[HN Gopher] What would a "good" WebMD look like?
___________________________________________________________________
What would a "good" WebMD look like?
Author : tomjcleveland
Score : 249 points
Date : 2022-08-30 13:03 UTC (9 hours ago)
(HTM) web link (blog.tjcx.me)
(TXT) w3m dump (blog.tjcx.me)
| rorykirchner wrote:
| Uptodate.
| jvmx wrote:
| This is 100% the correct answer - it's literally what actual
| doctors use, even while you're sitting in their office with
| them as they diagnose you. It's subscription only though.
| cm2012 wrote:
| How does the article and comment section not have one mention of
| liability?
|
| No one gives clear medical descriptions without 10 miles of
| caveats that water the information down completely. This is
| because no one wants to be sued for bad medical advice.
| [deleted]
| oneplane wrote:
| If only there was a profession where knowledge, experience and
| continuous development are used to provide advice and care for
| individuals who may not have specialised in that same area of
| expertise. </s>
| BurningFrog wrote:
| I assume medical websites are somehow kept vague in order to
| steer us to pay these highly regulated professionals a fee for
| a visit.
| bshep wrote:
| I'd say its more likely that they are vague because of
| regulations and liability.
|
| IE you cant/shouldn't give blanket medical advice and if you
| do you may be liable if someone has a bad outcome from the
| advice.
| BurningFrog wrote:
| That's my point!
|
| Regulations have been set up so you have to pay an AMA
| member to get any information that might be labeled
| "medical advice".
| lotsofpulp wrote:
| There is tons of medical advice. Wikipedia, cdc,
| health.gov, mayoclinic, webmd, Reddit forums, hacker
| news, etc.
|
| You can even get fake diagnosis and fake healthcare from
| chiropractors who are allowed to advertise themselves as
| doctors, and fake medicine from naturopaths or whatever
| who are also allowed to call themselves doctor.
|
| I am using fake to mean unsupported by evidence in the
| form of sufficiently blind trials and whatever else is
| needed to qualify as scientifically sound (not the same
| as FDA approved).
| mbreese wrote:
| I'd assume that they are kept vague so that users keep
| browsing the website and never quite get an answer. WebMD
| doesn't benefit if you actually make it to a doctor to look
| at that sketchy mole.
| oneplane wrote:
| I suppose there are lots of possibilities, but regardless of
| steering, fees and visits, a non-expert is unlikely to be
| able to self-diagnose, read a bit of text, and come up with a
| treatment plan.
|
| The problem isn't information availability, it's experience
| and interpretation which is not something you can do on an
| individual basis 'on the side', hence the expertise
| requirement. If the subject matter at hand was as simple to
| deal with as "see X, apply Y, get result Z", then that would
| be great. But as this is not an exact science, such a method
| does not truly exist, and therefore cannot be made effective
| in a listicle on a website or other medium.
| goethes_kind wrote:
| They have already been experimenting with expert knowledge
| systems in hospitals for decades. I am not sure what the
| result of that is but I rarely ever hear of them anymore.
|
| ref: https://en.wikipedia.org/wiki/Expert_system
| MR4D wrote:
| I work in Finance in the US, and I think our industry has a good
| model to build on. The SEC requires a decent amount of
| information for all sorts of investments and financial entities
| to publish at various times - everything from IPOs to management
| changes.
|
| I'm not sure if the FDA/CDC/NIH/etc has anything like this, but
| they should probably start requiring it and/or providing it.
|
| I think this would go a long way to solving this problem.
| faangiq wrote:
| A massive improvement would be listing probabilities of various
| symptoms. Typically you go to WebMD/similar, look something up,
| and it includes every possible symptom. This creates low signal
| to noise and makes it difficult to diagnose and understand risks.
| resoluteteeth wrote:
| WebMD is "awful" because a list of every medical condition with
| every possible treatment and every possible symptom is totally
| useless to normal people. When people visit WebMD what they
| really want is actual, personal medical advice.
|
| The solution isn't throwing technology at it to do "automated
| evidence synthesis," it's making it easier and more affordable
| for people to talk to get a consultation with an actual medical
| professional.
| mikenew wrote:
| Examine.com is the closest analogue to what this site is trying
| to do, and as far as I know, it works. It takes a while, but if
| people develop trust in a product or website they value that
| deeply, and are even willing to throw money at it. I don't even
| consider trying to google a supplement; I'll just go to examine
| and look at the body of evidence, recommended dosages, etc. I've
| paid for Examine and I would pay for this.
|
| Here's my point of feedback / wishlist item / thing I think is
| missing from the world. Examine is focused on supplements, which
| I don't actually care that much about. If my question is "How do
| I lower my fasting blood glucose", I don't want a list of what
| _supplements_ help with that, I want a list of _everything_ that
| helps with that. If daily cardio is 100X as effective as green
| tea catechins then IDGAF about green tea. Examine broadened a
| bit, but it 's still very supplement focused, which can give the
| false impression that some supplement is the best way to approach
| some condition.
|
| Going by the long covid example, it sounds like this glacierMD
| takes the broader focus of "here's all the things", which I
| absolutely love. And there could be a lot of value in that alone.
| But what I really feel is missing from the world is a
| comprehensive, _salutogenic_ look at health. Yes I want to know
| what the best treatments are for long covid. But what I also
| really want to know is what is the rank ordered list of things I
| can do to develop and maintain a strong immune system. Or how do
| I lower my resting heart rate. What even is the optimal fasting
| blood glucose for that matter? Any searching you do will just
| tell you "above 100 mg/dL is prediabetic, 99 and below you're
| perfectly healthy".
|
| Anyway, I love the demo. The author is correct that it is missing
| from the world. And I 100% think people would pay for it once it
| grows enough. I do just hope that it isn't purely build around a
| pathogenic way of thinking, like just about everything else in
| the medical world seems to be.
| bradhilton wrote:
| Thanks for sharing examine.com, looks interesting!
| AhmedF wrote:
| > Here's my point of feedback / wishlist item / thing I think
| is missing from the world. Examine is focused on supplement
|
| That's exactly what we're doing!
|
| We released version 2 of Examine less than two weeks ago.
| Here's a page on how to use: https://examine.com/how-to-use/
|
| It's still early, but the entire goal is to break down research
| on conditions and goals, and where they connect, relate them to
| interventions.
|
| Any questions, happy to answer them.
| FounderBurr wrote:
| A much better WebMD would like like Wikipedia.
|
| Hint: it's Wikipedia.
| Workaccount2 wrote:
| It's annoying that google has been forcefully pushing down
| wikipedia at least for medically related things. I don't want
| to have to go to the second page to get an article that isn't
| scared to use a word longer than 6 letters.
| davidrupp wrote:
| If I want information on medically related things, Wikipedia
| is my go-to. I skip Google (actually, DuckDuckGo) altogether
| and just start my search on the Wikipedia home page.
| boringg wrote:
| WebMD is for the general public (GP) and useless on anything you
| need in depth - helpful for broad inquiry. UpToDate which
| practitioners use is amazing but too much information for the
| general public.
|
| It's part of what I mentioned in another comment which is that
| the internet is to general and vague in its information (and
| generally low-mid quality) while private information is,
| sometimes, of higher quality. It leads people who want to learn
| more about things in a bind where they are limited by the
| accessibility to good quality information.
|
| Also you don't want the GP to have access to uptodate because
| they would self diagnose in so many of the wrong ways and
| wouldn't understand everything.
| skybrian wrote:
| Looks like UpToDate is $60 a month, or you can subscribe for a
| week for $20.
| thomasfedb wrote:
| They have patient/caregiver subscriptions. I'm not sure if
| it's the same set of articles that doctors get access to. The
| ones I use are definitely not written for the layperson,
| though they do have a whole series of articles written for
| laypersons "The Basics" and "More Than The Basics" which are
| designed to be handed out by doctors.
| skybrian wrote:
| Those prices are for the patient subscription. $20 for
| temporary access doesn't seem too bad for medical
| information if you need it, but most people aren't going to
| pay it without trying it out first. Particularly when free
| info is available.
|
| https://store.uptodate.com/ccrz__ProductDetails?viewState=D
| e...
| captainbland wrote:
| GP is quite a confusing initialism to use here as GP often
| means "general practitioner", which is like a family
| doctor/primary care physician in much of the anglosphere
| outside of the US.
| myself248 wrote:
| Ugh, and "family doctor" drives me nuts, I'm not a family,
| there's just one of me, I just want a general practitioner.
| intothemild wrote:
| I have a story for all of you on this topic, strap yourselves in.
|
| We had the solve for this issue, and we had it back in 2013.
|
| I remember interviewing for a brand new startup as the first
| employee, the idea was that you had an app/website and got the
| doctor to add what they told you into this app. I remember
| sitting there and saying during the interview, something like
| "That adds stress onto the doctors who are already stressed, you
| should be giving relief to them, perhaps what we need is
| something better than google/WebMD so people might not need to
| come in IF they find their anwser".
|
| So that was what we decided to do, to make a App/Website to give
| anwsers better than Google/WebMD, verified by doctors on our
| board.
|
| We called it Your.MD.
|
| It was a symptom checker, it took search queries like google, and
| ran NLP against that, then asked follow up questions based off
| the query... It worked really really well.
|
| Then our Chairman punched our first CEO, the CEO left, and we got
| a second CEO in, he got a couple board seats, and the writing was
| on the wall.
|
| He brought in some guy from Talking Tom... remember that talking
| cat app? The new CEO and this guy decided to change the working
| symptom checker and turn it into a chatbot.... we protested about
| as much as we could as founding members.. but it fell on deaf
| ears..
|
| We were forced to destroy something that worked perfectly for the
| abomination that became what Your.MD was...
|
| The CEO fired us all... well he tried, but labor laws are amazing
| here in Norway, so I got a nice exit.
|
| The CEO installed himself as the "Founder" on everything
| including the Wikipedia page.. I think the company has some new
| name now.. dunno don't care.
|
| But yeah.. We had the solve for this, the problem was always that
| people google things, and google isn't great (read terrible) at
| this problem, and WebMD suuuucks because .. well this article
| says it better than I could.
| [deleted]
| isaacfrond wrote:
| What are they talking about. I'm perfectly happy with WebMD. Well
| written and accessible articles. Often the first hit in a google
| search, and rightly so.
|
| Could the OP possibly be projecting a bit here?
| wizofaus wrote:
| Wikipedia exists despite all the barriers to doing so, yet
| remains generally an accurate and useful source of information
| that Google ranks highly. A version that's more tailored to
| health advice doesn't seem so hard to imagine... yet a quick
| Google brings up no evidence that anyone's tried to create one
| yet. Why is that?
| mananaysiempre wrote:
| > Why can't I see the percent of people who experience a
| particular side effect?
|
| Is that a US thing? Because I'm looking at the small-print paper
| thingie that came ( _has_ to come) with a moderately dramatic
| prescription drug, and it has:
|
| "Side effects:
|
| very frequent ( >= 10%): ...
|
| frequent ( >= 1% and < 10%): ...
|
| infrequent ( >= 0.1% and < 1%): ...
|
| rare ( >= 0.01% and < 0.1%): ...
|
| very rare ( < 0.01%): ...
|
| The following side effects were observed after this drug was
| released to market. The incidence rate is considered to be
| unknown, as it cannot be estimated from the available data.
|
| ..."
|
| (This seems especially weird because I expect most of the data to
| have come from FDA submissions.)
| pwinnski wrote:
| This information is absolutely available, just not on WebMD!
| jaydepun wrote:
| I, and my advisor's lab[1] work in this area. I'm going to focus
| on the technical aspects of evidence synthesis, as opposed to the
| business aspects.
|
| There's a difference between symptoms, diagnosis, treatment
| options, evidence for those, and the audiences for whom these are
| written. WebMD and friends target a broader market, scientific
| studies target...scientists and doctors.
|
| I think the hard parts of building a better WebMD (along the
| article's lines) are: - screening articles for
| relevance. This is more than mere search or finding potentially
| relevant articles, but also making a decision to include them
| - extracting _structured_ information from the articles.
| Frequently we talk about Populations/Problems, Interventions,
| Comparators (interventions), and (medical) Outcomes, collectively
| PICOs. Extraction of each component is easy. Assembling them is
| surprisingly hard. Finding equivalencies between them within
| documents is surprisingly hard. Finding facets or different parts
| of a treatment (how do you handle combined treatments for a
| single study? how about when some studies use them and some
| don't?) - establishing equivalencies for your evidence
| synthesis between documents is even harder: do you care about
| dosage? combination with other treatments? what happens when a
| slightly different formulation of a treatment gets used, or a
| treatment is administered poorly? I don't know of anyone within
| scholarly document processing community working on analysis of
| medical methods (possibly ignorance on my part!).
