Google health search goes back to medical school

Google announced earlier this year it would try to help both doctors and patients by reducing the anxiety and stress that often accompany symptom-related searches on its search engine app.

To do so, Google recruited consulting physicians and experts from Harvard Medical School and the Mayo Clinic to evaluate the medical conditions that appear in patient searches. The tech giant admits that patients looking up symptoms in the past often found the most extreme and rare medical cases rather than those most likely to be causing their ailment. 

Through a new algorithm, it will cross-reference symptoms with what Google deems “high quality medical information” to present a more balanced search result.

Google hopes its efforts result in better search results that provide patients with a starting point for more in-depth research and consultation with a local health professional. 

But is it working? We asked two doctors to test it out and tell us what they learned.

By David A. Galli, MD

Picture a middle-aged man, slouching in a chair in your office, looking exhausted. 

“Doc, I looked up my symptoms online,” he says before nervously letting out a weak laugh, “and I really think I’ve got cancer.”

Usually a detailed history and physical exam, along with some extra compassion and reassurance, can spare poor souls like him from further anxiety, needless testing and making premature funeral plans. The internet is an absolute treasure trove of valuable information, available in seconds for any seeker. Unfortunately, it is also home to outright falsehoods, medical quackery and products promising to give any man the virility of a 22-year-old. 

Tragic anecdotes posted on online forums make rare diseases seem like certainties to patients whose nature is to project a worst-case scenario from a common symptom. Trying to sort the wheat from the chaff leaves many patients bewildered. 

Google has introduced a new format to streamline the process for people seeking information on causes and treatments of common symptoms. Type in “headache,” for example, and among the diagnoses that pop up are migraine and tension headache, not frightening and rare ones like glioblastoma or brain-eating amoeba.

You want to dig deeper? Tap on “tension headache” and additional information appears, including a more detailed definition of the condition and the ages most commonly affected. Treatments are suggested, along with additional links for drugs and their side-effects and interactions.

Other warnings are given as to when to seek further care. Pithy bullet-points of advice appear next to easily-identifiable icons, such as a cartoon clock used to give the reader a time course to expect before they get better. For those really interested, links connect to the reputable National Center for Biotechnology Information and Mayo Clinic websites.

I tried a search on the app for another common symptom, “back pain.” Immediately, in bold letters, I found the words “very common,” along with the comforting truth that back pain is usually self-treatable and lab testing and imaging studies are rarely required. A conservative course of time, physical therapy and pain medications are recommended as ways to help.

A search on “acid reflux” gives a concise and easy to-understand definition, along with various levels of treatment, from dietary modifications, elevating the head of the bed, and weight loss to drug therapy with H2 blockers and proton pump inhibitors.

My major criticism here and on the search for back pain is the lack of mention of alarm symptoms. Symptoms such as dysphagia and unplanned weight loss with acid reflux or back pain in connection with persistent fever or history of cancer, are reasons to seek treatment sooner, and not evident on a cursory scan of the results.

Overall, however, the explanations flow in smooth fashion, are easy to navigate, and relay common-sense results backed up with the caveat to “consult a doctor for medical advice” and the disclaimer that “the information you see describes what usually happens with a medical condition, but doesn’t apply to everyone.”

The new Google health algorithm will be a helpful tool for patients seeking basic answers to questions about their symptoms. The information is in some ways overly simplistic, and the advice is not comprehensive, but it’s not meant to be. Hopefully this quick resource will provide sensible tips for initial management of common problems, and save some patients from sleepless nights. 

By Melissa Lucarelli, MD

Initially, when trying out the new health algorithm in the Google app, I was pleased with the well-illustrated and easy-to-understand explanations of common health conditions. Using my iPhone to search for “high blood pressure” resulted in a colorful graphic explaining how to measure blood pressure and an informative summary with clickable tabs about symptoms and treatments and related health conditions. Further down the page were other reference sources that mostly seemed to be from reputable websites (including the American Heart
Association and Mayo Clinic).

The Google app also performed better than its competitors when searching the same topics, resulting in less advertising than Bing and fewer off-topic websites than Yahoo. So after this initial success, I decided to enlist the opinions of a team of experts: my family.

What a difference it makes to change the question you ask! 

Test subject #1: My tech-savvy 40-year-old brother. He downloaded the iPhone app and found absolutely no difference in the quality or reliability of the search results compared to using the Google search engine on his home computer. His search topics were “Enbrel vs. Humira,” “headache from air freshener” and “Prozac for anxiety.” 

To demonstrate the improvements on the app, I suggested that he search instead for more general topics such as psoriasis, migraine or anxiety. After all these queries returned helpful but very basic patient education information, he commented that perhaps the Google app is not intended for people who already know how to use a computer.

Test subject #2: My 17-year-old son. His first search (using his Android phone) was for “rash on legs,” and I was pleased to see that a pop-up appeared with a quote from an article suggesting that atopic dermatitis or contact dermatitis are common causes. Below that were other articles with related conditions like shingles and stasis dermatitis. 

Next, he searched “herpes from a toilet.” Initially, a reassuring pop-up read, “It’s very unlikely that you would get genital herpes from a toilet seat. Genital herpes is a sexually transmitted infection (STI) spread by skin–to–skin contact.” 

Under this were a few helpful websites which my son scrolled over. He clicked on a link to a YouTube video that played an infomercial featuring someone wearing a white coat selling herbal products that supposedly treat herpes. 

The good news is that Google seems to be continuing to improve its health algorithm. When I repeated the herpes search in the app two weeks later, the medically questionable video had been taken down. 

Test subject #3: My 12-year-old daughter. I wasn’t too surprised when the first thing she typed into her Chromebook was “my butt itches.” For this search, the Google app performed wonderfully. It gave a clear definition of pruritis ani (anal itching) along with useful suggestions about hygiene and reasons to call a doctor. 

However, her search for “why am I fat” was-as my kids say-an epic fail. What followed was a series of juvenile self-quizzes and blog sites propagating misinformation and reinforcing many negative stereotypes about obesity. 

Is the Google app’s new health algorithm an improvement over other internet search tools? I think it certainly has potential. The patient education information about common health conditions such as hypertension and asthma was well-written and clear, and higher quality medical sites seem to have been prioritized in health-related searches. 

After comparing the health topic search results with those of other general search tools, I am much more likely to use the Google app in the exam room to illustrate common health conditions at the point of care rather than taking my chances with a random search on another site, including the desktop Google search website, or running out to the filing cabinet to grab a pamphlet or tear-off sheet. 

Apparently, Google plans to update the health algorithm within its standard website search engine soon, but for now, these optimizations are only available as an application on your tablet or phone. The app worked well on all platforms we tested, and the graphics looked good. Based on my family’s user testing, the Google app probably won’t add much benefi t to sophisticated internet users, and our experience reaffirmed to me that 12-year-olds should be encouraged to surf the web only with parental supervision.