A better question might be: Why is the private sector responsible for providing accurate health information? As this article shows, the incentives for people running medical websites and the people reading them are not aligned. I'd say the UK NHS website and symptoms/medications pages hit the nail on the head - https://www.nhs.uk/conditions/. It has no advertising and provides short, easily readable and actionable information on the majority of conditions and the correct way to use and take many different sorts of medication.
And crucially - if the information present is not sufficient, clear and obvious UI elements that direct the next best steps to get the help you need, whether that be ringing the non emergency helpline or immediately going to A&E. (It's been commented on before, but the new UK government sites are very consistently structured and open source their design systems https://service-manual.nhs.uk/design-system)
That's a nice page, and I'll definitely bookmark that one. But I don't see most of the public using something like that over WebMD.
WebMD is complete trash (I even block it in my Kagi search preferences), but it succeeds over sites like the NHS one because of blog SEO. WebMD is really a glorified blog with posts about every condition you might get paranoid over. I don't know how precisely they achieve this, but they're doing something right in an SEO sense if The Google continues to put them near the top of results after all these years.
Meanwhile, there are also sites like Merck Manuals, which is both a terrific resource and privately run, but I don't recall ever seeing it coming up for a search query like "what is that bump on the side of my neck."
The resources are out there. Whether The Google thinks the average person should read them is a different story. I don't believe The Google is going to ever filter out WebMD, so there must be a middle ground where sites like the ones you and I mentioned find a way to make themselves more WebMD-like without sacrificing their more academically-minded content they already have.
A fairly straightforward answer is that the government's goals are not necessarily aligned with your own. You, presumably, care very much about your own personal health. You also care about other people's health, but you really, really care about your own health, and probably don't want to die earlier than you need to.
The government, on the other hand, doesn't generally care about individuals, and is working on a statistical level. A good government wants the population overall to be in good health, and has a budget within which it must operate. It may make more sense for the government to ignore your rare disease if detection/treatment is expensive, and that money can be better used to save, say, 10 people with a more common disease.
Now, if the government was just providing health information, and individuals were on the hook for payment, this disconnect wouldn't really exist. But if the government is also providing the healthcare services "for free" to individuals, then there is an incentive to downplay testing for rare or expensive to treat diseases due to the cost/benefit ratio.
I think the issue isn't data, its the "packaging". Going through the NHS website, it's useful if you already know what you have. I'll use myself as an example because I had an ingrown hair on my neck a few weeks back, went on google and I didn't search for "Ingrown Hair" because at that stage, I didn't know that it was an ingrown hair. I searched for "bumps on your neck" which led me to conclude that it was an ingrown hair (followed by a doc telling me the same thing).
One idea I've had for a long time is the US Gov't (and all major governments) should have a large data gathering/distribution operation. This data would be things like medical research, and other data that would be in "the public interest" (basically all the data we have now, just in one place), everything from meeting notes, congressional bills, etc.
With a wealth of data from a single source, companies like WebMD could stop focusing on how to get the data, and shift their focus to how to "package" the data. A list of conditions with symptoms is nice, but lets repackage that into a "medical graph" that lets you explore related conditions through symptoms. Companies could then compete on the "packaging". You could go to FreeMD and get the same data as you could on WebMD, but WebMD has a much better search engine for X thing so they are worth the $4.99/month cost.
It would be expensive, and probably be a decade long multi billion dollar operation. But imagine the revolution in government services if there was a single source of truth for data.
There are arguments against this, mainly do you want a government to have that much power. But I think it could be done with some strict limits and checks. Data in this API would only be public government data, so IRS data and other private information is not on there.
One issue with the NHS is that I get the impression the information they publish that strongly respects their goals and desires perhaps to the detriment of patients sometimes.
I’ve certainly noticed in the past big differences in advice. The NHS will downplay and not suggest investigations whereas another (non UK) site does the opposite.
The NHS advice surely is carefully crafted not to cause unnecessary (from their point of view) GP visits, tests etc.
To extend this a bit, the ultimate solution is a quasi-government nonprofit organization along the lines of ICANN (or maybe part of ICANN) that operates a crawler and a database of crawled sites, plus an API for that data.
This would not be a search engine per se but a neutral backend that anybody could build a search engine on top of. Want to build a search engine and sell ads? Fine. Want to build a search engine specializing in health information subsidized by the drug companies? Fine. Want to build one as a neutral nonprofit and charge subscriptions? Fine. The same backend database works for them all. Even Google could build a frontend on top of it.
