We've all heard of crowdfunding, but now crowd-diagnosis (i.e. posters asking people to give or confirm a diagnosis) is becoming increasingly popular on social media platforms.
Many past studies have documented peoples' use of social media to share and request information on various health conditions and diseases. Recent research1, however, has delved into whether people ask for diagnoses on these platforms.
Focussing on sexually transmitted diseases (STDs), a topic of growing public health concern, the researchers attempted to ascertain how often requests for STD diagnoses were made online. Additionally, they examined whether these requests were for a second opinion after receiving a medical diagnosis from a healthcare professional.
Using Reddit, which boasts 330 million users and over 232 health forums, the researchers gathered 16,979 posts on the subject that were made since November 2010 and selected 500 random samples for analysis.
What they found was that in 58% of the posts within their sample, the poster requested a crowd-diagnosis, with 31% of posters including images of the physical signs they were experiencing. Around 20% of these posts sought a crowd-diagnosis to confirm a diagnosis already obtained from a medical professional.
Post questions included things like:
- "Help! What is this? Recently I've developed these bumps on my butt close to my vagina. Usually my skin is very clear. Can anyone assist in identifying this? Is it herpes?!"
- "Is this ingrown hairs or genital warts? I went to the doctor a couple of days back, and he said it's genital warts. I'm shocked because I always use condoms. I recently shaved the areas so could the doctor be wrong and they're just ingrown hairs? Here's a pic. I'd appreciate a second opinion. If it is warts, I may try apple cider vinegar first."
Of all the posts examined, 87% received a reply with an average response rate of 3.04 hours, and 79% were answered within in a day.
While the research is limited in that it only studied a single social media platform and didn't examine the characteristics of those posting and responding, the accuracy of the information posted and diagnoses received, and whether or not the posters actually followed the advice posted, it does give some insight into how people are choosing to address their health concerns in the digital age.
This prompts an exploration of the potential pros and cons of this type of behaviour.
Pros of seeking an STD crowd-diagnoses on social media
STDs are increasingly common, with the World Health Organization estimating that over 1 million sexually transmitted infections (STIs) are acquired each day across the globe2. Still, many feel embarrassed to discuss these openly or to undergo physical medical examinations for symptoms that could be associated with these types of infections.
Creating an anonymous profile or one using a pseudonym affords affected the ability to ask questions about various conditions online while maintaining anonymity and protecting personal privacy.
Rapid Response Rates
As the recent study indicated, most posts received an answer within a few hours. This relatively rapid response rate means that the person asking the question doesn't have to deal with their anxiety over the issue alone for too long.
Social support and comfort in sharing
Humans are inherently social creatures. Social platforms give us a way to connect and share our experiences. When it comes to STDs, knowing that we're not alone and that others have experienced them too may help to derive comfort.
Crowd-diagnoses offer numerous opinions from people across the globe. Getting various insights can help us to assimilate all of the information at hand and draw our conclusions from the majority's consensus.
Cons of seeking an STD crowd-diagnosis on social media
Responders are not always trained, medical professionals
When seeking medical advice or diagnosis on social media, the majority of responders are not trained medical professionals (unless you're specifically visiting a medical page that offers this service). In fact, it's often difficult to ascertain responders' levels of knowledge and experience at all.
Lay people, due to the lack of medical training, can easily make diagnostic mistakes or offer incorrect advice. This is true even if they have experienced a similar situations themselves. The chances of misdiagnosis are high when it comes to STDs, many of which offer almost identical initial presentations of signs and symptoms.
Some responders may not have personally had an STD. In these instances, their answers may be derived from their own beliefs and biases, what they've heard, or cursory Google searches on the subject. This often means that misinformation abounds, giving rise to unnecessary fear and anxiety, or worse, a false sense of security in the original poster. What's more, is that when the advice given is not medically accurate, it could be hazardous to the original poster's health should he or she follow it.
Some of the home remedies offered may also be ineffective in treating STDs. Following this advice delays medical treatment and may lead to severe complications that could have been avoided.
No consideration of medical history
To treat patients effectively, doctors often require a family, personal medical and social history. This information provides doctors with vital clues concerning your health as well as the potential health risks that may be faced future.
STDs often don't cause signs and symptoms. When they do, they can mimic and be mistaken for those experienced with other health conditions. For example, in women, a vaginal yeast infection may cause itching, irritation and a thick white vaginal discharge. Some STIs like herpes and trichomoniasis can cause similar symptoms.