|
| It would be nice if trial preregistration had all these details,
| but not all trials are preregistered, nor all outcomes published,
| the aim of the trial can shift, and there's a large pile of
| literature where this information isn't available.
|
| I think real time updates are the smallest problem among these:
| solving extraction (including the big structured objects) mostly
| solves this; the statistics of a meta-analysis are not
| complicated. To be clear, this is still an issue. I have a
| figure[2] highlighting the lag.
|
| Presenting the evidence in a digestible, meaningful way, seems
| like a hard HCI problem to do right, and easy to do poorly.
| Merely giving PICOs (structured!) and findings is easy and a bad
| UX for the non-technical, a narrative summary is interesting to
| provide and hard to do well, and a subgroup analysis can suffer
| problems from differing group sizes and effectiveness findings
| (tailoring is tricky).
|
| There are several organizations[3] working on these sorts of
| problems.
|
| [1] https://www.byronwallace.com/
|
| [2] https://www.semanticscholar.org/paper/MS%CB%862%3A-Multi-
| Doc...
|
| [3] https://community.cochrane.org/organizational-
| info/people/st...
| psim1 wrote:
| Unpopular opinion(?): online medical information should be
| inaccessible to the common person. It should be journal papers
| full of jargon, behind paywalls, and otherwise restricted. Laymen
| can't handle medical information. They use it to self-diagnose,
| or worse, diagnose others. They use it to question doctors
| because the doctor's advice doesn't match their Google-fu.
| Ridiculous sites like WebMD make it worse. WebMD will tell you
| that you have cancer no matter what you search. I sympathize with
| those in the health care system who are too busy, and those who
| are waiting for care. But giving the public a bunch of
| misinformation with which to shoot their feet seems like the
| wrong approach. (Anecdotal: I live with a Google warrior who
| distrusts all doctors because they think their understanding of
| medicine is superior.)
| thomasfedb wrote:
| As a doctor I have a brief moment of sympathy with this idea -
| I've seen far too many patients badly mislead by "Dr Google" -
| but ultimately I think it is important to provide clear,
| helpful, and well-targeted health information online for the
| layperson.
|
| Of course there's no incentive for WebMD to do this, they just
| want clicks on ads. But in Australia our governments publish a
| fair bit of helpful health information online, and I do often
| print some of it out for my patients when they go home.
| Sometimes it's not enough in itself, but it's great for a
| "you've got X, here's some info about it" situation.
|
| UpToDate is the medical-grade, actually helpful, for
| professionals only, quite expensive "Wikipedia for Medicine", I
| use it every day, among a few other resources. But it's not
| something you can just open up and use - it's very much
| designed to be used by people with the right background
| knowledge - you need to know how to find what you want, and you
| need to know how to use what you find.
| AshamedCaptain wrote:
| Just watch what happens on every HN article which is about
| anything possibly medical. One day you have one conclusion, the
| next day you have the completely opposite conclusion, and the
| only thing that's common is that the comment section of _both
| articles_ is filled with people who will readily claim "this
| worked for me".
| AtlasBarfed wrote:
| A lot like wikipedia.
|
| Which begs the question: why is wikipedia the best source of
| medical information online?
|
| Doctors, research hospitals, and the like should be required to
| maintain best of breed public health information.
|
| Public universities are funded to the level of A TRILLION DOLLARS
| A YEAR.
|
| Think about that.
| Kalanos wrote:
| graph database backend for textmining/associations
| xivzgrev wrote:
| I don't have to imagine - Healthline.
|
| it's clearly an SEO game that's cropped up recently, but it's
| executed in a sustainable way. The articles I stumble on are
| actually helpful.
|
| For example, there was a recent HN article on research supporting
| the practice of grounding. So I googled it, and found a
| Healthline article:
| https://www.healthline.com/health/grounding#benefits
|
| It clearly explained what it was, why it may have benefits, what
| a few experts say, risks, etc.
|
| There are ads but barely (for now) - on a recent article on
| mobile, it's one small banner, and then one in-line ad that
| doesn't even look like one. It's not a barely-readable dumpster
| fire like WedMD.
|
| Of course, all roads lead to Rome, so at some point Healthline
| may look like a dumpster fire as well, so enjoy it while we can!
| fudgefactorfive wrote:
| I worked for a company that tried to do exactly what this article
| is proposing, I was responsible for parsing the data from
| publications into exactly this sort of table.
|
| The primary reason is that it is _very_ hard to come up with a
| schema that even 5% of papers would adhere to. The vast majority
| of this knowledge is phrased as natural language.
|
| There are databases that track compounds and the publications
| related to them, but those papers again are natural language and
| cannot be readily converted to tabular data. Our first basic
| approach involved POS tagging and then trying to associate proper
| nouns with numeric values. Again the issue became how do you
| interpret a sentence like "may lead to sudden death" as a
| symptom? Something like "may lead to symptom X in Y% of
| respondents" is a nightmare to consistently parse without heavy
| ML running over huge datasets of just text.
|
| In the end we wound up having to shut down concluding that until
| papers are released with not only arbitrary XML tables/results we
| were not equipped to handle the task. And even worse, what if our
| models didn't interpret things correctly and a consumer got
| {symptom:"sudden death", chance:0%} and insisted on that compound
| for their indication only to later realize the paper stated "in
| lab setting 0% of animals didn't experience sudden death after
| being administered X after diabetes diagnosis". Paying a hundred
| students to work around the clock couldn't get the volume
| processed accurately for months, let alone getting a second army
| of validators to confirm each entry.
| fudgefactorfive wrote:
| In the end the only functional parts that worked algorithmicly
| are exactly those featured in the GlacierMD demo. What trials
| are running related to this indication, what compounds are
| being tested for the indication and what other indications are
| related.
|
| That's the easy part, it's effectively a word association game,
| TF-IDF did this job admirably, scoring proper nouns by their
| uniqueness and then associating them with one another and
| searching for publications with similar words as the requested
| indication. Effectively a medical word cloud for each
| indication and compound. Parsing them into symptoms is the
| first nightmare, the second is numeric values associated with
| those symptoms and paper results.
|
| There is a very good reason the demo only has one indication
| and a handful of symptoms, it's being done manually and then at
| best showing publications related to the words encountered.
|
| It's not a matter of cost, although the author is all but
| doomed if they want to cover more than a few indications, it's
| a matter of not forcing publicly funded health publications to
| use an electronically parseable Format despite the simplicity
| of them being able to parse their paper by definition.
|
| See the standards XKCD, the issue is getting many different
| academics and departments to agree on a set of schema to
| include alongside their publications. PubMed at least tries
| with their XML dumps but even those are inconsistent at best
| and non-syntactically interpretable at worst. The Japanese
| compound tracker is great to learn about a specific compound
| and their indications but stops there.
| intrasight wrote:
| Just make it a condition of funding and they'll probably get
| on board with machine-readable standards. But the first thing
| the feds will have to do is fund and do a big competition to
| define those standards.
| lupire wrote:
| I don't get the WebMD hate. It's leagues ahead of Healthline.
|
| WebMD is full of doctors. The gov and AMA should be sanctioning
| doctors for abuse of license if the content is bad.
| joegahona wrote:
| The atrocious UX isn't helping. Paginated articles, popups,
| autoplay ads within the well of content... these tactics put
| you in a bad neighborhood with bot-farm-type sites, no matter
| how many doctors are involved in the actual content creation.
| ksdale wrote:
| I don't really get it either. My biggest complaint is that they
| tell you to go see the doctor for everything and 9/10 of the
| time the doctor will tell you to go home and take ibuprofen and
| see what happens.
|
| I think it's generally possible to tell, based on what's
| provided on WebMD, what symptoms would cause a doctor to
| recommend an immediate trip to the ER or surgery or
| pharmaceuticals. It's required learning more than I would
| otherwise know about how my organs function, but I also don't
| think I know like... an exceptional amount about the human
| body.
| Tao3300 wrote:
| > brief feelings similar to electric shock
|
| To be fair, that's a side effect of stopping the medication
| suddenly. They ought to have worded that better. Happens when I
| forget to order more of my own preferred SSRI. As far as electric
| shocks go, it's definitely on the milder end of the spectrum (I
| suspect most of the commentariat here have some experience with
| such things) -- more unusual than painful. Sometimes we call them
| "brain zaps", which would probably sound even worse on WebMD.
| guerrilla wrote:
| Someone already mentioned the NHS website, but also the Mayo
| Clinic's is great [2]. We have a great one run by the Swedish
| state too [3]. I think the article is wrong that "we accept" them
| though, they've just SEO spammed themselves over anything that
| actually _is_ useful. It 's not like we vote on search results
| (yet.) NHS, Mayo Clinic or others that must exist would be top if
| these assholes didn't scam their way in.
|
| 1. https://www.nhs.uk/conditions/
|
| 2. https://www.mayoclinic.org/diseases-conditions
|
| 3. https://www.1177.se
| aeternum wrote:
| A good WebMD would be probability based.
|
| Rather than list all the possibilities, it would calculate in
| real-time the probability of each diagnosis and show how that
| probability changes as you add/remove symptoms or possibly even
| test results.
|
| Even doctors would benefit from this as Bayesian inference is
| hard and even healthcare professionals generally put too much
| weight on a single positive test result.
| jmyeet wrote:
| I'd go further than this and ask why pretty much _everything_ is
| awful.
|
| This issue comes up a lot when people talk about Google
| "stealing" content or favoring their own properties. I think
| there's some merit to this argument and it's worth monitoring but
| the other side is that Google ends up embedding things in search
| results because the sites for those things are both trivial and
| awful.
|
| Example: go Google "mortgage calculator". You will get exactly
| what you want embedded at the top. Put in the principal, loan
| length and interest rate and it'll tell you waht the payment is.
|
| Now go click on any of the links on the first page. You will get
| hammered by ads. You will get pages that split their calculators
| over multiple pages to get more ad impressions. The whole
| experience is just plain awful.
|
| So it's no surprise to me that Google just embedded their own for
| what is really a trivial function. As a user I much prefer that
| and would hate to see any government action forbid such a thing.
|
| So, WebMD. WebMD is an example of all the bad incentives that
| make those mortgage calculators terrible. It's all about
| maximizing ad impressions.
|
| Now I absolutely hate Google AMP but I also understand the
| motivation for it (even if I vehemently disagree with the
| solution). So many sites are just plain awful and slow.
|
| Exceptions to the "slow and awful" principle are rare but exist.
| Stack Overflow is a prime example.
| afryer wrote:
| tangential resources for nutritional/dietary supplements:
|
| Consumer focus: https://examine.com/ Professional focus:
| https://naturalmedicines.therapeuticresearch.com/
|
| Both sites maintain nice monographs that curate evidence and
| provide easy to interpret effectiveness scores.
|
| Natural Medicines database goes even further and maintains a
| database for commercial products.
|
| I find both incredibly useful for evaluating ingredients and
| their structure/function effects
| entwife wrote:
| Merck Manuals, also known as MSD Manuals, can be accessed here:
| https://www.msdmanuals.com/
|
| This is a fact-based, peer-reviewed, classic manual of Western
| medicine.
| entwife wrote:
| Also, Merck manual consumer version is free to access online.
| It should be a first stop for medical information.
| gnz11 wrote:
| Goes without saying, but "Don't google your symptoms." has been
| an unwritten law of the Internet since Google first became the
| dominant search engine. WebMD and its knockoffs have been hot
| garbage for quite some time now.
| chasd00 wrote:
| yeah they all pander to hypochondriacs and people who suffer
| from anxiety. Oh and they all absolutely prey on new parents.
| Never ever resort to the internet as a new parent, just call
| your pediatrician. As a father of two, i can't stress the
| previous sentence enough.
| Cd00d wrote:
| There's a standup bit, I don't remember who the comic is, where
| he says, "my elbow was kinda sore after I was playing a bunch
| of tennis. I looked it up on the internet and oh no! It turns
| out I have elbow cancer!"
| savanaly wrote:
| Extremely relevant Slate Star Codex/Astral Codex Ten piece:
| https://astralcodexten.substack.com/p/webmd-and-the-tragedy-...
| NavinF wrote:
| Wow that article does a much better job explaining the problem
| than the submission does.
| csours wrote:
| Why do scientific studies have such poor user experience?
