msgbartop
Research Health Information
msgbarbottom

16 nov 11 Moteur de recherche médical : Google est plus forts que les médecins

Google pose un meilleur diagnostic que les médecins?

Le titre est assez étonnant et met en surface un nouveau concurrent des médecins. En réalité, il ne s’agit pas d’un concurrent mais d’un assistant qui va aider les praticiens dans leurs décisions et aussi les aider à informer les patients.

L’histoire du « IPEX » a mis en évidence le rôle que Google (ou les moteurs de recherche médicaux) peut apporter dans le diagnostic médical et pas uniquement dans l’information médicale des patient. La nécessité d’un moteur de recherche médical conçus pour les médecins est née.

L’histoire de l’IPEX :

Cette histoire est publiée dans le journal NEJM(1) sous le titre  « . . . And a Diagnostic Test Was Performed »  ou Robert Greenwald raconte l’histoire d’un patient atteint du l‘IPEX (immunodeficiency, polyendocrinopathy, enteropathy, X-linked). Malgré la consultation de plusieurs praticiens autour de ce cas, aucun concensus n’a été adopté mais il suffisait de taper les points importants du rapport de la biopsie et les test immonologique dans Google et le diagnostic apparait. Après confirmation du diagnostic par des tests génétique, il s’est avéré que Google avait raison!!

 

Voici l’histoire publiée sur le Nejm (1):

« At a recent case conference with a distinguished visiting professor, a fellow in allergy and immunology presented the case of an infant with diarrhea; an unusual rash (“alligator skin”); multiple immunologic abnormalities, including low T-cell function; tissue eosinophilia (of the gastric mucosa) as well as peripheral eosinophilia; and an apparent X-linked genetic pattern (several male relatives died in infancy). The attending physicians and house staff discussed several diagnostic possibilities, but no consensus was reached. Finally, the visiting professor asked the fellow if she had made a diagnosis, and she reported that she had indeed and mentioned a rare syndrome known as IPEX (immunodeficiency, polyendocrinopathy, enteropathy, X-linked). It appeared to fit the case, and everyone seemed satisfied. (Several weeks later, genetic testing on the baby revealed a mutation in the FOXP3 gene, confirming the diagnosis.)

“How did you make that diagnosis?” asked the professor. Came the reply, “Well, I had the skin-biopsy report, and I had a chart of the immunologic tests. So I entered the salient features into Google, and it popped right up.”

“William Osler,” I offered, “must be turning over in his grave. You googled the diagnosis?”

Where does this lead us? Are we physicians no longer needed? Is an observer who can accurately select the findings to be entered in a Google search all we need for a diagnosis to appear, as if by magic? The cases presented at clinicopathological conferences can be solved easily; no longer must the discussant talk at length about the differential diagnosis of fever with bradycardia. Even worse, the Google diagnostician might be linked to an evidence-based medicine database, so a computer could e-mail the prescription to the e-druggist with no human involvement needed. The education of house staff is morphing into computer-search techniques. Surely this is a trend to watch. »

 

  1. Greenwald R …. And a diagnostic test was performed. N Engl J Med2005; 353: 208990.