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Say you're having muscle twitches and you enter this symptom into a general Web search. One of the first results that comes up might be ALS, which is a serious degenerative disease that affects nerve cells in the brain and the spinal cord. Based on the results generated by the search engine, your anxiety causes you t­o focus on researching ALS, derailing you from finding information about a more probable and less harmful cause, such as muscle strain.

­In 2008, a comprehensive study on cyberchondria and search engines was completed by Microsoft researchers Ryen White and Eric Horvitz. White and Horvitz concluded that when a Web search is used to diagnose a symptom, it has the potential to increase the anxieties of users who don't have proper medical training or education. They used the term escalation to describe this increase in anxiety. They also found that search engine results could lead to unnecessary doctor visits, resulting in a waste of time and money.



People tend to focus on the first couple of results rather than looking through all of their options -- or considering that, unlike their physician, Dr. Google doesn't factor in important things like age, health background and family history to the diagnosis.

In one aspect of the study, the researchers surveyed 500 Microsoft employees about their experiences in searching for health-related information on the Web. Nine out of 10 said that a Web search for basic medical information had led to researching a more serious condition. This was a surprising discovery, given that none of the participants described themselves as having excessive health concerns.

Another important finding in this study was that many of the participants seemed to think that search engines ranked the results of their searches according to the likelihood of having a particular disease. In actuality, search engines use mathematical algorithms that rank pages and turn up results based on factors such as how many times a keyword is mentioned, how many clicks a page receives and how many links there are on a page. This creates a situation where worried users click on a page containing information about a rare illness which in turn drives the page rank up, increasing the likelihood that another worried user will come across that page as well.

­White and Horvitz concluded that search engine architects have a responsibility to improve search and navigation procedures to ensure that results related to health inquiries are less anxiety inducing. They acknowledge that this presents "algorithmic challenges" and are pursuing the creation of classifiers that will help indicate when someone is attempting to use a search engine to diagnose a symptom.

In the next section, we'll talk about how taking Internet research to your doctor could affect your doctor-patient relationship.