|
| Partly because they're written to pass peer review, not to inform
| practitioners or the public.
|
| I want to know one main thing before I read your study - Why
| should I believe your study? That is: what is the sample size,
| did you pre-register methods, who funded the study, what type of
| study is it, etc.
|
| Studies are written for paper publications, but that hasn't been
| the main distribution method for years.
| AshamedCaptain wrote:
| > Why do scientific studies have such poor user experience?
|
| > Partly because they're written to pass peer review, not to
| inform practitioners or the public.
|
| Neither you nor the public nor practicioners should be reading
| "scientific studies". Please remember that the actual value of
| any one scientific study is practically _zero_. They are only
| useful to big companies and/or national scientific bodies which
| actually may have the resources to even try to reproduce them.
| robbiep wrote:
| This is a very pertinent point, and i speak from experience
| when I say that if less laymen (and women) tried to read
| scientific papers on their conditions, real or imagined, the
| job of a doctor would be easier
| hrdwdmrbl wrote:
| I think it would need to ask more questions. Interrogate the
| question asker more, like a doctor would
| JackFr wrote:
| Plot twist (spoiler alert?) - in the last section the author
| _reveals he 's got prototype WebMD replacement!_
| mtts wrote:
| This problem is pretty solved in the Netherlands.
| https://www.thuisarts.nl is set up by the Dutch federation of
| General Practitioners and provides good, non-sensationalist
| information that is guaranteed to be vetted by the likes of the
| very doctor you'd normally visit (or by the people who train
| them, I presume - pretty sure if you look up a GP handbook you'll
| find almost the same text as on that site, only with more detail
| and with more complicated language).
| jonatron wrote:
| To take the example of Aspirin and Essential Oils, NHS has no ads
| and has information on Aspirin
| https://www.nhs.uk/medicines/aspirin-for-pain-relief/ , but
| doesn't have information on Essential Oils. It probably doesn't
| list supporting evidence because most people don't want to read
| it and wouldn't understand it.
| readthenotes1 wrote:
| Stopped paying attention at "a 47% increase in all published
| health knowledge."
|
| Not hardly. Maybe a X% decrease (if Science is advancing), but
| the amount of garbage, not knowledge, is overwhelming. (Maybe
| biased memory, but I think every PubMed article that has come up
| here has been ripped to shreds)
| VancouverMan wrote:
| I wish I could have had a 35% to 40% satisfaction rate with the
| various actual medical professionals I've dealt with in-person
| over the years.
|
| I'd say that fewer than one in five such encounters has left me
| feeling like I got good advice, and a favourable outcome. Even
| just a 25% satisfaction rate would be a notable improvement for
| me.
| [deleted]
| joegahona wrote:
| > And every SEO expert knows that long articles rank higher than
| short ones, so now "treating covid headache" takes you to a
| thousand-word article when really I just want short summaries of
| the top three treatments.
|
| John Mueller from Google has been saying the opposite for years:
| https://www.reddit.com/r/bigseo/comments/clg1hn/how_to_find_...
| debacle wrote:
| Compare WebMD to examine.com
|
| The difference? You pay for examine.com.
|
| The outcome? The highest quality site for information on
| supplements, vitamins, etc available on the Internet.
|
| WebMD just needs to be good enough for Google.
| jandrese wrote:
| > The outcome? The highest quality site for information on
| supplements, vitamins, etc available on the Internet.
|
| This just sounds like snake oil advertising but with the
| privilege of paying to see it.
| Workaccount2 wrote:
| There are in fact a lot of supplements that are effective.
| Magnesium for heart issues, Calcium for bone density,
| creatine for weight lifting.
|
| There are also a lot of supplements that do nothing. The
| "snake oil".
|
| Examine exists so that you can use studies to determine which
| is which.
| daniel-cussen wrote:
| Snake oil per se is an analogue of fish oil, effective.
| It's use as a pejorative term dates to false advertising of
| petroleum as actual snake oil in the 19th century. The
| biggest problem was it wasn't well processed at the time,
| and was not really edible like petroleum derivatives can
| now be made to be.
|
| And I generally don't take it at face value, I accept it as
| a glitch in English.
| Semaphor wrote:
| > The difference? You pay for examine.com.
|
| Shouldn't it be "You can pay"? Because I get all the
| information I need on Examine for free (and checking their paid
| offering, they seem to have changed from "professionals" to
| "laypeople" as their target audience, with everything being a
| guide and behind a clearer interface).
| throwaway12372 wrote:
| not owned by big pharma
| jefftk wrote:
| Doctors generally use a service like UpToDate, which I understand
| is pretty good.
|
| Issues with providing the same quality of service to consumers
| include:
|
| * Doctors are willing to pay a lot (ex: UpToDate is ~$500/y) and
| you might not be able to keep such high fees for doctors if you
| also offered a great consumer-focused option.
|
| * Consumers have a wide range of experience levels, where it's
| going to be hard to make a page that satisfies both people who
| know very little and have minimal medical background and others
| who are looking seriously into their condition.
|
| * Liability is very different when you're writing directly for
| consumers.
| robbiep wrote:
| It's a different service because it's generally quite
| technical, and also it has a fairly large editorial team
| constantly reviewing and updating the content. The 'simple
| English' UpToDate is Wikipedia or the NHS website
| lbriner wrote:
| The article does smell a bit like "tech can fix everything" when
| the problem with WebMD and others is not that they are full of
| ads or SEO optimisation.
|
| The simple truth is that medical care is more complex than just
| "headache = paracetomol". Some drugs don't work on some people,
| others might be more effective but more expensive. Some are not
| compatible with e.g. pregnancy or other drugs you might be taken.
|
| As for symptom identification, many of us have seen "House MD"
| and should know that pain + swelling could be any of about 1000
| conditions. This is why we still need Doctors.
|
| Sure, us "clever" types might be able to self-diagnose 90% of the
| time but we need the doctor who can see the pale skin, the yellow
| eyes, who asks about recent changes in lifestyle or health,
| things that we could easily miss.
|
| Now if you could encapsulate all of that on WebMD....
| firasd wrote:
| An interesting example: a few months ago I dropped something on
| my toenail and it turned black.
|
| Wading through WebMD etc (which is where google was sending me)
| was not helpful, especially in between the popups and autoplay
| videos
|
| I finally restricted my search to wikipedia and quickly found out
| that it's called 'subungual hematoma' and "usually self-
| resolving", which is what I needed to know.
|
| Recently I tried this query on GPT-3 and it worked well too:
|
| _Prompt: Something fell on my nail and it turned black
|
| GPT: Possible causes for a black nail include: trauma to the
| nail, a melanoma, or a subungual hematoma (a collection of blood
| under the nail). If the black nail is accompanied by pain,
| swelling, or redness, seek medical attention. If the black nail
| is not painful and has no other symptoms, it is likely a
| subungual hematoma and will eventually grow out with the nail._
| InCityDreams wrote:
| >especially in between the popups and autoplay videos
|
| I hop ur toes get gooder.
| AhmedF wrote:
| To summarize: a good version of WebMD would have: * structured,
| quantitative information * real-time updates * summaries of
| supporting evidence
|
| I'm obviously very biased, but that is _exactly_ what we 're
| building with www.Examine.com
| matheusmoreira wrote:
| It would look like an open access UpToDate.
| mrpf1ster wrote:
| I see a lot of people talking about WebMD but not much about the
| prototype the author made to fix it: https://www.glaciermd.com/
|
| I really love the website, it's simple, fast, and very useable
| from a mobile context!
| lastofthemojito wrote:
| I always figured it was due to liability. WebMD wants the
| monetizable traffic but not the liability of ya know, providing
| health care. So they profit off of the user's duress and just
| recommend they see a health care professional anyhow.
| criddell wrote:
| Of all the places Google could send people, WebMD isn't the
| worst.
|
| Amazon reviews, for example, have lots of terrible medical
| advice in them. Go to an apricot kernel page and look at the
| product reviews. I just did and the first review says:
|
| > I have cancer, have not treated it yet but I've started with
| these. Easy to use, clean fresh product
|
| A few reviews down:
|
| > THE BITTER THE BETTER! And they really are! People need to be
| more educated about the benefits of the BITTER apricot kernels!
| THEY MUST BE BITTER in order to kill and prevent the cancerous
| cells in your body! All you need is 2 kernels a day!
| aabajian wrote:
| I'm an interventional radiology resident near the end of my
| training. I think Google needs to index the clinician-facing side
| of UpToDate. It can't right now because it's paywalled.
|
| For those unfamiliar with UpToDate, it is considered the #1
| online reference for evidence-based medicine. What they do is
| write articles that summarize research articles from each domain.
| They have much more content than this, but it's the expert-
| summaries that make it a "killer app" for clinicians. We simply
| don't have time to read all the latest research.
|
| Also, UpToDate is the #1 most expensive subscription that most
| academic universities pay for (e.g. in terms of journal
| subscriptions).
| thenerdhead wrote:
| WebMD and hypotheticals like this blog reminds me of a quote from
| Hamlet:
|
| "There is nothing either good or bad, but thinking makes it so"
|
| I do not think you can make a good nor bad version of WebMD. But
| what it does today is makes you think about things that you're
| better off not thinking about.
|
| Health is subjective to start with. It is more qualitative than
| it is quantitative at the individual level. The exact problem of
| WebMD is that it uses the latter to help inform the former.
|
| I have got way more answers from old books than I can find
| online. Especially those on back pain, chronic illness, and even
| regular headaches. Much of this information is not new and even
| goes back to the idea that "thinking makes it so".
|
| The real question in my head is whether WebMD does more harm than
| it does good or vice versa. It's pointless to think about because
| it is what it is.
| kwertyoowiyop wrote:
| Sure this article is spammy self-promotion, but their prototype
| is exciting. I'd use it. It's frustrating to go to a drugstore
| and see medicines for a cough, let's say, each with a different
| active ingredient, and be unable to find concrete information
| comparing the effectiveness of each ingredient.
|
| And wow, the WebMD article they mentioned on essential oils was
| terrible. It really lowers my opinion of WebMD. At this point I
| get more helpful information about medicines from Reddit.
| thomasfedb wrote:
| Isn't that what the pharmacist is for? Pharmacies sell some
| dumb stuff, but if you actually ask for advice from the person
| with a license they'd like to keep, you should get some
| straight talk I'd think.
| kwertyoowiyop wrote:
| As an experiment, I will try that next time I'm buying an OTC
| remedy. It sounds like we share an opinion: Given that
| drugstores unironically place homeopathic nostrums and
| essential oils right next to actual medicines, I treat them
| as hostile environments out to scam unwary consumers rather
| than honest sources of information. But, as I said, I will
| give that a fair test.
| chasd00 wrote:
| the pharmacist at a chain store has zero control of what's
| out there on the shelf. Just talk to them and see what they
| say. I suspect they'll give you an active ingredient
| suggestion first and then a handful of options of stuff
| they have on the shelf with that active ingredient.
| 1auralynn wrote:
| I'd say over 50% of the time at my pharmacy, this would
| involve waiting in line for 20 min and talking to a harried,
| overworked pharmacist who may or may not be up on the latest
| research... not a great UX.
| mikkergp wrote:
| I just read the essential oils article and it doesn't seem that
| bad? They recommend lavender for sleep, aromatherapy for stress
| reduction and tea tree oils for foot fungus. It's not great,
| but as far as trying to be objective goes, it's not like
| they're arguing it cures cancer. They could, as I think is
| covered more generally provide more data, but while I don't
| think we should swallow "alternative therapies" whole hog, I
| don't think we should be biased against them just because they
| sound woo-ey. The evidence should speak for itself. what was
| your specific beef with the essential oils article(as compared
| to other WebMD articles)
|
| Also interesting he contrasted it with Aspirin, because
| ironically, I don't think pain killers have all that much power
| when studied against placebo.(heart benefits notwithstanding)
|
| For example: https://pubmed.ncbi.nlm.nih.gov/19673707/
| kwertyoowiyop wrote:
| They actually do dance around a claim regarding cancer:
|
| > Many essential oils have antioxidant properties.
| Antioxidants help prevent damage to cells caused by free
| radicals. This damage can lead to serious diseases such as
| cancer.
|
| For comparison, Wikipedia:
|
| > Aromatherapy may be useful to induce relaxation, but there
| is not sufficient evidence that essential oils can
| effectively treat any condition.
| mikkergp wrote:
| Is the wikipedia article actually more accurate though?
|
| https://www.healthline.com/health/tea-tree-oil-for-nail-
| fung...
