手機APP及各大網站是否可以取代醫生

There's a warning out today for those who go online or to apps to figure out why they have an upset tummy or nagging cough or occasional chest pain. Symptom checkers are accurate only about half of the time.

很多人胃不舒服、咳嗽或者偶爾胸口疼痛時會上網諮詢或者訴諸於各類應用，對此我們提出警告。因爲這些工具能精確檢查症狀的機率只有50%。

The finding is from a Harvard Medical School study that reviewed 23 sites. One third listed the correct diagnosis as the first option for patients. Dr. Ateev Mehrotra, one of the study's authors, urges patients to be cautious when using these tools.

此項發現源於哈佛醫學院的研究，該研究對23個網址進行了檢查。三分之一的網站能夠提供正確的診斷，作爲患者的首選療法。該研究的作者只有Ateev Mehrotra醫生，警告患者使用這些工具時要謹慎。

About a third of U.S. adults use the sites in place of going to the doctor. Mehrotra says, these online tools are about as accurate as the call-in lines offered by many physician groups. "

美國約有三分之一的成年在使用這些網站，而不是去看醫生。Mehrotra 表示這些網絡工具與很多醫師提供的電話服務幾乎一樣準確。

The diagnosis accuracy rate for physicians is 85 to 90 percent. But Jason Maude says he does not want a Web versus doctor showdown.

醫師診斷正確率爲85%至90%。但是Jason Maude表示並不希望網絡跟醫生之間一決雌雄。

"The whole point is not to set the patient against the doctor or replace the doctor, but to make the patient much better informed and to ask the doctor much better questions, and then together they should do a much better job," he says.

他表示：“關鍵不是讓患者與醫生相互對立，或者換掉醫生，而是要患者瞭解更多信息以便向醫生諮詢更好的問題，這樣才能達到最好的效果。”

Isabel ranked well in the study, showing the correct answer more than 40 percent of the time in the first diagnosis. Those high results, Maude says, may be because the site lets patients type in their own description of symptoms. They might describe a "tummy ache" or "stomach cramps" rather than the more clinical choice of "abdominal pain" used by many online symptom checker tools. And Isabel asks just two or three questions before patients describe their problem, as compared to sites that ask patients to click through 20 questions .

網站Isabel在該項研究中的排名很好，初診時給出正確答案的概率爲40%。Maude表示，正確率高可能是因爲患者可在該網站輸入對症狀的描述。患者可以輸入“肚子疼”或者“胃部痙攣”，而不是很多症狀檢測工具使用的“腹部疼痛”。此外，患者對自己的症狀進行描述之前，Isabel只向患者提問兩三個問題，而其他網站則設定了20個問題。

Clarifying how and why patients use these tools is critical, say the study's authors. They could reduce unnecessary office visits or inform patients as they talk with their doctors. But for some, the tools may encourage people to seek unnecessary care.

該項研究的作者表示，理清患者使用這類工具的方式和原因，非常重要。這類工具能夠減少不必要的尋醫就診，患者與醫生交談的過程中也能獲取更多信息。但對於一些人來說，這類工具可能會讓人們尋求不必要的醫療護理。

Mehrotra says patients used symptom checkers more than 100 million times last year, a fact that may stun some physicians. "While most doctors know patients are going to the Internet to search for medical advice, in terms of these symptom checkers.I've been surprised that few of my colleagues even knew they existed," he says.

Mehrotra 表示，很多患者去年使用病症檢查工具的次數超過了一億次，這讓很多內科醫生都大吃一驚。他表示：“雖然很多醫生都知道患者會向網絡尋求醫療建議，我吃驚的是，我的同事中很少有人知道這些網站和應用的存在。”