Yes it would be expensive. The government would have to pay for all the backend infrastructure (whether the government buys it or rents it from Amazon, Google, Microsoft, etc.), and Cloudflare and robots.txt would have to allow "icanncrawler" to access sites without friction. But it would finally allow the creation of neutral search engines not beholden to advertisers. It's a piece of infrastructure the modern Internet sorely needs.
In the US, the CDC has been really bad at providing health information, and the FDA has been really bad at providing food safety info. They also don’t have incentive alignment (incentives are mostly to grow the bureaucracy and serve careers).
I’d expect private enterprise to eventually converge on better info… eventually consumers will choose services that provide the best info amidst competition.
Check out the National Library of Medicine’s MedlinePlus resource for an equivalent to the NHS’s consumer-oriented health info portal: https://medlineplus.gov/
The phenomenon they describe for health information is, IMHO, absolutely rife across many different domains. Try looking up information about gardening, plant management, home improvement, etc - you'll find the same thing. Search results dominated by sites that have mastered the art of producing SEO-optimised "content" that is not authoritative, full of waffle, and not especially helpful.
For whatever reason, the business model of "draw a huge amount of traffic" outcompetes the business model of "provide a really good source of information".
It's interesting to ponder why in very specific domains, that's not the case: for instance, StackOverflow dominates in programming queries, and provides very useful content.
Someone much smarter than me should write a really good blog post about this.
Because StackOverflow successfully (for some value of success) transitioned the forum model to the modern web.
We had these "really good sources of information" - we had forums dedicated to almost any topic you could want to know about, and people educated in the area would frequent them.
They've almost all died out - some remain as a mostly static reference (which is incredibly useful!), others continue to plod along. A few subreddits pop up now and then, but it's not really the same thing (subreddits are even more prone to "flooding" from outside "contributors" who end up turning it into a meme-reddit).
If a company is tangentially related to a topic, you can do worse than dedicating a few full-time employees to a forum on that topic. We're posting on one right now!
Another somewhat successful area: Very specific task based home maintenance instructional videos on youtube.
I'm not sure why but if I look up specific tasks I do find what seem like capable handy man / plumbers or similar folks with good quality advice.
Medical stuff.... oh gawd almost no chance of good advice there. But maybe that's because the range of "hey we don't know" or "it's complicated" that you're going to get from honest folks when it comes to the medical world, and most folks gravitate towards solid answers that hucksters love to give.
Hucksters might find it hard to monetize "how to cut down a small tree", while "cold remedies" are prime grounds for them.
I have noticed this on YouTube as well, I would assume something similar is happening on other video sites.
Sometimes there is a video on a trending topic among the first few Google search results, and when you go over to YouTube and have a look it turns out to be a montage of stock and/or stolen photos, with a synthesized voice reading a narration that was obviously churned out by a content mill somewhere very low-wage, if not generated by "AI."
It baffles me that Google ranks these things highly, it's not like they don't have an eye on YouTube activity.
In the end I have no better explanation than institutional rot: so much money is flowing in, and engineering incentives are so perverse, any problem that doesn't directly irritate the cash cow is not gonna get fixed.
I believe you don't have this problem with stackoverflow because it's user generated content. Answers provided by people doing it out of passion are usually better. That's why you'll often find the best answers on Reddit.
As to why there is no successful medical overflow.com: Software developers are inherently more web-affine and likely to help there. On top of that it's a great way for developers to show their knowledge in a way they can show to prospective employers. The medical field is a lot more old-school sand I cannot imagine a doctor showing their online help history to a potential employer.
> Try looking up information about gardening, plant management, home improvement
I found a particularly egregious offender the other day.. the #2 result for "best cordless screwdriver" is one of those content farms that made a "Best of 2022" article. Their top recommendation in 2022 is an old NiCad one that was discontinued in 2015!
Tragedy of the Commons. We all could use easily accessible, accurate and unbiased medical information, but most people can't or won't pay a website to procure and publish such content, especially when they don't really know if they can trust the site! It's rather circular.
If only there were some association of all people, some kind of organization that included all members of the public, which could collect a nominal fee for common goods and services and then provide them freely after the fact. Some sort of union that governs what goods and services are provided...
This seems like a side effect of centralized power in general. You see it at amazon too which is full of either subpar goods or counterfeit products[1]. It becomes a game of manipulating these companies into showing your product/good/service, and only part of winning that game is producing a quality product
I think it's because professionals and expert users know what good content looks like, which feeds back into the algorithm. The average gardener using the web (not books or other local knowledge) for advice doesn't.
Google says "democracy on the web works" which means that what wins is what looks good to the average person among the population who uses that search term.
