As any voracious Googler can attest, relying on the wisdom of crowds is a dicey practice, particularly when it comes to medical diagnosis. No matter how strange the query (Will the microwave fry my ovaries? Does this headache signify a brain aneurysm?) there's always a pool of babbling internet trolls dispensing unhelpful advice.
All the same, internet-driven diagnostics have earned newfound cachet in recent years, owing to a few high-profile cases and a broader movement to bring Big Data into medicine. Last year, IBM announced that its supercomputer, Watson, is better at diagnosing cancer than any human doctor. In March, 20,000 social media users petitioned a biotech company to use experimental medication on a dying 7-year-old. Then in July, The New Yorker profiled a young boy with a disease that's new to science; his father sought treatment in the blogosphere.
Meanwhile, a San Francisco startup called CrowdMed is presenting its own alternative system, inviting users to submit queries to an online community of "medical detectives." The detectives — a mix of doctors, nurses, researchers, med students, and laymen — offer recommendations which in turn get vetted and ranked by their peers. It's not a bona fide treatment plan, CrowdMed founder Jared Heyman cautions. But it saves the patient from visiting scores of experts before returning to her doctor.
Heyman speaks from firsthand experience: His sister spent three years with a medical condition that took dozens of doctors and six-figure medical bills to solve. CrowdMed cracked her case in a few weeks, he says.
Yet some medical ethicists, among them University of Southern California law professor Michael Shapiro, aren't entirely persuaded by the company's marketing pitch.
"It's hard to see crowdsourcing as such as the practice of medicine," Shapiro writes via email, with the caveat that people are certainly free to do research, and crowds are free to opine, so long as they don't hold themselves out as licensed professionals. (Most of the site's medical detectives remain anonymous.)
However, he says, if these detectives are indeed presenting themselves as groups of physicians, then they may be opening the door for lawsuits or regulatory snarls. Liability is a sticky thing, and it depends largely on whether the detectives' "solutions" are interpreted as mere hypotheses or actual diagnoses. The latter carries a lot more risk than the former.
Then again, not seeking information is risky, too. And, Shapiro notes, anyone who tries to sue CrowdMed might run into both the First and 14th Amendments, which protect individual liberty and personal security (i.e., the right to protect oneself medically by seeking information). "Free speech poses risks," Shapiro writes, "but squishing it is way worse." Thus, "crowd wisdom" might be better than no wisdom at all.
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