Saturday, June 23, 2007

Who Is Sick?

Are you ever sick but not enough to bother with a visit to the doc? Do you wonder if you've just caught the bug that is going around? Thanks to an interesting new site, you can now dial up a snapshot of illness over the past two months in your zip code.

Who Is Sick? is a new website where users self-report their symptoms and can see if others have the same thing. I have some sniffles today, so took a first-hand tour of the system. Call up your zip code and you'll see a map with a bunch of little trivial pursuit game pieces. Averages of the reported symptoms and a bar graph of total illness reports in the past two months is also visible.

The default mode is for posting an illness. Users fill in their pies, but instead of Science, Arts or Sports & Leisure, they choose wedges like Fever, Stomach Ache or Cough. I clicked the Runny Nose box, filling in a red wedge. Select your age and gender before reporting more details. I entered, "General malcontent with sniffles. Could be allergies and/or stress & fatigue."

One 40 year old woman claims to have picked
up her "Runny Nose, Stuffy Nose, Sneeze, Cough Sore Throat, Fever, Chills, Muscle Ache, Body Ache, Tired" illness "from a child at the KEXP's annual Father's Day dance party."

The site is inspired by other simple Web 2.0 functions like Craig's List and real estate mapping programs. It is easy to use and has a clever interface. I might use it again, but probably will not stake any personal medical decisions on it. As a future physician, I am not sure if I would rely on hearsay from other providers about what is "going around" more or less than a site like this. If it produced generalized reports for a city, I might give it the benefit of the doubt. Public health experts from Seattle give it mixed reviews.

This site would improve
its utility if users were forced to report a date of symptom onset. Also, the bar graph indicating "# of sicknesses over the last 8 weeks" will be unreliable until some steady state usage is achieved. Right now, it doesn't seem to me that nearly enough people are reporting for there to be a reasonable chance of discovering someone with the same illness. This begs a question: How many different upper respiratory illnesses, stomach flues, influenzas, head colds and other contagious goodies are there out there at any time? Can we really identify a preponderance of particular causative agents based on symptom reports?

And who are the folks registering symptoms? I am going to guess there is a tendency for self-reporters to be slightly more hypochondriac than most. This or any similar skewing of the data is a data collection problem public health officials call reporting bias. I picked from one list at least ten other types of bias.
If this data were to be used in any sort of study or health recommendations, it would have a number of problems. The website authors clearly indicate it is not their intent to use this for public health assessments. From their website,
Who Is Sick was started in 2006 with a mission to provide current and local sickness information to the public - without the hassle of dealing with hospitals or doctors.
There you have it. The motivation behind this site was the hassle of dealing with hospitals or doctors. Ouch!

Instead of tracking stomach aches and head colds, maybe someone should think about reducing the hassle of medicine!


Karen Ventii said...

Great post Thomas.

I have been hearing more and more about this website and honestly, I have often questioned its usefulness.

On a positive note the site may provide useful information for people who need to take extra precautions or plan ahead when it comes to sickness (such as the elderly, immunocompromised individuals or those with young children).

On the other hand, this method of self-reporting one’s symptoms has its own unique set of problems, many of which you touched on. I think the main challenge to making this website as useful as possible will be getting more people to contribute frequently…and honestly.

Pat Washburn, said...

Thanks for your post, Thomas! I've included it in the latest edition of the Medicine 2.0 Blog Carnival.