A better WebMD already exists, and it’s called UpToDate. It’s target audience is doctors, but you can pay ~$20 for a week as a consumer (you can pay less per week for longer also). It’s a great resource, and has a summary of the most recent consensus view on common medical topics. It doesn’t expand pages out with fluff or talk down to you, though it won’t have too much info about assumed medical fundamentals. You can pull the citations and look up the references.
Reading it makes your appreciate why WebMD exists. Not everyone wants to read highly technical medical jargon and read medical papers. But the HN audience probably has a lot of folks that are down to do that, and I strongly recommend UpToDate for those that do. I use almost every time I have a substantial new issue that requires a physician visit.
I can give a nice example of how some of UpToDate’s information is compiled, and why its so high quality.
I built a new diagnostic test that replaced and upgraded upon one that had previously been discontinued. After building it a clinician who is a top expert on that specific diagnostic reached out since he was responsible for the relevant up to date page. We had a knowledgeable discussion and they gained a full understanding of the diagnostic I had built. After that they wrote up a new and high quality UpToDate piece describing the new diagnostic and its clinical usefulness. Overall it felt like a very effective process, and one that happened pretty early on in the life cycle of the new product.
Sure this article is spammy self-promotion, but their prototype is exciting. I’d use it. It’s frustrating to go to a drugstore and see medicines for a cough, let’s say, each with a different active ingredient, and be unable to find concrete information comparing the effectiveness of each ingredient.
And wow, the WebMD article they mentioned on essential oils was terrible. It really lowers my opinion of WebMD. At this point I get more helpful information about medicines from Reddit.
I just read the essential oils article and it doesn’t seem that bad? They recommend lavender for sleep, aromatherapy for stress reduction and tea tree oils for foot fungus. It’s not great, but as far as trying to be objective goes, it’s not like they’re arguing it cures cancer. They could, as I think is covered more generally provide more data, but while I don’t think we should swallow “alternative therapies” whole hog, I don’t think we should be biased against them just because they sound woo-ey. The evidence should speak for itself. what was your specific beef with the essential oils article(as compared to other WebMD articles)
Also interesting he contrasted it with Aspirin, because ironically, I don’t think pain killers have all that much power when studied against placebo.(heart benefits notwithstanding)
Isn't that what the pharmacist is for? Pharmacies sell some dumb stuff, but if you actually ask for advice from the person with a license they'd like to keep, you should get some straight talk I'd think.
Examine.com is the closest analogue to what this site is trying to do, and as far as I know, it works. It takes a while, but if people develop trust in a product or website they value that deeply, and are even willing to throw money at it. I don't even consider trying to google a supplement; I'll just go to examine and look at the body of evidence, recommended dosages, etc. I've paid for Examine and I would pay for this.
Here's my point of feedback / wishlist item / thing I think is missing from the world. Examine is focused on supplements, which I don't actually care that much about. If my question is "How do I lower my fasting blood glucose", I don't want a list of what supplements help with that, I want a list of everything that helps with that. If daily cardio is 100X as effective as green tea catechins then IDGAF about green tea. Examine broadened a bit, but it's still very supplement focused, which can give the false impression that some supplement is the best way to approach some condition.
Going by the long covid example, it sounds like this glacierMD takes the broader focus of "here's all the things", which I absolutely love. And there could be a lot of value in that alone. But what I really feel is missing from the world is a comprehensive, salutogenic look at health. Yes I want to know what the best treatments are for long covid. But what I also really want to know is what is the rank ordered list of things I can do to develop and maintain a strong immune system. Or how do I lower my resting heart rate. What even is the optimal fasting blood glucose for that matter? Any searching you do will just tell you "above 100 mg/dL is prediabetic, 99 and below you're perfectly healthy".
Anyway, I love the demo. The author is correct that it is missing from the world. And I 100% think people would pay for it once it grows enough. I do just hope that it isn't purely build around a pathogenic way of thinking, like just about everything else in the medical world seems to be.
An interesting example: a few months ago I dropped something on my toenail and it turned black.
Wading through WebMD etc (which is where google was sending me) was not helpful, especially in between the popups and autoplay videos
I finally restricted my search to wikipedia and quickly found out that it's called 'subungual hematoma' and "usually self-resolving", which is what I needed to know.
Recently I tried this query on GPT-3 and it worked well too:
Prompt: Something fell on my nail and it turned black
GPT: Possible causes for a black nail include: trauma to the nail, a melanoma, or a subungual hematoma (a collection of blood under the nail). If the black nail is accompanied by pain, swelling, or redness, seek medical attention. If the black nail is not painful and has no other symptoms, it is likely a subungual hematoma and will eventually grow out with the nail.
