As a pediatric allergist, I treat several conditions that commonly affect children, including asthma, food allergies, eczema and allergic rhinitis. Almost everyone knows someone affected by some form of allergic condition, which makes for frequent questions from families, referring providers, and the public at large.
Early in my career, I noticed that many patients (and even colleagues in other specialties) were asking me questions that were either outdated or born entirely out of myth. Do kids with egg allergy need to avoid the MMR or influenza vaccine? If someone has a shellfish allergy, are they going to have an allergic reaction to radiocontrast media? Can you test for food allergies through IgG testing? Does a parent pass their own food/medication/venom allergy on to their children? Does milk/gluten allergy cause autism? These are but a few examples of questions that I routinely receive (by the way — the answer to all of them is NO).
I soon became interested in understanding the evidence behind these interesting questions and spent a lot of time reviewing PubMed for peer-reviewed articles. I learned that most were previously addressed and refuted, but the evidence had yet to reach the mainstream. In some cases, there was no evidence at all.
Then I did something that completely changed the way I practice medicine: I performed the same research using Google.
After inputting some of the same questions or simple search terms, I quickly learned that the Internet is filled with misinformation. Our patients really don’t stand a chance. Search results are affected by paid sites that appear at the top, and thus seem more reputable. Algorithms within the search engines determine what order sites appear in a given search. Unfortunately, validity or integrity of a given site does not enter into the equation. It was challenging even for me to tell the difference between reputable sites and some non-medical blogs/sites, or worse — sites deliberately providing misinformation to profit from patients in desperate search of a miracle cure.
Being active on social media has taught me similar lessons. Facebook groups and other social media platforms can serve as echo chambers of misinformation where patients offer their own stories as ‘evidence’ of treatment or results.
I try to stay current with misleading headlines regarding medical studies and use social media to follow the trending topics/stories pertaining to my specialty. This has helped me better understand the information that my patients may be finding on their own. I readily address this misinformation during patient encounters and provide cautionary guidance regarding looking online for medical information.
Without a doubt, this perspective has made me a better doctor. I understand the pseudoscience touted in online forums and have awareness of the snake oil being sold to unwary patients. This has led to productive discussions with patients upfront, during which I anticipate and address their concerns.
I believe it is useful for all medical providers to understand the evidence behind our medical decision making. I also encourage everyone to look online from a patient perspective and see if you are equally appalled … and hopefully inspired to become a myth buster yourself.
David R. Stukus is an associate professor of pediatrics, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus OH.
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