|
| "Results of a 1994 studyTrusted Source found pure tea tree
| oil was equally as effective as the antifungal clotrimazole
| (Desenex) in treating fungal toenail infections.
| Clotrimazole is available both over the counter (OTC) and
| by prescription."
|
| Reading through the wikipedia article it seems they're
| conflating all use of essential oils and specifically the
| use of essential oils in aromatherapy treatment, which is
| what the linked article is about.
|
| Also fair point on the cancer line but:
|
| https://www.cancer.gov/about-cancer/causes-
| prevention/risk/d...
|
| "In laboratory and animal studies, the presence of
| increased levels of exogenous antioxidants has been shown
| to prevent the types of free radical damage that have been
| associated with cancer development" -- which seems close to
| what they were saying. A bit overstated for something
| published to the public, but technically accurate.
|
| Overall it seems like the dismissal is a bias of the idea
| of essential oils, not necessarily a comprehensive review
| of the literature.
| kwertyoowiyop wrote:
| Honestly I'm WAY out of my lane here. I have no medical
| training and can't even call myself an interested
| amateur. So me trying to argue via random snippets of
| internet text would just waste everyone's time! :-)
|
| The only thing I can really say is, there's a lot of
| medical-related material out there that seems vague and
| hopeful, that I don't think is doing much good for anyone
| but its creators. I'm with you - let's see what the
| research says and what the studies show, while keeping
| the placebo effect in mind. If crabgrass cures cancer,
| I'm down for some grazing.
| jsight wrote:
| Two words: Revenue optimization
|
| Everything free on the web is optimized to maximize the delivery
| of advertisements and referrals at the expense of everything
| else. And Google no longer rewards credible sources vs ad-laden
| garbage.
| ahstilde wrote:
| Disclaimer, I am the founder of Wyndly (YCW21) -- we fix
| allergies for life through telehealth and personalized
| immunotherapy.
|
| WebMD, Healthline, and Verywell Health all monetize off of views.
| They're exceptional SEO operators, and they know how to game
| Google. The trick is to find people who aren't monetizing off of
| just views.
|
| Actually helpful information is coming from services that don't
| monetize off of views, or where the content is written for more
| than just SEO. For example, Anja Health is educating people about
| a novel idea (https://www.tiktok.com/@kathrynanja). At Wyndly, we
| build trust with our content by having my co-founder answer
| common questions (https://www.instagram.com/wyndlyhealth/).
|
| These are experts sharing their niche. In fact, we source the
| questions we answer from our support inbox. So, not only are we
| putting useful information our into the world, we're creating
| resources for our support team. It's a win-win.
|
| Side note: yes, we do play the SEO game somewhat. At the end of
| the day, if we have a successful video, it'd be foolish not to
| resource it for Google and for people:
| https://www.wyndly.com/blogs/learn/what-kind-of-doctor-for-a...
| mindprism wrote:
| Basically just a big banner page that reads "Yep, you probably
| have cancer."
| kurupt213 wrote:
| And AIDS
| victorclf wrote:
| Medscape is what WebMD should be. It targets health professionals
| but it's a great resource for independent learners.
|
| There are great summaries for every disease and treatment written
| by doctors and researchers. Summary includes epidemiology,
| symptoms, causes, prognosis, possible treatments, novel
| treatments, differential diagnoses, etc.
|
| Given that there are bad professionals in every area, it's a
| great resource to evaluate if your doctor's diagnosis and
| suggestions make sense.
|
| Unlike your local doctors, good online resources don't have
| financial incentive to recommend unnecessary drugs or surgeries
| where the risks outweigh the benefits.
| Javantea_ wrote:
| Medscape is owned by WebMD fyi.
| ahwvd37js wrote:
| I gave up on WebMD and its ilk years ago. You get better
| information by just searching for med literature on google
| scholar, and you can read anything with sci-hub. Or ask a doctor
| friend to download a subject page from UpToDate.
| giantg2 wrote:
| I don't see what the big problem is. WebMD, drugs.com, etc are
| generally fine for me when I want some quick basic info. Some of
| the stuff they're complaining about WebMD not having, like
| percentage of different side effects, are available on other
| sites like drugs.com. If I want in-depth info, I'll visit PubMed.
| Sites like NIH, CDC, and FDA can be helpful, but generally not
| any better than WebMD in regards to format, content,
| searchability, or precompiled rankings/lists.
| aantix wrote:
| Five year survival rates listed for local surgeons across the
| procedures they perform. Sortable by number of procedures
| performed, death rates on the table, survival rates.
|
| I don't care how "kind" the physician is, if they listened to my
| concerns.
|
| I want to know their effectiveness.
| FalcorTheDog wrote:
| How useful would that information be? Seems like a good way to
| "punish" surgeons that take more difficult cases.
| aaaddaaaaa1112 wrote:
| InCityDreams wrote:
| Maybe the patients were crap.
| chasd00 wrote:
| the best site would be a single page that says "talk to your
| doctor" vertically and horizontally aligned in a large font.
|
| If you want to read about how not using a certain brand of band-
| aids means your child is destined to become a serial killer then
| research medical information online. For medical information the
| Internet is the last place i go.
| [deleted]
| wyre wrote:
| Not when a large percentage of Americans can't afford a visit
| to their doctor, that disclaimer is only going to be ignored
| and users will look elsewhere.
| daniel-cussen wrote:
| Yeah there's a highly restrictive quota, your affording
| medicine comes at other Americans's expense. Cornered market.
|
| Now if you were to travel to South America or in particular
| to Cuba that would not restrict health care access to other
| Americans. On the contrary. They basically all speak English
| in Chile, accent yeah just deal with it, better than a
| 50-minute wait for a 6-minute appointment meant to last 20
| minutes.
| foolinaround wrote:
| maybe a new wikipedia, where not any tom, dick or harry gets to
| write/edit articles, but one who is acknowledged as a subject
| matter expert?
|
| To start with, in each topic, there is a broad expert, and then
| he creates additional topics, and names experts in this, and so
| on....
| paperpunk wrote:
| I've been involved in an attempt to do this at a smaller scale,
| for a specific discipline: https://maxfacts.uk/ - which aims to
| be a complete resource for patients and professionals in the oral
| and maxillofacial field. Like WebMD, but up-to-date, properly
| researched, and very thorough.
|
| The linked article here talks about having structured, quantitive
| information, but I think this might be an engineer's view on
| medicine. The reality on the ground is much messier. We tried to
| give people enough information on medical practice, explanations
| on the biological/chemical mechanisms, and other resources to
| make their own informed choices about their treatment and care.
| For example, trying to explain the mechanics of taste, and
| texture for eating food so that people can understand what kind
| of adaptations they can make to improve their quality of life. I
| think we probably fall short of that goal sometimes because our
| material is overly technical or scientific but it's a work-in-
| progress.
| warrenm wrote:
| >So to summarize: a good version of WebMD would have
|
| > - structured, quantitative information
|
| > - real-time updates
|
| > - summaries of supporting evidence
|
| >So why hasn't anyone done this yet?
|
| >The short answer: cost.
|
| Money
|
| It's always money
| kurupt213 wrote:
| If I need information I look for the publications linked from the
| NIH website.
|
| I think the problems with health information are that the vast
| majority of the population isn't sophisticated enough to
| understand the physiological and biochemical specifics, and that
| generic info is pretty much worthless.
|
| People should listen to their doctors (who specifically advise
| against running to google for every symptom)
| standardUser wrote:
| Doctors can be wrong (they have been for me multiple times) and
| I feel a certain sense of responsibility for learning about and
| understanding what is going on in my body. Now, if I had a
| panel of doctors at the ready to answer my questions and
| explain things to me in the detail I want, that would be great.
| But that seems unrealistic. So we do need something to bridge
| the gap between the fallible doctor we very occasionally get to
| talk to and our otherwise deep ignorance of our own health and
| bodies.
| hedora wrote:
| Back when I was a kid, my mom had a 1,000 page book that is more
| or less what this article is asking for. I wonder what ever
| happened to that book. (Are there newer editions, for example?)
| 082349872349872 wrote:
| Sounds like the Merck Manual. (see other comments for links)
| jjar wrote:
| A better question might be: Why is the private sector responsible
| for providing accurate health information? As this article shows,
| the incentives for people running medical websites and the people
| reading them are not aligned. I'd say the UK NHS website and
| symptoms/medications pages hit the nail on the head -
| https://www.nhs.uk/conditions/. It has no advertising and
| provides short, easily readable and actionable information on the
| majority of conditions and the correct way to use and take many
| different sorts of medication.
|
| And crucially - if the information present is not sufficient,
| clear and obvious UI elements that direct the next best steps to
| get the help you need, whether that be ringing the non emergency
| helpline or immediately going to A&E. (It's been commented on
| before, but the new UK government sites are very consistently
| structured and open source their design systems https://service-
| manual.nhs.uk/design-system)
| [deleted]
| googlryas wrote:
| A fairly straightforward answer is that the government's goals
| are not necessarily aligned with your own. You, presumably,
| care very much about your own personal health. You also care
| about other people's health, but you really, really care about
| your own health, and probably don't want to die earlier than
| you need to.
|
| The government, on the other hand, doesn't generally care about
| individuals, and is working on a statistical level. A good
| government wants the population overall to be in good health,
| and has a budget within which it must operate. It may make more
| sense for the government to ignore your rare disease if
| detection/treatment is expensive, and that money can be better
| used to save, say, 10 people with a more common disease.
|
| Now, if the government was just providing health information,
| and individuals were on the hook for payment, this disconnect
| wouldn't really exist. But if the government is also providing
| the healthcare services "for free" to individuals, then there
| is an incentive to downplay testing for rare or expensive to
| treat diseases due to the cost/benefit ratio.
| shuntress wrote:
| You are talking about "The Government" as if it is some
| uncontrollable force of nature. Here in reality, we are
| actually self-governing.
|
| Obviously it's messy, complicated, and not as simple as just
| "deciding what to do and doing it".
|
| But it is fair to say that pretty much every rational person
| agrees that we should take care of each other _including_
| anyone with a rare condition.
| adolph wrote:
| > Here in reality, we are actually self-governing.
|
| Given there is more to we than just me, "The Government"
| would refer to mostly other people and specifically other
| people with a particular proclivity toward involving
| themselves in the lives of others, to what effect is in the
| eye of the beholder.
| nickff wrote:
| The terse version of this is to say that the government would
| prefer you die cheaply rather than live at great expense.
| quickthrower2 wrote:
| The government is pulling the lever on the train track
| thats saves 5 but kills another 1.
| jeromegv wrote:
| Is that supposed to be an advertisement for private
| healthcare? With insurances companies deciding based on
| profit margins? I'd say the government incentives are a lot
| more aligned to have their population healthy and productive,
| than the insurance company looking at how much you paid for
| your premium and how much the treatment is.
| nickff wrote:
| It's best to know and understand each party's interests.
| Insurance companies want to keep you alive and paying
| premiums. Hospitals (government, for-profit, and non-
| profit) want you to receive a lot of treatment. The
| government treasury wants to keep you alive as long as your
| future tax payments exceed their healthcare and other
| expenditures. Government health departments have an
| extremely complicated set of incentives, dependent on
| exactly how they're organized.
| googlryas wrote:
| Pointing out a conflict of interest is not an advertisement
| for anything. It is what it is. You could also have
| publicly funded, 100% government provided healthcare which
| provided some base level of care but allowed individuals to
| pay for specific treatments if they wanted them and they
| weren't a part of the base level of care.
| decebalus1 wrote:
| > the government's goals are not necessarily aligned with
| your own.
|
| as opposed to the private sector?
|
| > But if the government is also providing the healthcare
| services "for free" to individuals, then there is an
| incentive to downplay testing for rare or expensive to treat
| diseases due to the cost/benefit ratio.
|
| Which is what current private insurers often do. The
| government's incentives aren't just to cut costs and run more
| efficiently. It mostly cares about staying 'the government'
| and having people live long enough to pay taxes. I want to
| hear the same argument when you're talking about the
| government's incentives to be more cost effective when it
| comes to funding the armed forces.
|
| I think the gist of it is that as an individual, in theory,
| you have leverage over the government via your votes or
| representatives. You have none of that when dealing with the
| private sector. So in this case, if I'm bothered by what the
| government publicizes about diseases and such, I have several
| tools at my disposal to deal with it (FOIA requests to track
| down who's responsible, town halls, writing to the
| representatives, lobby, voting etc..). If a private company
| does it, what am I going to do? Write a bad review?
