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November 13, 2019

Diagnosis by Social Media

Social media sites like Reddit are being used to “crowd-diagnose” STDs. What does this say about the healthcare system?

Young people, especially those who are worried about STDs and are either too embarrassed to go to the doctor or don’t have access to a doctor or the health insurance to help pay for one, are turning to a new form of diagnosis. It’s not Dr. Google. Instead, it’s other users on the website Reddit.

Reddit is ranked ahead of Amazon and Twitter, with 330 million active users, according to a new study from UC San Diego. Among its offerings are various communities or forums, including an STD page, on which posts have doubled in the last year. This is in line with the fact that the prevalence of STDs is also rising in the U.S., but, the researchers say, the problem is that the number of visitors to STD clinics has not been going up in proportion to the rise in infection and is not as high as it should be statistically.

Since the posters are generally not doctors, their responses weren’t always accurate, which could present serious problems.

The authors wanted to determine how many people were posting requests for crowd-diagnoses of STDs on Reddit’s page, and how many responses they were getting. Of nearly 17,000 total posts, 58 percent of people posting on the STD page requested a crowd-diagnosis. Thirty percent of the posts included a photo. Eighty-seven percent of all crowd-diagnoses requests received a reply, and just under 80 percent were answered in less than a day. “Try getting a doctor's opinion in that time,” said study author, John W. Ayers, in a statement. Many of the requests had multiple replies, and the median time for a first response was three hours.

The authors point out that if this is how many people are posting on the STD page alone, the total number of people posting about all health issues must be much higher. And Reddit is just one of the websites that users may be visiting for this purpose.

“Our case study is especially conservative at estimating how common crowd-diagnoses may be because no one would expect that thousands of people would be willing to share pictures of their symptoms on social media rather than seeing a trained physician,” said study author Eric Leas. “Imagine all the other crowd-diagnoses the public are seeking on Reddit, Twitter and the like for STDs and other conditions.”

Of course, since the posters are generally not doctors, the responses weren’t always accurate, which could present serious problems, particularly since STDs can masquerade as other issues. But it may also say a lot about the state of healthcare today — and how much people want virtual assistance for certain health issues.

“Although crowd-diagnoses have the benefits of anonymity, speed, and multiple opinions, many are wildly inaccurate,” said study author Christopher Longhurst. “By studying crowd-diagnoses broadly we could identify what conditions and what types of information the public is willing to share and build out evidence-based resources to match those needs. Few clinicians would have expected so much unmet demand for remote treatment referral among patients with potential STDs.”

The medical community should listen to the need, the authors say, and think about how they might use social media to connect with all the people who need care.

“It is our responsibility to ensure that the thousands or millions seeking out crowd-diagnoses get help,” said Ayers. “By partnering with social media companies we can combat the spread of misinformation or mis-diagnoses and ensure life-saving help is found. Social media platforms could be improved to facilitate more reliable and actionable crowd-diagnoses. For instance, experts could moderate requests for crowd-diagnoses, resulting in social media being a vehicle to connect the public to professional healthcare.”

The study was published in the Journal of the American Medical Association.

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