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Would You Let a Crowd Diagnose You?

Carrie Steckl earned her Ph.D. in Counseling Psychology with a Minor in Gerontology from Indiana University – Bloomington in 2001. She has spent over ...Read More

Ah, technology. In some ways, I think you are brilliant, revolutionary, and the key to solving some of the world’s most pressing problems. In other ways, I fear you and the potential you carry for misuse, abuse, and great harm.

And many times, I both admire and fear you at the same time. This is how I felt when I read about a new approach to medicine that combines the Internet, crowdsourcing, and gambling (yes, you read that correctly).

Go check out CrowdMed and tell me what you think, because I really don’t know how I feel about it yet. CrowdMed targets two populations: people who need medical diagnoses and people who want to make money by providing and/or betting on the most accurate ones.

Here’s how it works. Say a person (the patient) is experiencing a “medical mystery” – the person has been to several doctors, has a variety of symptoms, and no one has been able to come up with a viable diagnosis. The patient, desperate for an answer, goes to CrowdMed and submits an anonymous medical profile with the option of uploading medical reports, lab results, imaging files, etc.

Intrigued yet? It gets more interesting. The person has the option of submitting his or her “case” for free to have the crowd of “medical detectives” analyze it and provide suggestions. However, the website states several times that cases generate much more interest when the patient provides a cash incentive to the medical detectives.

And who are these medical detectives more jazzed by making money than by simply helping people? According to CrowdMed’s website, they are a hodgepodge of retired physicians, naturopaths, medical students, chiropractors, nurses, and “regular people who enjoy solving medical mysteries.”

These folks choose which cases they wish to bet on with points allotted to them via their medical detective status. They can offer possible diagnoses and wager their points on the solutions they find most attractive. Keep in mind that they can win more points, and possibly more cash, when they bet on less popular answers that end up being the best ones.

Cases might stay active for up to 3 months, at which time a predictive algorithm is used to aggregate the crowd’s opinions on the patient’s possible diagnosis. The patient is offered a rank-ordered list of diagnoses to discuss with his or her physician. The patient then reports back to CrowdMed with feedback on which offered solution was the best, and points and dollars are shelled out to the medical detectives as appropriate.

Aside from the whole idea that it’s okay to gamble on another person’s wellbeing (Can you say, “Ick”?), I can see one benefit to a program like CrowdMed. There is evidence that more and better ideas are generated by groups as compared to individuals. It could be that crowdsourcing could provide individuals with hard-to-diagnose medical problems with the creative answers they need but could not find within their traditional health care system. In fact, CrowdMed reports that since its inception, its medical detectives have solved over 200 cases in a matter of months instead of the years it would have taken otherwise.

But many things about CrowdMed make me uneasy in addition to the gambling aspect already mentioned. I fear that desperate patients will use the diagnoses provided them via CrowdMed to self-treat without verifying whether the top solutions are actually correct. Granted, the program includes a disclaimer instructing the patient to take the recommendations to his or her doctor rather than treating the recommendations as final answers. But how do we know that this actually happens? If patients are so fed up with the health care system that they have turned to a crowd of strangers to diagnose their very intimate medical issues, why would we trust that they would go back to that health care system for verification? It seems more likely that they would take the recommendations and run with them, putting themselves at risk of inappropriate treatments and over-the-counter supplements.

Finally, it deeply disturbs me that CrowdMed urges patients to offer financial incentives to medical detectives by suggesting that their cases won’t receive adequate attention unless they fork over some money. This implies that cases without financial incentives are not worth solving as much as those with money tied to them – as if the lives of patients without money are not worth saving as much as the lives of the rich. Furthermore, while CrowdMed presents itself as a departure from traditional medicine, the program’s preferential treatment of those who can pay is really no different from mainstream health care and its marginalization of those who are economically challenged.

And so, I ask you again: What do you think? Would you let a crowd diagnose you? Please share your thoughts – I’m listening.

Keep Reading By Author Carrie Steckl, Ph.D.
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