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Ever since I began researching my own medical
problems over the Internet in the mid 1990s, I have always considered the
Internet a friend of the smart consumer who is interested in learning more
about his or her treatment options. But lately, I am not so sure, especially
when the events of the past couple of weeks are considered.
Two recent items curiously involve the conglomerate
GlaxoSmithKline. Last Monday, the company took out a large advertisement in the
Times (and perhaps other papers) promoting its role in making "safer"
meds. The ad was based on Senate hearing testimony and described the rather
tortured process by which investigators from the Food and Drug Administration
tried to track down discount drugs that they ordered over a Web site. The site
claimed to sell cheaper prescription drugs from
Also during this hearing, our Senators
heard from a parent whose 24-year old son died from taking various medications
he received over the Internet (p. 72 of the transcript), and other horror
stories. And as the number of spam messages offering cheaper meds continue to
fill our inboxes with even more come-on offers, clearly something is wrong
here.
Sure, the Internet is a great place to research your
treatment. Or, for the hypochondriacs, your symptoms.
But separating the signal from the noise is getting harder, and the more
information that gets posted on various Web sites makes the process of finding
quality information more difficult. I have found that joining several
discussion groups works best for me: While the people in the group aren't all
doctors, they can give you plenty of advice and places to look, as well as the
right questions to ask your own doctor. And, given that this is the Internet,
members of one of my groups have even invented this acronym: IANADADPOOTV (I am
not a doctor and don't play one on TV). Meaning, your mileage will vary, so
watch your back.
But as I said, the more stuff out there, the more
noise. Glaxo also last week announced that they are
posting all of their clinical drug trials on the Web and have started with
posting the results of one series of diabetes-oriented trials.
Initially, I thought this was a Good
Thing. Now I am not so sure. Try plowing through all the trials listed on the
site now, and it gets tedious pretty fast. The data isn't searchable and even a
professional clinician would need help navigating through all this data. And
this is just for one drug! Other companies have joined in and are posting their
own trials and the federal government and a drug makers' trade association also
have sites to keep track of some trials too. Posting all this data is going to
quickly get out of hand.
The trouble with these clinical trial
sites is that you either don't trust them (what if the company only posts the
favorable trials?) or can't grok them because the
information isn't presented in a form that you can easily parse. For example,
the Glaxo clinical trial data needs a better
presentation and filtering system, so that laypeople and professionals alike
can see which trials are pro and which are con.
We need a filter here, which is what
your friendly physician is supposed to do. And while some docs are
Web-friendly, this isn't something that they have learned in medical school or
even in clinical practice. The best situation is when you can find a doctor who
will take queries from their patients via email. This has become standard
practice for me whenever I am trying to vet a new specialist, but again, is far
from universal. And of course you don't necessarily want to have your doctor do
email diagnosis.
We are all still feeling our way with the
medical Web. Doctors still need to be more comfortable with using email,
patients need better ways to access state-of-the-art treatment information and
background sources, and drug companies need to build a better trust with both
their consumers and their dispensers. In the meantime, be sure to take your
medical info from the Internet with a few grains of skepticism. And do not call
me in the morning.
Entire contents copyright 2004 by David Strom, Inc.
David Strom, dstrom@cmp.com, +1 (516) 562-7151
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