EDITOR- I read Coulter's1 editorial with great interest as I have already reported2 exactly the kind of problems clinicians are likely to face in future from uncritical interpretation, or as in my case, "misinterpretation", of the huge amount of unregulated health information currently available on Internet.
In one of the growing numbers of such cases that I have been seeing recently, a carer, "a self confessed bit of a computer buff", who claimed to have got information from a "world authority" was convinced that his patient was suffering from side effects of prescribed medication and "advised" me to change it, when in reality , the patient was exhibiting clear signs of vascular dementia (a diagnosis the carer probably found it hard to come to terms with), some of which the carer was "misinterpreting" as adverse effects of antidepressants the patient was on for depression.
The rise of consumerism and the increasing reluctance of the growing number of "well educated" patients or carers to accept medical advice uncritically may provoke better practice of evidence-based medicine, but there is a definite case to be made of the dangers of that process if some form of regulation of the quality and appropriateness of such information is not put in place now. Because of its inherent lack of golden standards for diagnosis and treatment, psychiatry as a medical speciality can be especially vulnerable, more so in the modern climate of litigation.
Being the largest circulating medical journal in the UK, the BMJ could take an active role in building up such a regulatory process by actively encouraging doctors to report all cases as above so that a database could be formed before any corrective measures are taken.
Word count: 282.
References
1. Coulter A. Evidence based patient information; Is important, so there needs to be a national strategy to ensure it. BMJ 1998;7153: 225-226.
2. Sikdar S. Psychiatry, the internet and the public. Hospital Medicine1998; 59,6: 509.
Author
Dr. Sudip Sikdar
Specialist Registrar in psychiatry
Fazakerley Hospital, Liverpool, L9 7AL.
Rapid Response:
Evidence Based Patient Information
EDITOR- I read Coulter's1 editorial with great interest as I have already reported2 exactly the kind of problems clinicians are likely to face in future from uncritical interpretation, or as in my case, "misinterpretation", of the huge amount of unregulated health information currently available on Internet.
In one of the growing numbers of such cases that I have been seeing recently, a carer, "a self confessed bit of a computer buff", who claimed to have got information from a "world authority" was convinced that his patient was suffering from side effects of prescribed medication and "advised" me to change it, when in reality , the patient was exhibiting clear signs of vascular dementia (a diagnosis the carer probably found it hard to come to terms with), some of which the carer was "misinterpreting" as adverse effects of antidepressants the patient was on for depression.
The rise of consumerism and the increasing reluctance of the growing number of "well educated" patients or carers to accept medical advice uncritically may provoke better practice of evidence-based medicine, but there is a definite case to be made of the dangers of that process if some form of regulation of the quality and appropriateness of such information is not put in place now. Because of its inherent lack of golden standards for diagnosis and treatment, psychiatry as a medical speciality can be especially vulnerable, more so in the modern climate of litigation.
Being the largest circulating medical journal in the UK, the BMJ could take an active role in building up such a regulatory process by actively encouraging doctors to report all cases as above so that a database could be formed before any corrective measures are taken.
Word count: 282.
References
1. Coulter A. Evidence based patient information; Is important, so there needs to be a national strategy to ensure it. BMJ 1998;7153: 225-226.
2. Sikdar S. Psychiatry, the internet and the public. Hospital Medicine1998; 59,6: 509.
Author
Dr. Sudip Sikdar
Specialist Registrar in psychiatry
Fazakerley Hospital, Liverpool, L9 7AL.
Conflict of interest: none
Competing interests: No competing interests