| googlryas wrote:
| The private sector will generally be happy to give you a
| service if you come with cash in hand. Which is why in the
| UK I can go get a brain MRI at a private clinic if I had a
| dream that I was developing MS, whereas I can't do that
| with the NHS.
| davidgerard wrote:
| NHS Conditions was what I came here to post. You'll notice your
| GP glances at precisely those pages when they're talking to you
| too.
| smoe wrote:
| I also highly recommend the NHS website.
|
| The information there a couple of years ago helped me losing a
| lot of weight and adapt a healthier overall lifestyle.
|
| The information is dry, concise and easy to understand for a
| layperson. I cannot judge how well it is aligned with recent
| science, but I trust the site much more than most others,
| because their incentives after all is public health (I'm sure
| some politics play a role as well), not selling you books and
| courses with unrealistic expectations.
| switch007 wrote:
| One issue with the NHS is that I get the impression the
| information they publish that strongly respects their goals and
| desires perhaps to the detriment of patients sometimes.
|
| I've certainly noticed in the past big differences in advice.
| The NHS will downplay and not suggest investigations whereas
| another (non UK) site does the opposite.
|
| The NHS advice surely is carefully crafted not to cause
| unnecessary (from their point of view) GP visits, tests etc.
| gadders wrote:
| Agreed. I think you would be naive to not think the NHS
| information factors treatment cost/managing demand into their
| answers as well.
| jmye wrote:
| > One issue with the NHS is that I get the impression the
| information they publish that strongly respects their goals
| and desires perhaps to the detriment of patients sometimes.
|
| Do you have data that supports the NHS withholding or
| advising against necessary care that results in worse patient
| outcomes?
|
| More utilization is not inherently better, and even in the
| systems like the NHS, everyone is incented heavily to keep
| patients healthy and out of the hospital system. The idea
| that they want you to be sicker rather than provide
| relatively cheap preventive care is, generally, absolute
| nonsense.
| mclouts91 wrote:
| NHS is focused on the appropriate allocation of resources to
| the problem. It strikes an excellent balance of doing the
| right work when necessary and based on probabilities. If you
| have evidence that the process recommended by the nhs is
| failing patients in statistically significant numbers I would
| agree with you on them not doing enough tests but frankly, I
| think NHS would perform very well if it was adequately
| resourced (it's currently starved of necessary funding).
|
| The NHS follows a strict set of guidelines for the
| identification and treatment of illnesses. They do not act
| like medical businesses such as hospitals whose goal is to do
| as much testing as they can justify to get more money from
| insurers.
| lupire wrote:
| That's nice, but when I'm sick, I want to get well, and I
| might be willing to pay for it with my money, time, or
| labor.
|
| I don't want to die just because it's more cost efficient
| for the government to save two others.
| Angostura wrote:
| I wouldn't necessarily assume that _not_ suggesting
| investigations is detrimental to patient health. There is a
| continuing big debate in the UK medical profession about how
| over-investigation and over-medication /medicalising people
| can be a real problem in terms of patient health.
|
| If you are seeing a disparity between UK and US in terms of
| advice about when something needs to be investigated, it
| _could_ be that the US site is over-promoting investigations.
|
| Keep in mind that the NHS puts a _lot_ of work into
| prevention, into staying healthy without medication - it will
| quite often advise life-style changes, rather than popping
| pills - and that 's for patient benefit.
| lupire wrote:
| The point is that they aren't neutral. They have a bias
| toward what they think is best, and they don't overcome it
| by acknowledging and advertising alternative views.
| switch007 wrote:
| I was careful to say non-UK. (I'm also not American fwiw)
|
| I agree with many of your points.
| Angostura wrote:
| Apologies for the US assumption.
| RosanaAnaDana wrote:
| Just another aspect of neoliberalism. An undue faith in
| markets.
| _fat_santa wrote:
| I think the issue isn't data, its the "packaging". Going
| through the NHS website, it's useful if you already know what
| you have. I'll use myself as an example because I had an
| ingrown hair on my neck a few weeks back, went on google and I
| didn't search for "Ingrown Hair" because at that stage, I
| didn't know that it was an ingrown hair. I searched for "bumps
| on your neck" which led me to conclude that it was an ingrown
| hair (followed by a doc telling me the same thing).
|
| One idea I've had for a long time is the US Gov't (and all
| major governments) should have a large data
| gathering/distribution operation. This data would be things
| like medical research, and other data that would be in "the
| public interest" (basically all the data we have now, just in
| one place), everything from meeting notes, congressional bills,
| etc.
|
| With a wealth of data from a single source, companies like
| WebMD could stop focusing on how to get the data, and shift
| their focus to how to "package" the data. A list of conditions
| with symptoms is nice, but lets repackage that into a "medical
| graph" that lets you explore related conditions through
| symptoms. Companies could then compete on the "packaging". You
| could go to FreeMD and get the same data as you could on WebMD,
| but WebMD has a much better search engine for X thing so they
| are worth the $4.99/month cost.
|
| It would be expensive, and probably be a decade long multi
| billion dollar operation. But imagine the revolution in
| government services if there was a single source of truth for
| data.
|
| There are arguments against this, mainly do you want a
| government to have that much power. But I think it could be
| done with some strict limits and checks. Data in this API would
| only be public government data, so IRS data and other private
| information is not on there.
| edmundsauto wrote:
| This is the model for weather in the US. Do you like
| weather.com and all the derivatives?
| hundchenkatze wrote:
| weather.com is a private company owned by IBM.
|
| https://en.wikipedia.org/wiki/The_Weather_Company
| giantg2 wrote:
| Is weather.com the root, or is it noaa.gov?
| lotsofpulp wrote:
| I assume edmundsauto meant weather.gov instead of .com,
| otherwise their comment does not make sense to me.
| secabeen wrote:
| NOAA.gov is. They are the official source of the data,
| and the only organization that puts out weather
| alerts/warnings, etc.
| swores wrote:
| NHS already offers a (fairly rudimentary, last I checked)
| diagnostic tool in the form of NHS 111, which as well as
| being a phone number that people in the UK can call to talk
| to someone, is also a website (https://111.nhs.uk/) where you
| can give your symptom(s) and get a suggestion if possible
| causes.
|
| It may not yet be good enough in all cases, I'm not sure, but
| is that what you're asking for? I'm not quite sure as you
| dived into things like data licensing without being clear on
| your actual hoped end result.
|
| (Of course, the 111 site is designed as part of the wider NHS
| system, so when in doubt it's more likely to give advice to
| speak to a GP / call to speak to a nurse / visit a hospital,
| than to say "not sure, here are all the conditions it could
| be". But as it gets better I expect it to be able to do
| both.)
|
| Not to mention that the main NHS site also lets you search
| for symptoms in the main search bar, so you don't need to
| know the condition to use it to search for possible
| conditions. edit: as better pointed out by jjar here
| https://news.ycombinator.com/item?id=32650958
| snarf21 wrote:
| It is the misaligned incentives that come from advertising.
| Click-bait and outrage drive views and ad revenue. Look at the
| "news" segment these days.
| ravenstine wrote:
| That's a nice page, and I'll definitely bookmark that one. But
| I don't see most of the public using something like that over
| WebMD.
|
| WebMD is complete trash (I even block it in my Kagi search
| preferences), but it succeeds over sites like the NHS one
| because of blog SEO. WebMD is really a glorified blog with
| posts about every condition you might get paranoid over. I
| don't know how precisely they achieve this, but they're doing
| something right in an SEO sense if The Google continues to put
| them near the top of results after all these years.
|
| Meanwhile, there are also sites like Merck Manuals, which is
| both a terrific resource and privately run, but I don't recall
| ever seeing it coming up for a search query like "what is that
| bump on the side of my neck."
|
| https://www.merckmanuals.com/
|
| The resources are out there. Whether The Google thinks the
| average person should read them is a different story. I don't
| believe The Google is going to ever filter out WebMD, so there
| must be a middle ground where sites like the ones you and I
| mentioned find a way to make themselves more WebMD-like without
| sacrificing their more academically-minded content they already
| have.
| Spooky23 wrote:
| I disagree with the WebMD hate. It's not the best site out
| there, but it isn't delivering misinformation or otherwise
| problematic data.
|
| That type of site is difficult in general. People seeking
| medical advice via online means are always going to struggle.
| MisterTea wrote:
| > I don't know how precisely they achieve this, but they're
| doing something right in an SEO sense if The Google continues
| to put them near the top of results after all these years.
|
| One hand washes the other. WebMD is chock full of google and
| other ads.
| brokenodo wrote:
| I'm honestly blown away by the Merck Manuals! How can this
| resource be so comprehensive and clear yet seemingly never
| come up in topical searches?
|
| It seems like the most comparable medical version to
| Cornell's Legal Information Institute.
| https://www.law.cornell.edu/
| harvey9 wrote:
| I wonder if UK users see the NHS site further up the
| rankings?
|
| I'd be curious to know if people are putting in 'NHS' as a
| search term as well.
| noneeeed wrote:
| I consistently see NHS results at or near the top for most
| symptom searches.
|
| I don't know if that's geography specific.
|
| I just tried it for "swollen ankles" and the NHS came top,
| followed by webmd.
| raesene9 wrote:
| One anecdote from a UK internet user. I just tried googling
|
| long covid
|
| and the top result was NHS. Not sure if it is for other
| nationalities but they're definitely getting good ranking
| in the UK
|
| edit: I also tried flu and meningitis and NHS is top for
| both of those queries too.
| n4r9 wrote:
| Yes, I'm in the UK and will often include "NHS" in the
| search terms when reading up on health issues or advice.
| habosa wrote:
| Here in the UK the NHS website has excellent SEO. I land
| there all the time
| ricardo81 wrote:
| > Whether The Google
|
| Indeed. You mention it being SEO but I see the NHS website
| has a nice site hierarchy and even has schema.org data.
|
| SEO in one sense is to 'help search engines understand a
| page', maybe the crossing point is where it outranks and
| appears too much. A site/page ranking well in Google says as
| much about Google as the site/page.
| lupire wrote:
| Google's problem is that it ranks pages, not sites. It will
| much prefer a crappy site with a crappy page that is highly
| specific to your search query, instead of showing you a good
| site related to the idea you are looking for.
|
| It puts far too much faith in its language _parser_ , which
| doesn't _comprehend_.
| mitchdoogle wrote:
| Sites definitely matter. All indications are that domains
| have a ranking as well as individual pages
| [deleted]
| bogota wrote:
| Not to mention pretty much every health condition you look up
| will list that you have cancer or some mental illness.
| Melatonic wrote:
| I still have a super old merck manual I keep just in case of
| emergencies. Makes me wonder if I should be purchasing one
| that is up to date.....
| tmoravec wrote:
| So there's a private option that's terrible (WebMD) and a
| private option that's terrific (Merck Manuals). And it's the
| terrible one that ranks well at Google.
|
| Sounds like a Google problem and apparently only a Google
| problem.
| ajmurmann wrote:
| That's where I continue to want to see what results in a
| search engine would look like that heavily punishes
| presence of advertisements in a result. All the SEO spam
| pages are ad-driven, so cutting out anything following that
| incentive should result in removal of all pages that follow
| that terrible SEO spam pattern that ruins search results.
| hombre_fatal wrote:
| Punishment/vengeance is a popular idea around here, but
| you have to also remember that a search engine is
| supposed to bring you the most relevant results.
|
| Filtering out, say, Stack Overflow or Reddit because it
| has ads doesn't help you when it answers your question
| and is perhaps the only thing on the internet that truly
| does.
|
| People seem to think there's this ad-less replica of the
| internet, sitting right behind our ad-riddled internet,
| where everything they want exists for free, it's just
| hidden. In reality, the websites making money are the
| ones providing the vast majority of things people are
| looking for.
|
| Use https://search.marginalia.nu if you want to severely
| punish ads.
| nvrspyx wrote:
| Maybe instead of heavily punishing websites with ads, a
| search engine could instead punish heavily ad-driven
| websites. A lot of the SEO-exploiting blog mills are
| filled to the brim with ads where the goal is to get you
| to visit to view as many ads as possible, not provide
| good content that's funded by ads.
| function_seven wrote:
| Some sort of ratio algorithm would be nice.
|
| Does this site (in general, not just this page) have more
| than 5 advertisements per page? Between 2 and 4?
|
| Does this site attempt to load 12 trackers? "Only" 4
| trackers? Just 1?