There is an excellent version of WebMD called UpToDate.
The primary audience is physicians / clinicians, and they make money by selling subscriptions. So not a consumer health product, but an example of what the gold standard in this space looks like.
> Why can't I see the percent of people who experience a particular side effect?
Is that a US thing? Because I’m looking at the small-print paper thingie that came (has to come) with a moderately dramatic prescription drug, and it has:
“Side effects:
very frequent ( ≥ 10%): ...
frequent ( ≥ 1% and < 10%): ...
infrequent ( ≥ 0.1% and < 1%): ...
rare ( ≥ 0.01% and < 0.1%): ...
very rare ( < 0.01%): ...
The following side effects were observed after this drug was released to market. The incidence rate is considered to be unknown, as it cannot be estimated from the available data.
...”
(This seems especially weird because I expect most of the data to have come from FDA submissions.)
If only there was a profession where knowledge, experience and continuous development are used to provide advice and care for individuals who may not have specialised in that same area of expertise. </s>
So to summarize: a good version of WebMD would have:
* structured, quantitative information
* real-time updates
* summaries of supporting evidence
So why hasn't anyone done this yet?
They have: https://www.clinicalkey.com/ However, it's for professionals, and it's not free. Only a professional has the knowledge, experience and context to use the information properly. For patients there are separate products/resources that clinicians can use to give patients more information about their case. But the patient can't just diagnose themselves. And certainly the effort of curating the dataset and developing the toolkit to power it isn't free.
Goes without saying, but "Don't google your symptoms." has been an unwritten law of the Internet since Google first became the dominant search engine. WebMD and its knockoffs have been hot garbage for quite some time now.
Disclaimer, I am the founder of Wyndly (YCW21) -- we fix allergies for life through telehealth and personalized immunotherapy.
WebMD, Healthline, and Verywell Health all monetize off of views. They're exceptional SEO operators, and they know how to game Google. The trick is to find people who aren't monetizing off of just views.
Actually helpful information is coming from services that don't monetize off of views, or where the content is written for more than just SEO. For example, Anja Health is educating people about a novel idea (https://www.tiktok.com/@kathrynanja). At Wyndly, we build trust with our content by having my co-founder answer common questions (https://www.instagram.com/wyndlyhealth/).
These are experts sharing their niche. In fact, we source the questions we answer from our support inbox. So, not only are we putting useful information our into the world, we're creating resources for our support team. It's a win-win.
I worked for a company that tried to do exactly what this article is proposing, I was responsible for parsing the data from publications into exactly this sort of table.
The primary reason is that it is very hard to come up with a schema that even 5% of papers would adhere to. The vast majority of this knowledge is phrased as natural language.
There are databases that track compounds and the publications related to them, but those papers again are natural language and cannot be readily converted to tabular data. Our first basic approach involved POS tagging and then trying to associate proper nouns with numeric values. Again the issue became how do you interpret a sentence like "may lead to sudden death" as a symptom? Something like "may lead to symptom X in Y% of respondents" is a nightmare to consistently parse without heavy ML running over huge datasets of just text.
In the end we wound up having to shut down concluding that until papers are released with not only arbitrary XML tables/results we were not equipped to handle the task. And even worse, what if our models didn't interpret things correctly and a consumer got {symptom:"sudden death", chance:0%} and insisted on that compound for their indication only to later realize the paper stated "in lab setting 0% of animals didn't experience sudden death after being administered X after diabetes diagnosis". Paying a hundred students to work around the clock couldn't get the volume processed accurately for months, let alone getting a second army of validators to confirm each entry.
WebMD is "awful" because a list of every medical condition with every possible treatment and every possible symptom is totally useless to normal people. When people visit WebMD what they really want is actual, personal medical advice.
The solution isn't throwing technology at it to do "automated evidence synthesis," it's making it easier and more affordable for people to talk to get a consultation with an actual medical professional.
I always figured it was due to liability. WebMD wants the monetizable traffic but not the liability of ya know, providing health care. So they profit off of the user's duress and just recommend they see a health care professional anyhow.
It clearly explained what it was, why it may have benefits, what a few experts say, risks, etc.
There are ads but barely (for now) - on a recent article on mobile, it's one small banner, and then one in-line ad that doesn't even look like one. It's not a barely-readable dumpster fire like WedMD.
Of course, all roads lead to Rome, so at some point Healthline may look like a dumpster fire as well, so enjoy it while we can!
