulman,et al.  Medical Problem Solving: An Analysis of Clinical Reasoning , 1978 .

[7]  A. Tversky,et al.  Judgment under Uncertainty: Heuristics and Biases , 1974, Science.

[8]  Dc Washington Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[9]  A R Jadad,et al.  Rating health information on the Internet: navigating to knowledge or to Babel? , 1998, JAMA.

[10]  Graham A. Colditz,et al.  Trends in the Incidence of Coronary Heart Disease and Changes in Diet and Lifestyle in Women , 2000 .

[11]  Hao Yang,et al.  MedSearch: a specialized search engine for medical information , 2007, WWW '07.

[12]  L. Baker,et al.  Use of the Internet and e-mail for health care information: results from a national survey. , 2003, JAMA.

[13]  Taketoshi Takuma Die Wiederaufnahme unterbrochener Hand-lungen bei schwachsinnigen Kindern , 1957 .

[14]  J. Kronenfeld,et al.  Chronic illness and health-seeking information on the Internet , 2007, Health.

[15]  R. Fleet,et al.  Panic disorder in emergency department chest pain patients: prevalence, comorbidity, suicidal ideation, and physician recognition. , 1996, The American journal of medicine.

[16]  Eric Horvitz,et al.  Disruption and recovery of computing tasks: field study, analysis, and directions , 2007, CHI.

[17]  Steven Taylor,et al.  Health Anxiety : clinical and research perspectives on hypochondriasis and related conditions , 2001 .

[18]  Suresh K. Bhavnani,et al.  Domain-specific search strategies for the effective retrieval of healthcare and shopping information , 2002, CHI Extended Abstracts.

[19]  Filip Radlinski,et al.  Query chains: learning to rank from implicit feedback , 2005, KDD '05.

[20]  Susan T. Dumais,et al.  Analysis of topic dynamics in web search , 2005, WWW '05.

[21]  Suresh K. Bhavnani,et al.  Exploring the distribution of online healthcare information , 2003, CHI Extended Abstracts.

[22]  Barbara M. Wildemuth,et al.  The effects of domain knowledge on search tactic formulation , 2004, J. Assoc. Inf. Sci. Technol..

[23]  R. Kellner,et al.  Diagnosis and treatments of hypochondriacal syndromes. , 1992, Psychosomatics.

[24]  G Eysenbach,et al.  Information in practice Towards quality management of medical information on the internet : evaluation , labelling , and filtering of information , 1998 .

[25]  Matthew S. Eastin,et al.  Worried and Wired: Effects of Health Anxiety on Information-Seeking and Health Care Utilization Behaviors , 2006, Cyberpsychology Behav. Soc. Netw..

[26]  R. Kravitz,et al.  Health information on the Internet: accessibility, quality, and readability in English and Spanish. , 2001, JAMA.

[27]  Mary Czerwinski,et al.  A diary study of task switching and interruptions , 2004, CHI.

[28]  Pierre Pluye,et al.  Shortcomings of health information on the Internet. , 2003, Health promotion international.

[29]  M. J. Hurst,et al.  The Heart, Arteries and Veins , 1974 .

[30]  J. Powell,et al.  Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review. , 2002, JAMA.

[31]  A. Folsom,et al.  Trends in the incidence of myocardial infarction and in mortality due to coronary heart disease, 1987 to 1994. , 1998, The New England journal of medicine.

[32]  Mark H Pollack,et al.  Predicting panic disorder among patients with chest pain: an analysis of the literature. , 2003, Psychosomatics.

[33]  R. J. Cline,et al.  Consumer health information seeking on the Internet: the state of the art. , 2001, Health education research.

[34]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[35]  Susan T. Dumais,et al.  Improving Web Search Ranking by Incorporating User Behavior Information , 2019, SIGIR Forum.

[36]  Doug Downey,et al.  Models of Searching and Browsing: Languages, Studies, and Application , 2007, IJCAI.

[37]  Ryen W. White,et al.  WWW 2007 / Track: Browsers and User Interfaces Session: Personalization Investigating Behavioral Variability in Web Search , 2022 .

[38]  Yin Yang,et al.  A study of medical and health queries to web search engines. , 2004, Health information and libraries journal.

[39]  W R Hersh,et al.  How well do physicians use electronic information retrieval systems? A framework for investigation and systematic review. , 1998, JAMA.

[40]  Charles P. Friedman,et al.  Research Paper: Factors Associated with Success in Searching MEDLINE and Applying Evidence to Answer Clinical Questions , 2002, J. Am. Medical Informatics Assoc..

[41]  G A Colditz,et al.  Trends in the incidence of coronary heart disease and changes in diet and lifestyle in women. , 2000, The New England journal of medicine.

[42]  G. Klerman,et al.  Overview: hypochondriasis, bodily complaints, and somatic styles. , 1983, The American journal of psychiatry.

[43]  G. Eysenbach,et al.  Christian Köhler tests , and in-depth interviews Qualitative study using focus groups , usability health information on the world wide web ? How do consumers search for and appraise , 2002 .

[44]  Maria Ovsiankina,et al.  Untersuchungen zur Handlungs- und Affektpsychologie , 1928 .

[45]  Elizabeth Sillence,et al.  Trust and mistrust of online health sites , 2004, CHI.

[46]  J. Biermann,et al.  Evaluation of cancer information on the Internet , 1999, Cancer.

[47]  David K Ahern,et al.  Cognitive behavior therapy for hypochondriasis: a randomized controlled trial. , 2004, JAMA.

[48]  D. Demello,et al.  Arteries and Veins , 2006, Encyclopedia of Respiratory Medicine.

[49]  Larry J Baraff,et al.  Use of the Internet and E-Mail for Medical Advice and Information by Parents of a University Pediatric Faculty Practice , 2003, Clinical pediatrics.