|
| Does an AI text analysis of the first few paragraphs
| match on this nonsense?:
|
| > _Fixing your gadget is important. Many people find that
| their gadget sometimes breaks. Gadget helps us do action
| easier, and improves our lives. We all hate it when our
| Gadget doesn 't work the way we expect it to. It can be
| frustrating. Read below for tips on how to fix your
| gadget._ (Followed by 3 more paragraphs of filler before
| getting to regurgitated gems like "reboot it".
|
| I'm sure we have the AI tech now to semantically see this
| bullshit and downrank it. Right? (Ok, maybe I
| overestimate how easy this would be. Forgive me, I'm just
| ranting here)
| gregmac wrote:
| Do you mean the advertising company that runs a search
| engine should punish pages in the results that... show
| their ads? Or just when it's a "lot" of their ads? Or
| should they only do that if the pages are showing ads
| from their competitors?
| ajmurmann wrote:
| When I said "punish", I meant that the ranking algorithm
| should do that. It's not about vengeance, it's about
| filtering out SEO spam. The problem with filtering out
| SEO spam by detecting it as such is that it's by
| definition an arms race. That's why I propose to instead
| of looking for the symptom (SEO spam) pull it out at the
| wrong incentive structure that's causing it (ads).
| dbcurtis wrote:
| Imagine a world where the biggest search engine made its
| money from advertising. In that kind of a world, wouldn't
| the search engine primarily be incentivized to show you
| the results pages with the most advertising, regardless
| of the quality of the content?
| lupire wrote:
| No, because people would stop using the crappy search
| engine.
|
| That's how the world was before Google.
| dbcurtis wrote:
| And that differs from today because.... why?
| droopyEyelids wrote:
| This is so simple its easy to overlook the fact that its
| also ingenious
| lupire wrote:
| Anyone who wants attention is motivated to do SEO. Should
| engines downrank every site that has good SEO? That is,
| downrank every site that ranks highly?
|
| They already look at things like clickthroughand dwell
| time and bounce back. If enough people dislike
| Example.com enough to avoid clicking on it or come back
| to search after visiting it, the engine learns that it is
| a bad result.
|
| Maybe the problem is that most people like what you don't
| like.
| Calavar wrote:
| No, they key is to differentiate SEO'd pages with useful
| content from SEO'd pages with useless content.
|
| This is a game as old as search engines. In 2005, it
| meant filtering out sites that were just lists of
| keywords, not coherent sentences and paragraphs. It meant
| for giving extra points to articles with structure, such
| as header tags and paragraphs, as opposed to just blobs
| of text. It meant using PageRank to organically discover
| which pages real people thought were useful.
|
| It's a much subtler and more difficult problem in 2022,
| but there are also better tools to do it (big NLG
| models). It just seems that Google lost interest in
| quality control at some point.
|
| And I would guess they lost interest in quality control
| because of Chrome's market penetration. Chrome is a
| browser monopoly at this point, and with Google being the
| default search engine on Chrome, they no longer have to
| give quality results to maintain their search user base.
| On top of that, they control such a large share of the ad
| market that any SEO spam website is more likely than not
| to be using AdSense. Which means they have a financial
| incentive to deliver page views to SEO spam sites, which
| tend to have higher ad/content ratios.
| Consultant32452 wrote:
| This seems like a good fit for a ! solution like
| duckduckgo. !gov !universities These may already exist.
| ajmurmann wrote:
| That stuff definitely helps. That's also why do many now
| just search Reddit. However, wouldn't it be nice if the
| search engine could be smart enough to figure that out
| itself?
| zeruch wrote:
| "that heavily punishes presence of advertisements in a
| result." while that is pleasing to read at face value, it
| has two fundamental problems:
|
| 1. it's orthogonal to relevance of content (semi-solvable
| algorithmically I suspect) 2. it's antithetical to
| Google's core business model (a lot tougher nut to crack)
| fredophile wrote:
| > it's orthogonal to relevance of content
|
| I disagree. The way content is presented matters.
| Splitting an article into 4-6 pages and filling those
| pages with ads makes me not want to read that content.
| I'd much rather go somewhere that has the same text in a
| single page and only a few ads.
| beambot wrote:
| What about playing 2-3 unskippable video ads before
| watching the actual content? Thus, Google should degrade
| YouTube search results as well!
| ajmurmann wrote:
| The ideal search engine would show me the ad-free page
| first given otherwise identical quality. Of course Google
| will never do anything like that. That's why I'm hoping
| for an alternative search engine to do so.
| ajmurmann wrote:
| > 1. it's orthogonal to relevance of content
|
| The entire point of my comment was that it's not
| orthogonal. The ads are what fuels the click bait and
| SEO-driven articles. Nobody for example would ever pay a
| subscription to a website that is just waffle filler.
| While stackoerflow has ads, it's much better in that
| regard to the SEO spam pages.
| aendruk wrote:
| Teclis implements a fun approximation of this. It runs
| uBlock Origin on results and penalizes according to the
| number of items blocked.
| winternett wrote:
| Google can make or break any online business they want to.
| It is what it is... We let them get there... That being
| said, I haven't even tried to use Bing, and it's pretty
| much impossible to convince me that Microsoft Edge is worth
| a second look after all the years of MSIE, and how Windows
| has been slowly devolving over time.
|
| If worst comes to worst, just add "reddit" to your search
| term, and then all you have to do is determine whether he
| answers you find look like they came from a human, a
| spammer, or a corporation.
| Melatonic wrote:
| Edge is chromium based now so......
| jleyank wrote:
| No, as I suspect the ad revenues are just fine the way they
| are now. Google isn't altruistic. They want ad rates.
| [deleted]
| rootusrootus wrote:
| > Sounds like a Google problem and apparently only a Google
| problem.
|
| I want something like webrings to become A Thing again. A
| user curated search engine. And the users doing the curated
| need to be vetted. I don't know if this is even possible,
| but I get tired of having to come to HN to get a human
| recommendation that is miles better than the algorithmic
| crap from the current search engines.
| cecilpl2 wrote:
| > And the users doing the curated need to be vetted.
|
| It comes back to the age-old question: Who vets the
| vetters?
| mitchdoogle wrote:
| You do. I imagine people or groups curating lists of
| pages or sites - they decide what to put on their lists,
| but you decide to include them in your personal search
| engine or not. Or you could fork their list and edit as
| you see fit.
| echelon wrote:
| Unsolvable since it's a network of fallible humans we
| attempt to topologically score.
|
| You can make decent attempts, such as academic peer
| review. Even this system perpetuates its own problems
| (beta amyloid) and has perverse incentives (publish or
| perish, falsified results), though.
|
| Semantic web had some good ideas about this. Networks of
| signed FOAF data attached to articles and posts. You
| could form a side graph of trust information that you
| could revoke at any time.
| adolph wrote:
| There is the "awesome list" phenomena:
|
| Search "medical information awesome list"
|
| https://github.com/NeovaHealth/awesome-health
|
| https://github.com/lalaithan/awesome-health
|
| https://github.com/jeromecc/awesome-health
|
| Fork and make your own!
| hattmall wrote:
| T100 sites and the like seemed to be the peak of
| discovering interesting and relevant content to me.
| lupire wrote:
| Web of trust, not web rings.
|
| Post your bookmarks, share to your friends, encourage
| your friends to do the same. Import those bookmarks into
| a search engine site fliter extension.
| Cthulhu_ wrote:
| It's a bit of a conundrum; on the one side, the NHS and (in
| a different area) MDN are better, more authoritative, etc
| sources, so Google should promote those. On the other, this
| would mean that Google can no longer cite neutrality or
| hide behind "the algorithm", as has been their legal
| defense against a ton of lawsuits where the suers said one
| websites should go higher or lower in the rankings.
| david_allison wrote:
| Google already does this. Searching for "YMYL" (Your
| Money or Your Life) should produce useful results:
|
| > For pages about clear YMYL topics, we have very high
| Page Quality rating standards because low quality pages
| could potentially negatively impact a person's health,
| financial stability, or safety, or the welfare or well-
| being of society.
|
| https://static.googleusercontent.com/media/guidelines.rat
| erh...
| gtirloni wrote:
| If it's a human curating content or an algorithm doing
| so, I don't see how that helps Google on a lawsuit.
| Unless they blame sentience.
|
| The best algorithms adapt to feedback. Surely Google's
| own algorithm can accept Google's feedback to adjust for
| flaws in it.
| nradov wrote:
| What lawsuit? There is no legal basis for a lawsuit. As a
| private corporation, Google is free to rank search
| results however they like regardless of whether that's
| done by humans or algorithms.
| lupire wrote:
| Google chooses to rank "authoritative" sites based on its
| own notion of authoritativity (which they don't share,
| but they decide).
|
| They implement it as agnostic tuning as much as possible,
| avoiding single human chery picking sites. They use
| panels of humans (mturk style) for quality ratings.
|
| Could you imagine the outrage if Google said "The
| government is always the best source about everything?"
|
| What even would be the point? Use the government search
| engine for that use case.
| hhmc wrote:
| I'd make the claim (without any real data), that the NHS has
| _such_ institutional power in the UK that it goes a long way
| to transcend any SEO shortfall it may have.
| petepete wrote:
| It does. Google treats gov.uk and nhs.uk sites as
| authoritative sources and ranks accordingly. We typically
| pay no consideration to SEO on non-campaign sites.
|
| It doesn't stop ads from sneaking in above the results
| though. There's a whole industry of shady companies
| 'hijacking' and charging extra for free/cheap government
| services.
| biztos wrote:
| What does "non-campaign" mean in this context?
| petepete wrote:
| The sites that sit on gov.uk are usually either:
|
| * transactional services - those that let a person do a
| task, like applying for a driving licence or registering
| a trademark
|
| * information services - a collection of guidance on a
| subject, like maximum working hours or data protection
| responsibilities
|
| There are some that don't really fall into either
| category and are there to advertise something. They aim
| to be informational and inspirational. Some examples:
|
| * https://helpforhouseholds.campaign.gov.uk/
|
| * https://www.apprenticeships.gov.uk/
|
| * https://national-security.campaign.gov.uk/
|
| * https://skillsforlife.campaign.gov.uk/
|
| The reason SEO is more important on these is that there's
| often competition. For example, if I search for 'teach in
| uk' the Get Into Teaching campaign site will be competing
| with lots of teacher training colleges and companies, job
| sites, etc.
| lupire wrote:
| Why don't you use SEO on your non-campaign transactional
| and info sites?
|
| Those are the ones that need protection from fee
| scammers. It seems you've got it exactly backwards.
| nicoburns wrote:
| SEO is what the scammers use. When Google prioritises an
| authoritative page, that's making SEO _less_ important.
| nicoburns wrote:
| The NHS definitely does rank highly in the UK. Not sure if
| it ranks above web md, but they're usually both in the top
| 5 results if they have a relevant page.
| IshKebab wrote:
| It pretty much always ranks above WebMD in the UK. WebMD
| has a very low rank for me. Mayo Clinic is the site that
| I normally see tussling for the top spot with the NHS.
| Some examples randomly plucked from my brain:
|
| 1. Vitiligo: NHS: 1, Mayo Clinic: 2, WebMD: 7
|
| 2. Bronchiolitis: NHS 1, Mayo Clinic 2, WebMD: 9 (on the
| second page!)
|
| 3. Appendicitis: NHS 1, Mayo Clinic 2, WebMD: 3
|
| 4. Myopia: Mayo Clinic 1, WebMD 2, NHS: 3
|
| 5. Gastroenteritis: NHS Inform (never seen this before?)
| 1, WebMD: 2, Mayo Clinic 3, NHS: 4
|
| 6. Hodgkin's disease: Mayo Clinic 1, NHS: 2, WebMD: 5
| biztos wrote:
| > The Google continues to put them near the top of results
| after all these years.
|
| WebMD: the Pinterest of Health.
| scarby2 wrote:
| i wish pintrest could be scrubbed from the internet
| nonameiguess wrote:
| I think this is giving way too much credit to Google. WebMD
| has existed in some form since 1996 and first went live _as_
| WebMD in 1999. They 've been the web's most popular health
| information publisher from the beginning. This was before
| Google became the web's dominant search engine.
|
| If Google has an issue here, it's that it tries to rank
| things based on a more or less mathematical look at its
| actual popularity at the time of indexing. It isn't aiming to
| promote sites based on quality in order to make them popular.
| If a site is where other sites are pointing and people are
| visiting, then Google is going to rank them highly (modulo
| whatever the hell other secret sauce goes into the algorithm
| - i.e. punishing slow load times), even if the information
| content is bad. WebMD was very much already the web's most
| popular source of health information well before they hit the
| top of any Google search.
