Tuesday, June 02, 2015

House Calls

As a kid, I enjoyed watching medical shows, especially Dr. Kildare.  Later on, I liked Marcus Welby and Medical Center (although I would have run the other way before I'd let Chad Everett treat me for anything). My interest in medical dramas eventually died out. I saw St. Elsewhere once in a while, but never saw ER during its glory days with George Clooney. (I did watch it occasionally after Clooney's character, Dr. Doug Ross, checked out. In all the hysteria about his departure, I found myself missing him even though I'd never see the show.)

Somewhere along the line, medical dramas were replaced by cop shows as my TV preference.

But one of the fun things about the medical  shows was, of course, hypochondriac-ing along with them.

When Zohra Lampert was diagnosed with subdural hematoma , I was quite certain I had one, too. (Probably I just wanted Dr. Dreamboat, Jim Kildare, to lay hands on me.)

Fast forward, and my husband discovered House, and the two of us got entirely hooked on it.

If you hadn't seen that one, the highly eccentric and disagreeable Dr. Greg House was a genius at diagnosing odd-ball diseases. One of the things Jim and I always got a kick out of was how often sarcoidosis surfaced as a possibility when House and his genius-in-training young colleagues were trying to figure things out. We found this of interest because I had been diagnosed with sarcoidosis - a somewhat uncommon auto-immune condition with many different symptoms and manifestations - while in my thirties. Before I went into complete remission ten years later, my big symptom was lesions on my arms and legs that, unfortunately, resembled Karposi's sarcoma. Anyway, for me, sarcoid was just a weird little nuisance that went away - other than for its regular return on the possibilities list for House and his acolytes.

I thought of all this when I read an article a few weeks back in The Economist that talked about the growing interest in crowdsourcing to make rare diagnoses.

This makes tremendous sense, given all the info on the web, and all the doctors and doctor wannabes out there.

While most of us suffer from things that are fairly run-of-the-mill, this is not always the case:
Research published in 2013, in the Journal of Rare Disorders, says about 8% of Americans—some 25m people—are affected by rare diseases, and that it takes an average of 7½ years to get a diagnosis. Even in Britain, with all the resources of the country’s National Health Service at a GP’s disposal, rare-disease diagnosis takes an average of 5½ years. Also, doctors often get it wrong. A survey of eight rare diseases in Europe found that around 40% of patients received an erroneous diagnosis at first. This is something that can lead to life-threatening complications. (Source: The Economist)
The go-to site for trying to figure out a rare disease is CrowdMed, where you can post your condition (and maybe offer some cash compensation for the right answer) and get the wisdom of crowds to figure it out. According to The Economist:
It works. One woman, for example, had been burping as many as 150 times a day. Two endoscopies, a laryngoscopy and an abdominal ultrasonic scan all failed to identify her problem, and eliminating wine, chocolate and gluten from her diet failed to solve it.
Personally, I can't see how eliminating wine chocolate and gluten solves anything, but I'm not burping 150 times a day, either.
Crowdsourcing offered a diagnosis of “supragastric belching”. That suggested treatment by a specialist called a speech pathologist, which cured her...In a review that CrowdMed carried out of several hundred cases posted on the site, around 80% of patients said the suggestions proferred to them were accurate. Intriguingly, many of the best-performing cyber-diagnosticians were not those with the best formal medical credentials.
Given my historic interest in medical and cop shows, becoming a CrowdMed sleuth may be right up my alley. It beats becoming what doctors are apparently now calling "cyber-condriacs" and hitting the web to auto-diagnosis every off-kilter thing that can happen to your body over time.

I'd better join soon, however, IBM's got a super-diagnostic computer in the world crunching really big data and spitting out diagnoses right and left.

Some days, I hate the Internet and what it's done to us. Other times, I'm delighted by what it's doing for us. Think I'll go take two aspirins and hop on CrowdMed in the morning.

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