Transcription:

Melanie Cole (Host): You know, the internet can be a very helpful resource for finding health information. Of course, there's so much on the internet these days that it can often be difficult to know where to turn, whom to trust, and what to believe. It's really important that you have the right tools to know what sites are best and safest to use. My guest today is Dr. Mufaddal Dahodwala. He's a Primary Care Physician with UCLA Health, and he practices in Santa Clarita. Dr. Dahodwala, I love this topic so much. I'm so excited to have you on today because what we do is disseminate health information on the internet, and I, myself, use these resources for so much of the work that I do. How much do we know about online resources for health? What do we know about the accuracy of online health information? I have a million questions for you on this topic, so let's get started.

Dr. Mufaddal Dahodwala (Guest): Well, thank you so much for having me on. I agree with you. This is a really important issue. We're having more and more patients comes to our office every day armed with information that they gathered from the internet. This is something we talk about a lot with our patients here. The first thing to realize is that not all information is good information, but there is a lot of good information out there. It's really important to know where you're getting your information from, if it's applicable to you, in your specific case, and what to do with it.

Host: I think that's the most important thing is if it's applicable to you and what to do with it. How do we check the online sources? How do we start finding that information knowing we can trust it? So many people put their symptoms in, and right away, they think they've got some horrible cancer. How do we know what to trust and what to put in when we're looking?

Dr. Dahodwala: I think the first thing to do is to make sure that you're looking at a reputable site. Any website that is funded by or associated with a major medical center, whether it be the Cleveland Clinic or the Mayo Clinic, those are usually pretty good websites to get information about certain diseases, certain symptoms that can be associated with those conditions.

You're right; a lot of patients will sometimes just plug in their symptoms. Often times, you'll be misguided into what your symptoms could really be pointing towards. I would say if you could focus your search mostly on peer-reviewed websites, whether that be Medline, or Healthline, or the ones associated with major medical groups like the Cleveland Clinic or the Mayo Clinic, you're much better off.

I have a lot of patients who come in, and we start them on certain medications, and the first thing they want to do is to look up the side effects — which I think is a totally reasonable thing, and one that I do as a user of medications myself — but it's really, really important to know that not all information that you read, even on reputable websites that may be listing known side effects of medications are applicable in your particular case.

For example, I had a patient last week that was started on cholesterol medication. They went home, they looked up a bunch of the side effects from a reputable website that really tracks clinical trial data, and they came in with a list of about 50 different side effects that the medication was associated with, and they were fearful of starting the medication.

I think what's really important to know in general, whether it's related to medications or it's related to anything that's symptom-based, is that correlation is not the same as causation. That's something that's very easily missed on the internet and something as a consumer, you really need to watch out for. What I mean by that is — in this particular patient, for example, he found 50 different side effects — and yes, these are side effects that are known to be associated with the use of this medication — but that doesn't' mean that this mediation has been shown to cause these side effects. They're just correlated with them. I think the bottom line is to gather the information — I'm all about patients getting information on their own. It allows them to be stewards of their own health — but bring that information into your doctor. Go over those sources and where you're getting the information from. Talk about if this is applicable in my case or not.

Host: What a great point that you just made about — that it's the correlation. People may see all those symptoms, but that doesn't mean those are what is caused by that particular medication. When we're looking things up, should we be considering the source? Does it matter if we're reading the news or advertising, and what are some questions that you would like us to ask ourselves when searching out information?

Dr. Dahodwala: The first thing is who is publishing this information? What is the funding source of this site? Often times, when you read websites that claim that Study X has shown these three things about this medication or this condition, you always want to go back and look at the website and say, "Is that source material actually referenced in the article?" Did they site which studies they're talking about? Feel free to go and look up that particular study and make sure that it was adequately and appropriately represented in the article. It's very common for news sites, even reputable media sites — it doesn't matter what end of the spectrum they are, but you have to remember that these news sites are in the business of selling headlines. It worked because they got you to click on the link, right?

You always have to read with a critical eye and see what studies are they actually referencing? Are these studies funded by pharmaceutical companies? Are they funded by the National Institute of Health? Are they funded by the company who is trying to hawk a certain product, or medical device, or a medication? That's really important. You want to make sure you gather that information before you act on the information that you're reading.

A well-sourced website that is truly independent that is giving you accurate information will not hide their sources. They'll tell you exactly what study they're drawing information from. They may provide you with a reference so you can look it up online. I encourage all of my patients to do that, to look up the actual source information and bring that study in. It's really important even when you're assessing a study that you're reading to know if this study is involving five people, 50 people, 50,000 people. Obviously, the more people involved and that are subjects in the study introduces a lot more accuracy and validity in the data as opposed to a case study that involved five people.

Those are details that are not going to be found in the text of the article that you may be reading because that's the nitty-gritty information. It may not produce a beautiful headline that gets people to click on it, but that's really where you can assess whether this information is valid or not.

Host: That's so important. What an interesting topic, isn't this? You went over some really, really great points. So much of what people get today is from social media, Dr. D. Is it safe when you're getting your health information from Facebook or Twitter — because sometimes there is quality information. People share these shows on their social media, and they're quality information. How do we discern what we're seeing on social media versus what we're looking up when we Google our symptoms or side effects?

Dr. Dahodwala: Social media is blowing up these days. People are getting all kinds of information on it. I would say the first thing to remember — any time you read something on social media, whether it is somebody's personal experience with a medication, whether it's somebody's personal story with a particular illness is that in general, not just in medicine, but really in anything, people are more prone to post about negative experiences with medications or conditions rather than positive ones.