Someone already mentioned the NHS website, but also the Mayo Clinic's is great [2]. We have a great one run by the Swedish state too [3]. I think the article is wrong that "we accept" them though, they've just SEO spammed themselves over anything that actually is useful. It's not like we vote on search results (yet.) NHS, Mayo Clinic or others that must exist would be top if these assholes didn't scam their way in.
WebMD is for the general public (GP) and useless on anything you need in depth - helpful for broad inquiry. UpToDate which practitioners use is amazing but too much information for the general public.
It's part of what I mentioned in another comment which is that the internet is to general and vague in its information (and generally low-mid quality) while private information is, sometimes, of higher quality. It leads people who want to learn more about things in a bind where they are limited by the accessibility to good quality information.
Also you don't want the GP to have access to uptodate because they would self diagnose in so many of the wrong ways and wouldn't understand everything.
GP is quite a confusing initialism to use here as GP often means "general practitioner", which is like a family doctor/primary care physician in much of the anglosphere outside of the US.
Medscape is what WebMD should be. It targets health professionals but it's a great resource for independent learners.
There are great summaries for every disease and treatment written by doctors and researchers. Summary includes epidemiology, symptoms, causes, prognosis, possible treatments, novel treatments, differential diagnoses, etc.
Given that there are bad professionals in every area, it's a great resource to evaluate if your doctor's diagnosis and suggestions make sense.
Unlike your local doctors, good online resources don't have financial incentive to recommend unnecessary drugs or surgeries where the risks outweigh the benefits.
[+] [-] jjar|3 years ago|reply
And crucially - if the information present is not sufficient, clear and obvious UI elements that direct the next best steps to get the help you need, whether that be ringing the non emergency helpline or immediately going to A&E. (It's been commented on before, but the new UK government sites are very consistently structured and open source their design systems https://service-manual.nhs.uk/design-system)
[+] [-] ravenstine|3 years ago|reply
WebMD is complete trash (I even block it in my Kagi search preferences), but it succeeds over sites like the NHS one because of blog SEO. WebMD is really a glorified blog with posts about every condition you might get paranoid over. I don't know how precisely they achieve this, but they're doing something right in an SEO sense if The Google continues to put them near the top of results after all these years.
Meanwhile, there are also sites like Merck Manuals, which is both a terrific resource and privately run, but I don't recall ever seeing it coming up for a search query like "what is that bump on the side of my neck."
https://www.merckmanuals.com/
The resources are out there. Whether The Google thinks the average person should read them is a different story. I don't believe The Google is going to ever filter out WebMD, so there must be a middle ground where sites like the ones you and I mentioned find a way to make themselves more WebMD-like without sacrificing their more academically-minded content they already have.
[+] [-] googlryas|3 years ago|reply
The government, on the other hand, doesn't generally care about individuals, and is working on a statistical level. A good government wants the population overall to be in good health, and has a budget within which it must operate. It may make more sense for the government to ignore your rare disease if detection/treatment is expensive, and that money can be better used to save, say, 10 people with a more common disease.
Now, if the government was just providing health information, and individuals were on the hook for payment, this disconnect wouldn't really exist. But if the government is also providing the healthcare services "for free" to individuals, then there is an incentive to downplay testing for rare or expensive to treat diseases due to the cost/benefit ratio.
[+] [-] _fat_santa|3 years ago|reply
One idea I've had for a long time is the US Gov't (and all major governments) should have a large data gathering/distribution operation. This data would be things like medical research, and other data that would be in "the public interest" (basically all the data we have now, just in one place), everything from meeting notes, congressional bills, etc.
With a wealth of data from a single source, companies like WebMD could stop focusing on how to get the data, and shift their focus to how to "package" the data. A list of conditions with symptoms is nice, but lets repackage that into a "medical graph" that lets you explore related conditions through symptoms. Companies could then compete on the "packaging". You could go to FreeMD and get the same data as you could on WebMD, but WebMD has a much better search engine for X thing so they are worth the $4.99/month cost.
It would be expensive, and probably be a decade long multi billion dollar operation. But imagine the revolution in government services if there was a single source of truth for data.
There are arguments against this, mainly do you want a government to have that much power. But I think it could be done with some strict limits and checks. Data in this API would only be public government data, so IRS data and other private information is not on there.
[+] [-] switch007|3 years ago|reply
I’ve certainly noticed in the past big differences in advice. The NHS will downplay and not suggest investigations whereas another (non UK) site does the opposite.
The NHS advice surely is carefully crafted not to cause unnecessary (from their point of view) GP visits, tests etc.
