![]() ![]() ![]() Misdiagnosis could allow ongoing disease transmission, and others viewing a post may wrongly self-diagnose their own conditions. The characteristics of those posting and responding, the accuracy of the diagnoses, and whether individuals acted on the provided advice were not investigated.Īlthough crowd-diagnoses have the benefits of relative anonymity, rapid response, and multiple opinions, the underlying accuracy of crowd-diagnoses is unknown given that responders may be operating with limited information about the patient, and responders may lack medical training. Crowd-diagnosing may have been more or less common in other settings. Limitations include that a single social media platform and a single medical condition were assessed. In the case of r/STD, requests for crowd-diagnoses were frequent, with most receiving a reply within hours, and many of these requests were for second opinions after obtaining an original diagnosis from a health care professional. The median time for the first response was 3.04 hours (range, 59 seconds to 8.8 weeks), and 79% of requests (95% CI, 74%-84%) were answered in less than 1 day. Examples of posts obtained from r/STD are in the Table.Įighty-seven percent (95% CI, 83%-91%) of all posts requesting a crowd-diagnosis received a reply (mean responses, 1.7 ). Of those requesting a crowd-diagnosis, 20% (95% CI, 15%-24%) did so to obtain a second opinion after receiving a previous diagnosis by a health care professional. There was 80% agreement among all coders on crowd-diagnoses (Cohen κ = 0.73) and 88% agreement on whether the crowd-diagnosis was a request for a second opinion (Cohen κ = 0.53) among an overlapping sample of 50 posts.įifty-eight percent (95% CI, 54%-63%) of posts requested a crowd-diagnosis, of which 31% (95% CI, 26%-36%) included an image of the physical signs. There were 16 979 total posts, 8 in November and December 2010, 2478 in 2017, 3375 in 2018, and 908 in January and February 2019 ( Figure). All analyses adhered to Reddit’s terms and conditions, relied on existing public data with nonidentifiable participants, and were exempted by the University of California, San Diego human research protections program. R statistical software version 3.5.3 (R Foundation) was used to compute the percent of posts (with 95% CIs) that requested a primary or second-opinion crowd-diagnosis, contained an image of the physical signs, or received a reply, and the time to first reply from the random sample. Three authors (A.L.N., E.C.L., and J.W.A.) independently coded whether each post requested a crowd-diagnosis and if so, whether that request was made to obtain a second opinion after seeing a health care professional, using directed content analysis. ![]() To quantify the extent to which crowd-diagnosis occurred on r/STD, we drew a random sample of 500 posts. r/STD metadata, including the number of posts and time stamps, were described for the full sample. 6 We first obtained all posts from inception of the subreddit in November 2010 through February 2019. ![]() Reddit, a social media website with 330 million monthly active users that hosts more than 232 health forums, 5 includes a large subreddit (r/STD) that allows users to publicly share “stories, concerns and questions” about “anything and everything STD -related.” We selected r/STD because it focuses exclusively on a health topic of substantial public health concern. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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