When diagnosing these symptoms, a doctor will take the person's personal medical history into account. He or she will also ask pertinent questions to establish which condition is most likely and which tests to run to either confirm or rule out possible diagnoses. Those giving advice online will generally not have all of the pertinent information at hand or expertise to assist in making an accurate diagnosis.
While the numerous views garnered on social media are often considered a pro, they can also be a con. Facing a myriad of contradictory opinions can lead to confusion that causes unnecessary anxiety, fear and decision-making paralysis. If various home remedies are recommended, this may delay medical treatment as each one is trialled, again, increasing the risk of complication development.
The cons of seeking an STD diagnosis or confirmation of one on social media outweigh the pros in this instance. While STDs are treatable and many are curable, an accurate, timely diagnosis is required to deal with them effectively. Still, this is possible in the virtual world.
What to do when seeking an STD diagnosis or confirmation of diagnosis online?
When it comes to STDs, it is always advisable to visit your doctor or local clinic. These medical professionals are trained to deal with STDs, and with these infections being so common, you will not be the first or last person they see with one.
However, should you'd prefer to manage your diagnosis virtually, instead of posting on social media, you can purchase an STD test online. If you think you know the type of sexually transmitted infection you've contracted, then you can order the applicable test. If you're not sure what it is, you can request an STD panel test that screens for multiple types of infections.
There are generally two options when it comes to this type of STD testing:
- An at-home STD test kit is purchaed online. Once received via the post or courier, you follow the detailed instructions, take the required samples, package these and send them back. Quick, easy and anonymous.
- An STD test is ordered and all of the paperwork is completed online. You then report to one of the providers testing clinics to have the samples taken. While you still have to appear in person, your privacy is 100% guaranteed. No paperwork is handled on site, and the clinical staff present will not know what you're being tested for.
Both options generally offer a telephonic or online doctor's consultation to discuss the results and provide follow-up consultation and a medication prescription if necessary. This may be included in the initial cost of the test or offered as an add-on service at an additional cost. Either way, these types of services are the best way to use online services to diagnose and treat or manage any STDs you may have picked up with complete privacy.
Sexual health is extremely important. Ignoring signs or symptoms of sexually transmitted infections or having them misdiagnosed and incorrectly treated as a result can lead to serious health complications. These can range from eye infections to chronic pain conditions3 pregnancy complications and infertility4, heart disease5,6 and even cancer7,8. As such, time is of the essence. It's best to obtain a diagnosis or even get a second opinion or confirmation on a diagnosis by a trained medical professional using scientifically based screening methods to ensure the preservation of your long-term health and wellness.
1. Nobles A, Leas E, Althouse B et al. Requests for Diagnoses of Sexually Transmitted Diseases on a Social Media Platform. JAMA. 2019;322(17):1712. doi:1001/jama.2019.14390
2. Sexually transmitted infections (STIs). Who.int. https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis). Accessed November 6, 2019.
3. Workowski K, Bolan G. Sexually Transmitted Diseases Treatment Guidelines, 2015. Cdc.gov. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6403a1.htm. Published 2015. Accessed November 6, 2019.
4. Low N, Broutet N. Sexually transmitted infections—Research priorities for new challenges. PLoS Med. 2017;14(12):e1002481. doi:1371/journal.pmed.1002481
5. Vachiat A, McCutcheon K, Tsabedze N, Zachariah D, Manga P. HIV and Ischemic Heart Disease. J Am Coll Cardiol. 2017;69(1):73-82. doi:1016/j.jacc.2016.09.979
6. Four curable sexually transmitted infections still affect millions worldwide. https://www.who.int/. https://www.who.int/reproductivehealth/curable-stis/en/. Published 2019. Accessed November 6, 2019.
7. Coyne-Beasley T, Hochwalt B. Protecting Women Against Human Papillomavirus: Benefits, Barriers, and Evidence-Based Strategies to Increase Vaccine Uptake. N C Med J. 2016;77(6):402-405. doi:18043/ncm.77.6.402
8. Fortner R, Terry K, Bender N et al. Sexually transmitted infections and risk of epithelial ovarian cancer: results from the Nurses’ Health Studies. Br J Cancer. 2019;120(8):855-860. doi:1038/s41416-019-0422-9