[+] [-] dreamcompiler|3 years ago|reply
This would not be a search engine per se but a neutral backend that anybody could build a search engine on top of. Want to build a search engine and sell ads? Fine. Want to build a search engine specializing in health information subsidized by the drug companies? Fine. Want to build one as a neutral nonprofit and charge subscriptions? Fine. The same backend database works for them all. Even Google could build a frontend on top of it.
Yes it would be expensive. The government would have to pay for all the backend infrastructure (whether the government buys it or rents it from Amazon, Google, Microsoft, etc.), and Cloudflare and robots.txt would have to allow "icanncrawler" to access sites without friction. But it would finally allow the creation of neutral search engines not beholden to advertisers. It's a piece of infrastructure the modern Internet sorely needs.
[+] [-] alistairSH|3 years ago|reply
Still not perfect, but I've found it more useful than WebMD.
[+] [-] andrewljohnson|3 years ago|reply
I’d expect private enterprise to eventually converge on better info… eventually consumers will choose services that provide the best info amidst competition.
[+] [-] stevenbedrick|3 years ago|reply
It’s a fabulous and under-utilized resource!
[+] [-] stevage|3 years ago|reply
For whatever reason, the business model of "draw a huge amount of traffic" outcompetes the business model of "provide a really good source of information".
It's interesting to ponder why in very specific domains, that's not the case: for instance, StackOverflow dominates in programming queries, and provides very useful content.
Someone much smarter than me should write a really good blog post about this.
[+] [-] bombcar|3 years ago|reply
We had these "really good sources of information" - we had forums dedicated to almost any topic you could want to know about, and people educated in the area would frequent them.
They've almost all died out - some remain as a mostly static reference (which is incredibly useful!), others continue to plod along. A few subreddits pop up now and then, but it's not really the same thing (subreddits are even more prone to "flooding" from outside "contributors" who end up turning it into a meme-reddit).
If a company is tangentially related to a topic, you can do worse than dedicating a few full-time employees to a forum on that topic. We're posting on one right now!
[+] [-] duxup|3 years ago|reply
I'm not sure why but if I look up specific tasks I do find what seem like capable handy man / plumbers or similar folks with good quality advice.
Medical stuff.... oh gawd almost no chance of good advice there. But maybe that's because the range of "hey we don't know" or "it's complicated" that you're going to get from honest folks when it comes to the medical world, and most folks gravitate towards solid answers that hucksters love to give.
Hucksters might find it hard to monetize "how to cut down a small tree", while "cold remedies" are prime grounds for them.
[+] [-] biztos|3 years ago|reply
Sometimes there is a video on a trending topic among the first few Google search results, and when you go over to YouTube and have a look it turns out to be a montage of stock and/or stolen photos, with a synthesized voice reading a narration that was obviously churned out by a content mill somewhere very low-wage, if not generated by "AI."
It baffles me that Google ranks these things highly, it's not like they don't have an eye on YouTube activity.
In the end I have no better explanation than institutional rot: so much money is flowing in, and engineering incentives are so perverse, any problem that doesn't directly irritate the cash cow is not gonna get fixed.
[+] [-] ajmurmann|3 years ago|reply
As to why there is no successful medical overflow.com: Software developers are inherently more web-affine and likely to help there. On top of that it's a great way for developers to show their knowledge in a way they can show to prospective employers. The medical field is a lot more old-school sand I cannot imagine a doctor showing their online help history to a potential employer.
[+] [-] cyral|3 years ago|reply
I found a particularly egregious offender the other day.. the #2 result for "best cordless screwdriver" is one of those content farms that made a "Best of 2022" article. Their top recommendation in 2022 is an old NiCad one that was discontinued in 2015!
[+] [-] unethical_ban|3 years ago|reply
If only there were some association of all people, some kind of organization that included all members of the public, which could collect a nominal fee for common goods and services and then provide them freely after the fact. Some sort of union that governs what goods and services are provided...
[+] [-] tern|3 years ago|reply
It's quite interesting to ponder the implications of this.
[+] [-] SV_BubbleTime|3 years ago|reply
First hit was SEO garbage that started off “Before we explain the steps, let’s first examine what the proper stoichiometric ratio is!”
… I closed that site while grinding my teeth.
The internet kinda sucks now.
[+] [-] jvans|3 years ago|reply
[1] https://davidgaughran.com/amazon-has-a-fake-book-problem/
[+] [-] lupire|3 years ago|reply
Google says "democracy on the web works" which means that what wins is what looks good to the average person among the population who uses that search term.
