We’ve all been there before: headache, dizziness, sore throat. Uh-oh! Better Google the symptoms or maybe try WebMD’s online symptom checker to see what’s wrong.

But how accurate are these online symptoms checkers, anyway?

Turns out, millions of people are entrusting their health to some pretty lousy diagnostic systems.

Researchers tested 23 online symptom checkers and found that the correct diagnosis was provided first on a list of potential illnesses only about a third of the time. That means symptom checkers are spitting out wrong diagnoses two-thirds of the time.

“People who use these tools should be aware of their inaccuracy and not see them as gospel,” says Dr. Ateev Mehrotra, who led the research and is a professor of health care policy at Harvard Medical School. “They shouldn’t think that whatever the symptom checker says is what they have.”

The study, published Wednesday in The BMJ, examined some of the most popular online symptoms checkers, including Ask MD, iTriage, one from the U.K.’s National Health Service and another from the Mayo Clinic.

Each website was fed 45 standard patient vignettes with symptoms consistent with medical conditions ranging from acute liver failure and meningitis to mononucleosis and a simple bee sting.

The final information provided by the symptom checkers varied. Some provided a diagnosis, while others offered recommendations for care, such as stay at home, go to a doctor or head to the ER right away.

These treatment recommendations were right on compared to diagnosis accuracy, the research team says — at least when it came to emergency situations. In cases where the patients were seriously ill, the systems accurately urged them to head to the ER 80 percent of the time.

Timely treatment, Mehrotra says, is more important than getting the diagnosis exactly right. “If a patient isn’t feeling well, they’re thinking, ‘Is this something I have to take care of right away or can I stay home?'” he says. “We do not think distinguishing the exact problem is as important as getting to the hospital right away.”

On the other hand, the researchers found that the symptom checkers were overly cautious when it came to patients who had little cause for concern, suggesting they head to a clinic when staying home and having chicken soup was appropriate.

“Using computers to help diagnose and manage care is a new frontier,” Mehrotra says. “This is just the first generation [of symptoms checkers], and I’m hopeful that this research can help them improve.”

iMedicalApps founder Dr. Iltifat Husain agrees and is hopeful that the mobile health world will “mature and grow up” with time. Because current symptom checkers are so new, Husain, says he wasn’t surprised by the results.

“This is pretty consistent with what you see with medical-related apps out there now,” he says. “More and more studies are finding that apps are not using evidence-based techniques and that they don’t adequately reference medical content.”

However, that doesn’t stop Husain — an ER doctor at Wake Forest Baptist Medical Center — from recommending online systems and apps like symptom checkers.

“If used appropriately, these apps can help raise red flags so a patient is more proactive and seeks care in a timely fashion,” he says. “Nailing the specific diagnosis right away isn’t necessarily as important as nailing down, ‘Do I need a health care provider?'”

Besides, Husain adds, diagnosis is what doctors are made for.

“Symptoms checkers shouldn’t be for getting that final diagnosis,” he says. “We spend upwards of seven years in medical school and residency to figure out how to diagnosis effectively and an application isn’t going to replace that.”

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Medicare says that starting Jan. 1, 2016, it plans to pay doctors to counsel patients about end-of-life care.

Julie Rovner, senior correspondent with Kaiser Health News, tells our Newscast unit that many medical groups, including the American Medical Association, have long recommended the move.

“This is actually pretty much the same provision that created the huge outcry in 2009 when it was added by Republicans to the Affordable Care Act,” Julie says. “It would allow doctors to be reimbursed for talking to patients about what they want to do about end-of-life care; not necessarily at their end of life, but before that.”

Counseling would be voluntary for the patients.

The announcement comes just weeks after a Supreme Court decision solidified the Affordable Care Act. Julie tells Newscast that decision might have prompted Medicare officials to conclude that “it was safe politically … to go ahead with this.”

The Associated Press adds:

“Supporters say counseling would give patients more control and free families from tortuous decisions. Even so, there are often no simple answers. Patients may want less invasive care if they believe they will soon die, but predicting when death will happen is notoriously inexact. Terminal patients can live for years, potentially complicating a choice of less intensive treatment.

“Interested parties will have 60 days to comment on the new regulation before it is finalized.”

U.S. Rep. Earl Blumenauer, D-Ore., who repeatedly sponsored bills seeking to improve Medicare’s support for end-of-life planning, applauded the decision in a statement:

“Patients and their families should be encouraged to think about how they want to be treated at the end of their life and to express their goals, values, and preferences to their physicians. I encourage them, as well as providers and advocates, to support this proposed benefit.

“I’m confident the Obama Administration will consider all of the available social and medical evidence in favor of advance care planning to finalize this decision in the coming months.”

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Women are saving a lot of money as a result of a health law requirement that insurance cover most forms of prescription contraceptives with no additional out-of-pocket costs, a study finds. But the amount of those savings and the speed with which the savings accrued surprised researchers.

The average birth control pill user saved $255 in the first year after the requirement took affect, according to a study published Tuesday in the journal Health Affairs. The average user of an intrauterine device (IUD) saved $248. Those savings represented a significant percentage of average out-of-pocket costs.

“These are healthy women and this on average is their No. 1 need from the health care system,” said Nora Becker, an MD-PhD candidate at the University of Pennsylvania and lead author of the study. “On average, these women were spending about 30 to 44 percent of their total out-of-pocket [health] spending just on birth control.”

The study looked at out-of-pocket spending from nearly 800,000 women between the ages of 13 and 45 from January 2008 through June 2013. For most plans, the Affordable Care Act requirement began Aug. 1, 2012, or Jan. 1, 2013.