In our terms, we call that a publication bias. You really are publishing things online that are made to garner emotion from people, to get clicks. People who have a positive experience from mediations are not as likely to take the time to get on Facebook and write about how great their statin is. People who are having a bad experience with it, whether they're having a rare side effect or they didn't like the way it made them feel, they're much more likely to post about it online.

I would say that's a really important factor to keep in mind. You may be getting a misrepresented sample online of patients' true experiences with the medicine, or the device, or the condition. Now, if there are people that are reposting — whether it be interviews with professionals, or studies online, or independently reviewed articles — those are more reliable sources of information. You can feel much better about that. I think our general rules and guidelines about how to assess information apply in that case also. Make sure it's from an independent site that's independently funded that has adequate source and reference material. And then yes, I think in those cases, social media can be a powerful tool in disseminating information.

I'm on social media. I put out information for patients that I think would be helpful, and I try to make it educational. I try to make it something they can reference and look up their own articles online. I think in terms of personal anecdotes or personal stories about medications or conditions you always got to take it with a grain of salt and just keep in mind that for every one person who is going to be posting a negative experience, there may be a ton more people in this world who are having a positive experience.

Host: I love that you said that. That was funny. People aren't really posting their great experience with a statin, but they sure do get on there and post when something is negative.

What about mobile apps? There are a lot of mobile health apps now. These are ones that can help you find those resources. Listeners, just for my own self, I really like — as Dr. D. said — Healthline. Also, NIH, CDC, those ones are really, really good. American Diabetes Association, American Heart Association. What about some of these apps, Dr. D.? What do we think of those?

Dr. Dahodwala: Some of the apps — as physicians, we use apps every day. The medical training has changed so much now. Before, you really had just to memorize wrote information. Information that you memorized ten years ago was easily outdated. Now, with the way that we are training new physicians, our practice is constantly evolving. We don't have to memorize all of this stuff. We're able to put a lot of that knowledge that we have into these apps and pull from that because that's easily updatable.

Some apps that I use on a pretty regular basis — UpToDate. It's one word. It's a really common resource that a lot of physicians use to — it's constantly updated with clinical trial data and new information that's out there. It's vetted. It's peer-reviewed. It's a reliable source of information. They have an app, and it's a subscription-based kind of thing. They have patient information on there also.

There are apps that you can use for prescription drug information. Another example is something called Epocrates. That is free. Anybody can download that one. That gives you a lot of information about drugs, and dosages, and what have FDA approved indications, what are known side effects — with percentages of people who have experienced these side effects, so you know what's the more common one, what the less common one. That helps a lot.

I think apps are great. You have to have the right app, and you have to know where the information is coming from, but those are two that I like. You're right, the American Heart Association, the American College of Cardiology, they put out a lot more patient-friendly information that helps provide guidelines. It provides ways for you to use the information on a daily basis. Those can be really helpful also.

Host: And before we wrap up, what do you want people to know when they start looking up — even if they're looking up on really quality websites — as a physician, what do you want them to know about when they're looking up the dreaded symptoms? You've got pain in your ear. Oh my gosh, it could be brain cancer. You've got a headache, or you've got a little chest pain. Well, you're having a heart attack. Call 9-1-1. What do you want them to know about looking up those symptoms, and then talking with their doctor about those symptoms, and being honest so they can get an actual diagnosis instead of one online?

Dr. Dahodwala: Right. I think one of the biggest positives of the internet is the ability to disseminate quality information. I tell my patients, "Kudos. For you to get on the internet, be an advocate for your own health, look up your own symptoms, look up what possibilities there are. That's a good thing." I want to empower — in my own practice, I try to empower patients and say, "This is not my body. This is not your neighbor's body. This is your body." If you're not going to take care of your body, who is? Go ahead. Look up information. Be critical of the information that you're reading, and make sure it's a quality source. Then take that information to your physician.

The way I practice — I can't speak for all primary care physicians — but I encourage patients to bring in quality information, and talk about it, and say, "Hey, I found this thing. Does this make sense for my own case? Is this something that's applicable to me?" Take that information to a professional who has been doing it for years and say, "Hey, what do you think about this? Do you think this is something that we could try?"

I have patients who bring me information about new mediations, new trials that are going on that I don't know about. That's great. We learn things together. A lot of times, I have patients who bring in information, and maybe that information is not applicable to that patient, so I put their mind at ease and say don't worry about it. Good job for bringing it in, but that's not something that you need to worry about.

The flip side is also true where patients are bringing in information and opening up our eyes to different things that could be going on here. The bottom line I would say, to answer your question, is great job. Look up your own information. Be a steward of your own health and your own best advocate. That's always encouraged. Don't act on that information immediately without talking about it in your own care with a professional who knows you from a medical standpoint.

Host: What a great way to end it. Dr. D., what a great segment. Absolutely fascinating, and so important for all of us to hear that use the internet for all things health-related. Thank you so much for joining us. That wraps up another episode of It's Your Health Radio with Henry Mayo Newhall Hospital. Head on over to our website at HenryMayo.com for more information and to get connected with one of our providers. If you found this podcast as cool as I did, and really, that is such great information that we all need to hear, please share it with your friends and your family. Share it on social media because that is quality internet health information, and you're getting it right here. Check out all of the other interesting Podcasts in our library. I'm Melanie Cole.