[+] [-] savanaly|3 years ago|reply
[+] [-] strstr|3 years ago|reply
Reading it makes your appreciate why WebMD exists. Not everyone wants to read highly technical medical jargon and read medical papers. But the HN audience probably has a lot of folks that are down to do that, and I strongly recommend UpToDate for those that do. I use almost every time I have a substantial new issue that requires a physician visit.
[+] [-] blandry|3 years ago|reply
I built a new diagnostic test that replaced and upgraded upon one that had previously been discontinued. After building it a clinician who is a top expert on that specific diagnostic reached out since he was responsible for the relevant up to date page. We had a knowledgeable discussion and they gained a full understanding of the diagnostic I had built. After that they wrote up a new and high quality UpToDate piece describing the new diagnostic and its clinical usefulness. Overall it felt like a very effective process, and one that happened pretty early on in the life cycle of the new product.
[+] [-] kwertyoowiyop|3 years ago|reply
And wow, the WebMD article they mentioned on essential oils was terrible. It really lowers my opinion of WebMD. At this point I get more helpful information about medicines from Reddit.
[+] [-] mikkergp|3 years ago|reply
Also interesting he contrasted it with Aspirin, because ironically, I don’t think pain killers have all that much power when studied against placebo.(heart benefits notwithstanding)
For example: https://pubmed.ncbi.nlm.nih.gov/19673707/
[+] [-] thomasfedb|3 years ago|reply
[+] [-] culi|3 years ago|reply
[+] [-] mikenew|3 years ago|reply
Here's my point of feedback / wishlist item / thing I think is missing from the world. Examine is focused on supplements, which I don't actually care that much about. If my question is "How do I lower my fasting blood glucose", I don't want a list of what supplements help with that, I want a list of everything that helps with that. If daily cardio is 100X as effective as green tea catechins then IDGAF about green tea. Examine broadened a bit, but it's still very supplement focused, which can give the false impression that some supplement is the best way to approach some condition.
Going by the long covid example, it sounds like this glacierMD takes the broader focus of "here's all the things", which I absolutely love. And there could be a lot of value in that alone. But what I really feel is missing from the world is a comprehensive, salutogenic look at health. Yes I want to know what the best treatments are for long covid. But what I also really want to know is what is the rank ordered list of things I can do to develop and maintain a strong immune system. Or how do I lower my resting heart rate. What even is the optimal fasting blood glucose for that matter? Any searching you do will just tell you "above 100 mg/dL is prediabetic, 99 and below you're perfectly healthy".
Anyway, I love the demo. The author is correct that it is missing from the world. And I 100% think people would pay for it once it grows enough. I do just hope that it isn't purely build around a pathogenic way of thinking, like just about everything else in the medical world seems to be.
[+] [-] AhmedF|3 years ago|reply
That's exactly what we're doing!
We released version 2 of Examine less than two weeks ago. Here's a page on how to use: https://examine.com/how-to-use/
It's still early, but the entire goal is to break down research on conditions and goals, and where they connect, relate them to interventions.
Any questions, happy to answer them.
[+] [-] bradhilton|3 years ago|reply
[+] [-] firasd|3 years ago|reply
Wading through WebMD etc (which is where google was sending me) was not helpful, especially in between the popups and autoplay videos
I finally restricted my search to wikipedia and quickly found out that it's called 'subungual hematoma' and "usually self-resolving", which is what I needed to know.
Recently I tried this query on GPT-3 and it worked well too:
Prompt: Something fell on my nail and it turned black
GPT: Possible causes for a black nail include: trauma to the nail, a melanoma, or a subungual hematoma (a collection of blood under the nail). If the black nail is accompanied by pain, swelling, or redness, seek medical attention. If the black nail is not painful and has no other symptoms, it is likely a subungual hematoma and will eventually grow out with the nail.
[+] [-] pfisherman|3 years ago|reply
The primary audience is physicians / clinicians, and they make money by selling subscriptions. So not a consumer health product, but an example of what the gold standard in this space looks like.
[+] [-] quickthrower2|3 years ago|reply
[+] [-] mananaysiempre|3 years ago|reply
Is that a US thing? Because I’m looking at the small-print paper thingie that came (has to come) with a moderately dramatic prescription drug, and it has:
“Side effects:
very frequent ( ≥ 10%): ...
frequent ( ≥ 1% and < 10%): ...
infrequent ( ≥ 0.1% and < 1%): ...
rare ( ≥ 0.01% and < 0.1%): ...
very rare ( < 0.01%): ...
The following side effects were observed after this drug was released to market. The incidence rate is considered to be unknown, as it cannot be estimated from the available data.
