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Just before Thanksgiving, Microsoft released a study entitled, “Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search.” Ryen White and Eric Horvitz took advantage of a data set that few people have access to (log files from Microsoft’s Live Search engine and MSN Health and Fitness) as well as a survey of 515 Microsoft employees. They also did a great service to those of us who have a problem with the term “cyberchondriac” since they define cyberchondria as “the unfounded escalation of concerns about common symptomatology, based on the review of search results and literature on the Web.” That does not describe most internet users and therefore, people might think about retiring the term from general usage.

There were 350 males and 165 females in their sample and the median age was 35 (plus or minus 8 years). I’d hazard a guess that they are all college educated.  So one’s antennae might go up just on those grounds since that’s not even close to a representative sample of the current internet population.

But right away I was drawn in by their methods and their research questions. I think it’s a fantastic idea to harness the power of log files to investigate what people are actually doing online. That’s why I’m a big fan of Bill Tancer of Hitwise, who once told me that they have to remove all data related to porn from their data set in order to see anything else. “Adult” searches just swamp the rest of what’s happening online, apparently. That’s the beauty of log files over phone surveys: we can only get 15% of adults to tell our interviewers that they have visited adult websites.

But that’s also where my antennae went up again — the researchers use the word “may” a bit too often for me to feel comfortable with all of their assertions related to their very cool data set. For example:

Identifying the recurrence of concerns about a rare disorder — especially when the recurrence occurs during another search task — may indicate that earlier escalations extend over time, and that anxieties or heightened awareness continue to interrupt users’ online activities over prolonged time periods. Such findings may be proxies for the rise and persistence of deep concerns that may disrupt other aspects of daily life.

Or they may not!

John Markoff’s November 24 article in the New York Times, however, helped me put my finger on why I thought I’d heard something like this before: “Medical Web Searches and Escalating Fears: Microsoft Finds Top Results Lead to Anxiety.” Markoff described Eric Horvitz as an artificial intelligence researcher (bing! a bell goes off in my head) and concludes with the following:

In the 1990s, Microsoft researchers built a health advisory system for pregnancy and child care. Mr. Horvitz said that in the future it would be possible to create search engines that were able to detect medical queries and offer advice that did not automatically make Web searchers fear the worst.

Bing! Bing! Bing! Now I know where I have heard something like that before: Diana Forsythe in her classic article, “Old Wine in New Bottles,” described how artificial intelligence researchers, when designing a migraine information kiosk (yes, it was the 80s), didn’t ask patients what they wanted to know. They asked one doctor what he thought patients should know about their condition.  And guess what? He didn’t include the answer to the number one question asked by migraine sufferers:  Am I going to die from this?

No, the migraine patients weren’t going to die from the pain, but isn’t it their right to ask the question? In asking it, does it mean they want to “escalate” their anxieties? Who should be the trusted guide? Is it Microsoft?

I hope the conversation about this study continues since I am intrigued by the questions it raises.  And here I’ll give the last word to John Naughton, a columnist for The Observer:

The moral? If you’re a hypochondriac, stay off the web. And remember that, as the man said, the best cure for your condition is to forget about your body and become interested in somebody else’s.

I think more than 15% of American adults would agree.


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