|
| This isn't even a problem specific to the web, let alone
| Google. Medical textbooks were available at the time Chicken
| Soup for the Soul was a best seller. Consumers quite often
| prefer shittier information to better.
| briandear wrote:
| If the "government" becomes the only source of truth, that
| source of truth is necessarily political. The oft-mentioned NHS
| -- do they not have an incentive to lower health care
| expenditures? Would providing medical information to the public
| that prescribes a suggested course of action incentivize the
| course of action that is least expensive to the government but
| not necessarily the best treatment? Is there any potential for
| a conflict of interest there? Of course there is. If some
| condition is best treated with an expensive procedure, would
| the NHS be incentivized to recommend a cheaper, but less
| effective approach? Of course they would. The NHS routinely
| denies or delays life-changing surgeries over cost despite such
| denials not being in the best interests of the patient. (Try
| getting an NHS knee replacement.) There are treatments NHS
| won't recommend because a person is too old. Not because they
| can't handle the procedure but because the expense isn't worth
| the amount of lifespan remaining in the patient.
|
| Medical information provided by governments is often centered
| around what's best for "populations" and not necessarily the
| individual. Covid is a prime example: masking kids was bad for
| the kids but allegedly "good" for the population. Damaging to
| the individual for the alleged benefit of the so-called greater
| good. Despite all the kid masking "science" turning out to be
| garbage. Covid vax for kids is another example: the government
| right now in the US promotes vaccinating even toddlers despite
| their individual risk of serious illness being statistically
| zero.
|
| HIV is also something that the government really got it wrong
| in the 1980s. https://www.aier.org/article/fauci-was-
| duplicitous-on-the-ai...
|
| Covid information is another example: the government was wrong
| on multiple occasions throughout the pandemic. Yet when
| "official sources" are the only approved source of information,
| the public gets mislead. The marketplace of ideas is a real
| idea and it should be embraced. We need more private sector
| competition for information, not less.
|
| If WebMD is bad, the solution isn't government, it's a
| competitor.
| Aengeuad wrote:
| Of course the NHS has an incentive to lower costs, it's in
| their interest for doctors to prescribe the most cost
| effective treatment as patients rarely stop coming back as a
| result of ineffective treatment. Does this mean that
| objectively good preventative treatment (like physio) and
| quality of life elective surgery get pushed to the back of
| the triage queue, and that individual needs are occasionally
| failed? Absolutely, and in these cases where the NHS falls
| short there's always the option of going private, which just
| highlights that healthcare is always political.
|
| In a purely private healthcare system (which doesn't exist in
| the developed world) the politics are firstly whether you can
| pay and secondly how much you can pay. No point offering free
| dieting and lifestyle advice when risky weight loss surgery
| (which has a notoriously low success rate) offers instant
| success, got a bad back or knee? Try out this risk free*
| (*not actually risk free) surgery! It wasn't that long ago in
| the US that getting cancer without health insurance was a
| death sentence, and that again is a political choice, one
| that the US government reneged on.
| lupire wrote:
| > If WebMD is bad, the solution isn't government, it's a
| competitor.
|
| And how to decide who to trust? Still unsolved. The general
| public loves being lied to, as long as they like who is lying
| to them (same political party, religion, or just making
| impossible promises).
| andrewljohnson wrote:
| In the US, the CDC has been really bad at providing health
| information, and the FDA has been really bad at providing food
| safety info. They also don't have incentive alignment
| (incentives are mostly to grow the bureaucracy and serve
| careers).
|
| I'd expect private enterprise to eventually converge on better
| info... eventually consumers will choose services that provide
| the best info amidst competition.
| stevenbedrick wrote:
| Check out the National Library of Medicine's MedlinePlus
| resource for an equivalent to the NHS's consumer-oriented
| health info portal: https://medlineplus.gov/
|
| It's a fabulous and under-utilized resource!
| Melatonic wrote:
| What would be better if basic stuff like this was part of our
| public education system. We need the equivalent of "shop" class
| but for basic medical needs. Wilderness First Aid would be a
| good start
| alistairSH wrote:
| The closest I've found to the NHS sites are published by Mayo
| Clinic in the US... https://www.mayoclinic.org/diseases-
| conditions
|
| Still not perfect, but I've found it more useful than WebMD.
| coldcode wrote:
| I also prefer information from the NHS even though I live in
| the US. Here medical information online is all about making
| money from ads and who knows what else they sell. There is
| actually little money to make from providing relevant
| information, unlike a national heath care system (which despite
| its terrible current state politically in the UK, where it
| seems they want to move to the US model) has an incentive to
| provide good information.
| lotsofpulp wrote:
| The US government also provides healthcare info at cdc.gov,
| nih.gov, health.gov, or USA.gov/health.
| KerrAvon wrote:
| I don't know about the NHS, but we can't trust the
| information vended by the CDC -- they have proven willfully
| incompetent over the past two years. I will give just one
| example: they initially told us masks were ineffective
| against COVID, which they knew at the time was inaccurate.
| They said it because they didn't want a run on PPE required
| by medical workers. Result: there was a shortage anyway and
| they damaged their reputation irreparably. Great job
| everyone.
| lotsofpulp wrote:
| If one negative example decreases an entity's credit,
| would positive examples increase an entity's credit?
|
| What about the proportion of positive to negative
| examples? How does that impact an entity's credit?
| LawTalkingGuy wrote:
| Mistakes to correct statements, yes. Those balance out.
| The opposite of being right is being wrong, the
| proportion of these two is their score.
|
| Lies though, where we find out they knowingly said
| something they knew was wrong when they said it, don't
| balance out. The opposite of lying to someone to
| manipulate them is respecting them enough to let them
| make their own choices. They need to acknowledge that and
| start purely providing facts again - even at the cost of
| some political narratives, before they'll regain trust.
| lotsofpulp wrote:
| The intent of the lying also matters.
|
| Corruption is bad, lying with good intentions is context
| dependent bad, mistakes are OK. But if one is going to
| throw out the baby with the bath water at every instance
| of corruption/lying/mistake, you are not going to be left
| with much other than chaos.
|
| Humans are fallible creatures, we have to work and
| improve with what we have.
|
| The exceptionalism of the USA is the fact that most of
| its organization are open to criticism and repair. The
| FDA/CDC/USDA/DoT/EPA/etc and many other non governmental
| orgs are far from perfect, but they are pretty awesome
| compared to the alternatives around the world.
| mbostleman wrote:
| >>Why is the private sector responsible for providing accurate
| health information? As this article shows, the incentives for
| people running medical websites <in the private sector> and the
| people reading them are not aligned.>>
|
| I don't know that the cause of this particular misalignment is
| "private sector". But no doubt the current implementations by
| the private sector exhibit this misalignment.
|
| >>I'd say the UK NHS website <which is public sector> and
| symptoms/medications pages hit the nail on the head>>
|
| I assume this implies that the NHS website does not exhibit the
| previously noted misalignment. Why is that? Obviously this
| site's sole funding is not from advertising. I assume it's from
| taxes collected by the government. So what is incentivizing
| those that build this site and maintain its content to make it
| so good?
| mbostleman wrote:
| I'm wondering why my question got downvoted. I've had this
| happen before when asking questions. Could it be a matter of
| a couple of readers not assuming benign intent? As in,
| someone thinks I'm not actually asking a question but making
| a statement and they don't agree with the statement. Either
| way it's interesting.
|
| Perhaps the more likely to be read as benign version would be
| this: We all agree site A is bad because it's misaligned
| (which I think all agree is due to being driven by ads). Then
| we propose that site B is good - but there's no indication
| about WHY site B is good. We know why site A is bad, but why
| is site B good. And more specifically since we're describing
| the value in terms of alignment, what alignment is there in
| site B that drives the goodness?
| SilasX wrote:
| Interesting! But the first link you gave is just a list of
| conditions, which requires that I already know what my problem
| is. Is there a page that goes from symptoms to likely causes
| and what to do, like WebMD?
| jjar wrote:
| You can search at the top for symptoms:
| https://imgur.com/a/y5RUk5x
|
| I'd say if I were to suggest improvements the symptom search
| could definitely be better and more prominently placed. In
| the UK I personally (and I'd imagine most people) get to the
| NHS website directly from Google, which is better at finding
| more relevant pages.
| SilasX wrote:
| That doesn't really help. It just vomits a list of articles
| that mention coughs. The "killer" (rescuer?) feature of
| WebMD is being able to start from a symptom and narrow down
| through clarifying questions. You implied the NHS does this
| better, when it doesn't attempt that feature at all.
|
| I'm not sure this is the prime "UX done well for
| symptoms->cause" example you cited it as. Though I agree UK
| government sites follow much better UX patterns!
| dreamcompiler wrote:
| To extend this a bit, the ultimate solution is a quasi-
| government nonprofit organization along the lines of ICANN (or
| maybe part of ICANN) that operates a crawler and a database of
| crawled sites, plus an API for that data.
|
| This would not be a search engine _per se_ but a neutral
| backend that anybody could build a search engine on top of.
| Want to build a search engine and sell ads? Fine. Want to build
| a search engine specializing in health information subsidized
| by the drug companies? Fine. Want to build one as a neutral
| nonprofit and charge subscriptions? Fine. The same backend
| database works for them all. Even Google could build a frontend
| on top of it.
|
| Yes it would be expensive. The government would have to pay for
| all the backend infrastructure (whether the government buys it
| or rents it from Amazon, Google, Microsoft, etc.), and
| Cloudflare and robots.txt would have to allow "icanncrawler" to
| access sites without friction. But it would finally allow the
| creation of neutral search engines not beholden to advertisers.
| It's a piece of infrastructure the modern Internet sorely
| needs.
| duxup wrote:
| Is that NHS page what people go to webMD for?
|
| I feel like that's something else entirely.
| gpm wrote:
| It's my first time seeing it, but it seems like yes.
|
| I have a relatively new mole that I thought looked a bit
| funny, so I awhile ago now I looked up what malignant ones
| look like, thankfully it doesn't seem to be.
|
| This page is definitely clearer and more concise than what I
| found at the time: https://www.nhs.uk/conditions/moles/
| winternett wrote:
| It's a common conflict for info publishers, the only solution
| is really to get rid of advertising. WebMD relies too much on
| industry advertisers and on companies selling pharmaceuticals
| and it corrupts their ability to objectively provide health
| advice. Advertisers pressure publishers for prime placement,
| and for editorial influence when they have weight to them, and
| it corrupts the tone of what a site can publish by nature.
|
| The same is happening with many doctors that need to pay their
| overhead, many offices turn into "pill mills" because that is
| what keeps the lights on. We're at a very weird time in
| history, where people are more profitable as unhealthy
| individuals, so certain actors in health care peddle fear,
| confusion, and paranoia to sell medications as well as the
| valid issues and panaceas to them, and even minor and
| completely minute afflictions normally have commercials running
| non-stop on TV. WebMD is a tiny blip when you consider that
| people type their affliction into Google first.
|
| Perhaps for them, and as the online ad economy melts itself
| down, contracting with the government to provide official
| information on a non-ad funded site with a far less cluttered
| UI might be a better long-term profit model.
| wongarsu wrote:
| > We're at a very weird time in history, where people are
| more profitable as unhealthy individuals
|
| The thing is that to wider economy and society at large,
| people are vastly more profitable if they are healthy. This
| is one of the top reasons why countries spend so much on
| healthcare: healthy citizens are productive citizens.
|
| The entire problem is one of externalized costs and
| misaligned incentives.
| nicwolff wrote:
| Like https://www.thennt.com which friends of mine started and
| tried to monetize - but there's no obvious revenue source for
| unbiased evidence-based diagnosis and treatment recommendations.
| Or none that's obvious to investors.
| [deleted]
| m3kw9 wrote:
| One that doesn't say cancer in the same list as other
| possibilities every time you try to find out why there is a small
| issue. It's a UX/UI issue they can solve
| pixelpanic360 wrote:
| abrax3141 wrote:
| Better WebMd already exists. https://www.cochrane.org/
| peter_retief wrote:
| The health sector will probably be the last to get disrupted
| mainly because it is tightly controlled and regulated.
|
| Regulation probably isn't a bad thing in itself but if it isn't
| used to enforce the status quo, keep control and set prices.
|
| I have this idea that health data should be open sourced, I have
| no problems with my continuous blood pressure, sugar levels and
| pulse rate (etc) being used in machine learning to identify
| clusters that might be useful. Just a thought for now.
| candlemas wrote:
| Most medical research is junk science that doesn't replicate so
| any site relying on those studies is probably going to be useless
| anyway. That could be why the satisfaction is so low.