...”
(This seems especially weird because I expect most of the data to have come from FDA submissions.)
[+] [-] pwinnski|3 years ago|reply
[+] [-] Vecr|3 years ago|reply
[+] [-] oneplane|3 years ago|reply
[+] [-] 0xbadcafebee|3 years ago|reply
[+] [-] gnz11|3 years ago|reply
[+] [-] ahstilde|3 years ago|reply
WebMD, Healthline, and Verywell Health all monetize off of views. They're exceptional SEO operators, and they know how to game Google. The trick is to find people who aren't monetizing off of just views.
Actually helpful information is coming from services that don't monetize off of views, or where the content is written for more than just SEO. For example, Anja Health is educating people about a novel idea (https://www.tiktok.com/@kathrynanja). At Wyndly, we build trust with our content by having my co-founder answer common questions (https://www.instagram.com/wyndlyhealth/).
These are experts sharing their niche. In fact, we source the questions we answer from our support inbox. So, not only are we putting useful information our into the world, we're creating resources for our support team. It's a win-win.
Side note: yes, we do play the SEO game somewhat. At the end of the day, if we have a successful video, it'd be foolish not to resource it for Google and for people: https://www.wyndly.com/blogs/learn/what-kind-of-doctor-for-a...
[+] [-] fudgefactorfive|3 years ago|reply
The primary reason is that it is very hard to come up with a schema that even 5% of papers would adhere to. The vast majority of this knowledge is phrased as natural language.
There are databases that track compounds and the publications related to them, but those papers again are natural language and cannot be readily converted to tabular data. Our first basic approach involved POS tagging and then trying to associate proper nouns with numeric values. Again the issue became how do you interpret a sentence like "may lead to sudden death" as a symptom? Something like "may lead to symptom X in Y% of respondents" is a nightmare to consistently parse without heavy ML running over huge datasets of just text.
In the end we wound up having to shut down concluding that until papers are released with not only arbitrary XML tables/results we were not equipped to handle the task. And even worse, what if our models didn't interpret things correctly and a consumer got {symptom:"sudden death", chance:0%} and insisted on that compound for their indication only to later realize the paper stated "in lab setting 0% of animals didn't experience sudden death after being administered X after diabetes diagnosis". Paying a hundred students to work around the clock couldn't get the volume processed accurately for months, let alone getting a second army of validators to confirm each entry.
[+] [-] resoluteteeth|3 years ago|reply
The solution isn't throwing technology at it to do "automated evidence synthesis," it's making it easier and more affordable for people to talk to get a consultation with an actual medical professional.
[+] [-] lastofthemojito|3 years ago|reply
[+] [-] xivzgrev|3 years ago|reply
it's clearly an SEO game that's cropped up recently, but it's executed in a sustainable way. The articles I stumble on are actually helpful.
For example, there was a recent HN article on research supporting the practice of grounding. So I googled it, and found a Healthline article: https://www.healthline.com/health/grounding#benefits
It clearly explained what it was, why it may have benefits, what a few experts say, risks, etc.
There are ads but barely (for now) - on a recent article on mobile, it's one small banner, and then one in-line ad that doesn't even look like one. It's not a barely-readable dumpster fire like WedMD.
Of course, all roads lead to Rome, so at some point Healthline may look like a dumpster fire as well, so enjoy it while we can!
[+] [-] guerrilla|3 years ago|reply
1. https://www.nhs.uk/conditions/
2. https://www.mayoclinic.org/diseases-conditions
3. https://www.1177.se
[+] [-] boringg|3 years ago|reply
It's part of what I mentioned in another comment which is that the internet is to general and vague in its information (and generally low-mid quality) while private information is, sometimes, of higher quality. It leads people who want to learn more about things in a bind where they are limited by the accessibility to good quality information.
Also you don't want the GP to have access to uptodate because they would self diagnose in so many of the wrong ways and wouldn't understand everything.
[+] [-] captainbland|3 years ago|reply
[+] [-] skybrian|3 years ago|reply
[+] [-] victorclf|3 years ago|reply
There are great summaries for every disease and treatment written by doctors and researchers. Summary includes epidemiology, symptoms, causes, prognosis, possible treatments, novel treatments, differential diagnoses, etc.
Given that there are bad professionals in every area, it's a great resource to evaluate if your doctor's diagnosis and suggestions make sense.
Unlike your local doctors, good online resources don't have financial incentive to recommend unnecessary drugs or surgeries where the risks outweigh the benefits.
[+] [-] Javantea_|3 years ago|reply