So-called “grandfathered” health plans, those that have not substantially changed their benefits since the law was passed in 2010, are exempt from the mandate, as are a small subset of religious-based plans.

While making birth control substantially cheaper may not increase the number of women who use it, Becker said that the new requirements could well shift the type of birth control they use to longer-acting, more effective methods like the IUD.

“If prior to the ACA a woman was facing $10 to $30 a month for the pill but hundreds of dollars upfront for an IUD and now both are free, we might see a different choice,” Becker said.

The researchers also found that while out-of-pocket spending dropped dramatically for most types of prescription contraceptive methods, with the majority of women paying nothing by June 2013, spending barely budged for the vaginal ring or hormonal patch.

That could be because at first many insurers declined to make the ring or patch free, since, like pills, they are essentially hormone delivery methods.

Earlier this year, the Obama administration issued a clarification saying that while insurers do not have to offer every brand of every method, they do have to cover at least one product in each category, including rings and patches.

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Recognizing they lacked votes in a key Assembly committee, authors of legislation that would have allowed terminally ill Californians to legally end their lives pulled the bill Tuesday morning.

Senate Bill 128, the End of Life Option Act, had already cleared the state Senate, but faced opposition in the Assembly Health Committee. That included a group of southern California Democrats, almost all of whom are Latino, after the archbishop of Los Angeles increased its advocacy efforts in opposition to the bill.

“We continue to work with Assembly members to ensure they are comfortable with the bill,” said a joint statement from Sens. Lois Wolk, D-Davis, and Bill Monning, D-Monterey, and Assemblywoman Susan Eggman, D-Stockton. “For dying Californians like Jennifer Glass, who was scheduled to testify today, this issue is urgent. We remain committed to passing the End of Life Option Act for all Californians who want and need the option of medical aid in dying.”

Under the bill, mentally competent adults who are terminally ill with less than six months to live could request lethal medication from a physician.

Last month, a poll found that 69 percent of Californians overall and 70 percent of Latinos supported the bill. The poll was conducted by the advocacy group Compassion and Choices. “The bill is still alive and well,” Patricia Gonzalez-Portillo, a spokeswoman for the organization, said in an interview. “We will continue to work with Assembly members until they are comfortable with this bill.”

The bill had received a boost after the California Medical Association changed its stance from opposed to neutral.

The bill is modeled after a 1994 Oregon law which permits aid in dying. Four other states — Washington, Montana, Vermont and New Mexico — have authorized it as well.

In California, 29-year-old Brittany Maynard brought the issue to light after she moved to Oregon to utilize the state’s death with dignity law. She was terminally ill with brain cancer and died last November. A posthumous video she had recorded was shown at a Senate hearing in March.

This story is part of a reporting partnership with NPR, KQED and Kaiser Health News.

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Here’s more evidence that mammograms don’t always deliver the results that women want. They find more small cancers, but don’t lower a woman’s risk of dying of breast cancer, a study finds.

The study looked at data from 547 U.S. counties that reported the percentage of women over age 40 who had a screening mammogram between 1998 and 2000. More than 16 million women lived in those counties, and 53,207 were diagnosed with breast cancer in 2000.

Over the next 10 years, 15 percent of the women died of breast cancer.

There was a lot of county-to-county variation in the number of women who got screening mammograms, from 38 percent to 78 percent. So you’d think that the counties that did a better job at screening would have fewer breast cancer deaths.

That wasn’t the case. The risk of death from breast cancer over 10 years was pretty much the same.

But the scanning did find more cancers. For every 10 percent increase in screening, the number of cancers found rose by 16 percent, the study found. The results were reported Tuesday in JAMA Internal Medicine. This, the authors write, means “the most prominent effect of screening mammography is overdiagnosis.”

By that they mean identifying abnormalities that will never cause illness or death in the patient’s lifetime. Overdiagnosis has become an issue in screening for breast, prostate and thyroid cancer.

So what’s a woman supposed to do with this information? After giving a big fat dis to mammography, the authors write, “Nonetheless, we do not believe that the right rate of screening mammography is zero.” Focusing screening on higher-risk women would help, they say, as well as more watchful waiting instead of immediate treatment.

The study has its limitations, because it’s comparing large groups of people, rather than tracking the health of individual women from mammogram on. Or it may be that even with this large number of cases, deaths are still rare enough that they’re missed in this sort of study. Other studies have found a 20 percent reduction in breast cancer deaths as a result of mammography.

This is just the latest study pointing out the problem with overdiagnosis of breast cancer.

“This study shows that the more we look, the more you find,” says Joann Elmore, a professor of medicine at the University of Washington who wrote a commentary accompanying the study. “The more you screen, the more likely you are to detect early precancerous abnormalities like ductal carcinoma in situ and early-stage cancer.”

It’s not clear how many women are overdiagnosed; Elmore says 10 to 20 percent may be a good estimate. But with the current tests, there’s no way for a woman to know if she’s in that 10 to 20 percent or if she really does have a dangerous cancer. Thus most women who get a diagnosis of DCIS or early-stage invasive cancer opt for treatment, which can mean surgery, radiation or chemotherapy.

“That is so hard,” Elmore says. “I really feel for those women. I need help both figuring out how to explain this to women, and I need better research helping me look at the tissue and figure out whether these women are overdiagnosed or not.”

Elmore studies the reliability of breast cancer screening, and published a study in March that found that pathologists often misidentify DCIS and early-stage cancers when reading biopsies.

The medical community has come to accept that overdiagnosis exists, Elmore says. “This is something that wasn’t even considered when I was in med school years ago. We’re slowly realizing that we are taking healthy people and maybe potentially giving them harm.”

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