| 7373737373 wrote:
| Something I'd like is a diagnosis tool that worked similar to the
| software dispatchers use to obtain information from the caller
| Invictus0 wrote:
| Has no one here heard of the Merck Manual?
|
| https://www.merckmanuals.com/professional
| awinter-py wrote:
| 'seo' appears only twice in this but deserves way more blame imo
|
| The life cycle of an article now seems to be 1) legit author in
| legit place, possibly paywalled, 2) worse copies elsewhere, with
| or without sources
|
| (I can't say how prevalent this pattern is, but you've seen it
| too, and if google has _any nlp chops at all_ they are able to
| measure it in their index)
|
| even bad content doesn't come out of nowhere. an indexing
| platform that tried to tease out the 'copy of a copy' structure
| of the web would have a much easier time filtering out the blurry
| copies.
|
| not saying this is google's job, but they are the architects of
| the incentive structure here, and are in the best position to fix
| it if they wanted to
| brailsafe wrote:
| I like Healthline
| stevage wrote:
| The phenomenon they describe for health information is, IMHO,
| absolutely rife across many different domains. Try looking up
| information about gardening, plant management, home improvement,
| etc - you'll find the same thing. Search results dominated by
| sites that have mastered the art of producing SEO-optimised
| "content" that is not authoritative, full of waffle, and not
| especially helpful.
|
| For whatever reason, the business model of "draw a huge amount of
| traffic" outcompetes the business model of "provide a really good
| source of information".
|
| It's interesting to ponder why in very specific domains, that's
| not the case: for instance, StackOverflow dominates in
| programming queries, and provides very useful content.
|
| Someone much smarter than me should write a really good blog post
| about this.
| lupire wrote:
| I think it's because professionals and expert users know what
| good content looks like, which feeds back into the algorithm.
| The average gardener using the web (not books or other local
| knowledge) for advice doesn't.
|
| Google says "democracy on the web works" which means that what
| wins is what looks good to the average person among the
| population who uses that search term.
| tern wrote:
| A partial salve would be a search engine that only returns
| results from websites where the people writing cannot make
| money from their content.
|
| It's quite interesting to ponder the implications of this.
| myself248 wrote:
| When you put it that way, it's so glaringly obvious that
| Doubleclick (wearing their Google skin; keeping the name when
| they merged was the smartest thing the devil ever did) is the
| precise and irreconcilable opposite.
| cyral wrote:
| > Try looking up information about gardening, plant management,
| home improvement
|
| I found a particularly egregious offender the other day.. the
| #2 result for "best cordless screwdriver" is one of those
| content farms that made a "Best of 2022" article. Their top
| recommendation in 2022 is an old NiCad one that was
| discontinued in 2015!
| bombcar wrote:
| Because StackOverflow successfully (for some value of success)
| transitioned the forum model to the modern web.
|
| We _had_ these "really good sources of information" - we had
| forums dedicated to almost any topic you could want to know
| about, and people educated in the area would frequent them.
|
| They've almost all died out - some remain as a mostly static
| reference (which is incredibly useful!), others continue to
| plod along. A few subreddits pop up now and then, but it's not
| really the same thing (subreddits are even more prone to
| "flooding" from outside "contributors" who end up turning it
| into a meme-reddit).
|
| If a company is tangentially related to a topic, you can do
| worse than dedicating a few full-time employees to a forum on
| that topic. We're posting on one right now!
| markdown wrote:
| > They've almost all died out
|
| I'm a member of a few active old-school forums. The reason
| they didn't grow like StackOverflow did is because you really
| need to spend a lot of time reading through garbage (small
| talk, etc) to get to the good stuff.
|
| The answer to the question (as posed in the title), might be
| 3 pages away. With StackOverflow, the answer is almost always
| immediately under the question since it's been voted into
| that position.
| nerdponx wrote:
| Meanwhile search results are absolutely infested with sites
| that scrape and rehost StackOverflow content, and somehow
| manage to get better search engine rankings than
| StackOverflow itself on many queries.
| unethical_ban wrote:
| Tragedy of the Commons. We all could use easily accessible,
| accurate and unbiased medical information, but most people
| can't or won't pay a website to procure and publish such
| content, especially when they don't really know if they can
| trust the site! It's rather circular.
|
| If only there were some association of all people, some kind of
| organization that included all members of the public, which
| could collect a nominal fee for common goods and services and
| then provide them freely after the fact. Some sort of union
| that governs what goods and services are provided...
| dartharva wrote:
| The existence and success of Wikipedia (and other similar
| sites) easily counters this notion of _needing_ consumer
| propensity to pay for a knowledge repository. Sure,
| reliability and accuracy of the information may be put into
| question, but that would have been a concern either way even
| if it were a paid service.
| unethical_ban wrote:
| People are not encouraged to make personal health decisions
| by Wikipedia.
| SV_BubbleTime wrote:
| We all know the people that collect the nominal fee have the
| best interest in delivering a quality product - a serious
| responsibility to do so even - and not solely making their
| section of the entity larger and more powerful year over
| year.
|
| What is a bureaucrat if not a highly skilled creator who
| completes their mission ahead of time and under-budget?
| unethical_ban wrote:
| This, but unironically. A number of countries (and a number
| of federal and state orgs in the US) have competent sources
| of record for the public good. Why we don't have it for
| medicine is beyond me.
| quickthrower2 wrote:
| Governments would need to run big very expensive ad campaigns
| to change peoples behaviour from "googling" to entering a
| government website url. The browsers now make searching so
| much easier than typing an URL.
| biztos wrote:
| I have noticed this on YouTube as well, I would assume
| something similar is happening on other video sites.
|
| Sometimes there is a video on a trending topic among the first
| few Google search results, and when you go over to YouTube and
| have a look it turns out to be a montage of stock and/or stolen
| photos, with a synthesized voice reading a narration that was
| obviously churned out by a content mill somewhere very low-
| wage, if not generated by "AI."
|
| It baffles me that Google ranks these things highly, it's not
| like they don't have an eye on YouTube activity.
|
| In the end I have no better explanation than institutional rot:
| so much money is flowing in, and engineering incentives are so
| perverse, any problem that doesn't directly irritate the cash
| cow is not gonna get fixed.
| rchaud wrote:
| This is very common for electronic gadgets that haven't come
| out yet. Since there are no real reviews, but enough search
| interest, people will make awful slideshow-based videos that
| just repeat the specs and use OEM's own teaser footage.
| boboralice wrote:
| ajmurmann wrote:
| I believe you don't have this problem with stackoverflow
| because it's user generated content. Answers provided by people
| doing it out of passion are usually better. That's why you'll
| often find the best answers on Reddit.
|
| As to why there is no successful medical overflow.com: Software
| developers are inherently more web-affine and likely to help
| there. On top of that it's a great way for developers to show
| their knowledge in a way they can show to prospective
| employers. The medical field is a lot more old-school sand I
| cannot imagine a doctor showing their online help history to a
| potential employer.
| tetromino_ wrote:
| The difference is that software developers have a freedom of
| speech online. There is no legal liability or professional
| consequences for a junior coder accidentally giving out
| wrong-headed or misleading programming advice. So coders post
| freely, and the good posts eventually float to the top.
|
| In licensed and regulated fields - law, medicine, finance -
| the situation is quite different. Posting a bad answer might
| result in you getting sued by an angry reader or investigated
| by your field's regulatory body.
| SV_BubbleTime wrote:
| I wonder if a bounty or information-bridge would work?
|
| Make there an incentive for medical knowledge to dump on
| there, or have people who are incentivized to go get that
| data and deliver it.
| duxup wrote:
| Another somewhat successful area: Very specific task based home
| maintenance instructional videos on youtube.
|
| I'm not sure why but if I look up specific tasks I do find what
| seem like capable handy man / plumbers or similar folks with
| good quality advice.
|
| Medical stuff.... oh gawd almost no chance of good advice
| there. But maybe that's because the range of "hey we don't
| know" or "it's complicated" that you're going to get from
| honest folks when it comes to the medical world, and most folks
| gravitate towards solid answers that hucksters love to give.
|
| Hucksters might find it hard to monetize "how to cut down a
| small tree", while "cold remedies" are prime grounds for them.
| lupire wrote:
| Yeah handymen want to impress you so locals hire them. Mail
| order shops want to scam you into making one bad purchase.
| jvans wrote:
| This seems like a side effect of centralized power in general.
| You see it at amazon too which is full of either subpar goods
| or counterfeit products[1]. It becomes a game of manipulating
| these companies into showing your product/good/service, and
| only part of winning that game is producing a quality product
|
| [1] https://davidgaughran.com/amazon-has-a-fake-book-problem/
| SV_BubbleTime wrote:
| I looked up a "how to change guide spark plugs" for a vehicle.
|
| First hit was SEO garbage that started off _"Before we explain
| the steps, let's first examine what the proper stoichiometric
| ratio is!"_
|
| ... I closed that site while grinding my teeth.
|
| The internet kinda sucks now.
| SoftTalker wrote:
| > researchers published eight million new health citations--a 47%
| increase in all published health knowledge. So why hasn't any of
| this innovation made online health information even slightly
| better?
|
| Because the vast majority of this research does not change the
| current "standard of care" for most health issues that anyone is
| likely to experience.
|
| Trying to be your own doctor by reading websites is stupid.
| Doctors go to school for 8 years and many do years more
| eductation and practial training in a specialty. You are not
| going to outsmart them by spending 10 minutes reading an article
| on a website.
|
| If you are sick, see a doctor. If you are not sick, get an annual
| checkup if it makes you worry less. This isn't so complicated.
| Spivak wrote:
| Your last paragraph alludes to the gap in MDs, their strength
| is is in identifying and treating acute conditions that require
| surface level knowledge of everything.
|
| You will absolutely "outsmart"(ie consistently get better
| advice) if you are able to find a community of people living
| with your condition. You will get incredibly in depth reviews
| of medications, long term results of interventions, management
| strategies, incredibly updated research analysis.
|
| Anyone who says just to go the doctor if you're sick has never
| experienced the hellscape that is chronic conditions.
|
| The line between "we know exactly what is wrong with you and
| have 6 different treatment options" and getting diagnosed with
| "something-is-wrong-itis" is paper thin.
|
| No one is more obsessed with their disease then someone
| suffering from it 24/7.
| monkmartinez wrote:
| The first question would be; DO YOU HAVE A F**ING fever? If so
| treat that first, then call your doctor if that fails, then and
| only then do you call 911.
| InCityDreams wrote:
| Do you have an asterisk missing?
| Gadiguibou wrote:
| In the U.S., MedlinePlus [0] seems to be the best repository for
| vetted medical information. It's government-backed and links to
| the relevant organizations where appropriate.
|
| [0]: https://medlineplus.gov
| 0xbadcafebee wrote:
| So to summarize: a good version of WebMD would have: *
| structured, quantitative information * real-time updates
| * summaries of supporting evidence So why hasn't
| anyone done this yet?
|
| They have: https://www.clinicalkey.com/ However, it's for
| professionals, and it's not free. Only a professional has the
| knowledge, experience and context to use the information
| properly. For patients there are separate products/resources that
| clinicians can use to give patients more information about their
| case. But the patient can't just diagnose themselves. And
| certainly the effort of curating the dataset and developing the
| toolkit to power it isn't free.
| tern wrote:
| The author alludes to subscription services, and I think this is
| bearing out to some extent. Twitter accounts like
| https://twitter.com/grimhood are passionate generalist SMEs who
| take money from Patreon and deliver deep dives into various
| health topics. We're in the early days, but this guy is basically
| a subscription preventive health doctor knocking out topics one
| by one.
| cratermoon wrote:
| As other comments hint but don't directly say: the incentives for
| WebMD are the same as any other website: revenue through ad
| sales. WebMD is owned by Internet Brands, which is owned by
| private equity, so of course it's not just revenue, but _profit_.
| Any website needs a source of money, just to pay to keep the
| lights on, much less develop and maintain the content. As long as
| ad-driven revenue is the incentive, the result will always be
| perversely steered towards attention-getting content.
| pfisherman wrote:
| There is an excellent version of WebMD called UpToDate.
|
| The primary audience is physicians / clinicians, and they make
| money by selling subscriptions. So not a consumer health product,
| but an example of what the gold standard in this space looks
| like.
| quickthrower2 wrote:
| Example link: https://www.uptodate.com/contents/approach-to-
| chronic-cough-...
| jfdi wrote:
| Keep it up! Love where you are heading with this!
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