Meyer Ashley N D, Longhurst Christopher A, Singh Hardeep
Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Health Services Research and Development, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States.
J Med Internet Res. 2016 Jan 14;18(1):e12. doi: 10.2196/jmir.4887.
Despite visits to multiple physicians, many patients remain undiagnosed. A new online program, CrowdMed, aims to leverage the "wisdom of the crowd" by giving patients an opportunity to submit their cases and interact with case solvers to obtain diagnostic possibilities.
To describe CrowdMed and provide an independent assessment of its impact.
Patients submit their cases online to CrowdMed and case solvers sign up to help diagnose patients. Case solvers attempt to solve patients' diagnostic dilemmas and often have an interactive online discussion with patients, including an exchange of additional diagnostic details. At the end, patients receive detailed reports containing diagnostic suggestions to discuss with their physicians and fill out surveys about their outcomes. We independently analyzed data collected from cases between May 2013 and April 2015 to determine patient and case solver characteristics and case outcomes.
During the study period, 397 cases were completed. These patients previously visited a median of 5 physicians, incurred a median of US $10,000 in medical expenses, spent a median of 50 hours researching their illnesses online, and had symptoms for a median of 2.6 years. During this period, 357 active case solvers participated, of which 37.9% (132/348) were male and 58.3% (208/357) worked or studied in the medical industry. About half (50.9%, 202/397) of patients were likely to recommend CrowdMed to a friend, 59.6% (233/391) reported that the process gave insights that led them closer to the correct diagnoses, 57% (52/92) reported estimated decreases in medical expenses, and 38% (29/77) reported estimated improvement in school or work productivity.
Some patients with undiagnosed illnesses reported receiving helpful guidance from crowdsourcing their diagnoses during their difficult diagnostic journeys. However, further development and use of crowdsourcing methods to facilitate diagnosis requires long-term evaluation as well as validation to account for patients' ultimate correct diagnoses.
尽管看了多位医生，许多患者仍未得到诊断。一个新的在线项目CrowdMed旨在通过让患者有机会提交病例并与病例解答者互动以获得诊断可能性，来利用“群体智慧”。
描述CrowdMed并对其影响进行独立评估。
患者在网上向CrowdMed提交病例，病例解答者报名帮助诊断患者。病例解答者试图解决患者的诊断难题，并经常与患者进行在线互动讨论，包括交流更多诊断细节。最后，患者会收到包含诊断建议的详细报告，以便与医生讨论，并填写关于治疗结果的调查问卷。我们独立分析了2013年5月至2015年4月期间从病例中收集的数据，以确定患者和病例解答者的特征以及病例结果。
在研究期间，完成了397个病例。这些患者此前平均看了5位医生，医疗费用中位数为10,000美元，平均花了50小时在网上研究自己的病情，症状持续时间中位数为2.6年。在此期间，有357名活跃的病例解答者参与，其中37.9%（132/348）为男性，58.3%（208/357）在医疗行业工作或学习。约一半（50.9%，202/397）的患者可能会向朋友推荐CrowdMed，59.6%（233/391）报告称这个过程让他们获得了一些见解，使他们更接近正确诊断，57%（52/92）报告称估计医疗费用有所减少，38%（29/77）报告称估计学习或工作效率有所提高。
一些未确诊疾病的患者报告称，在艰难的诊断过程中，通过众包诊断获得了有用的指导。然而，进一步开发和使用众包方法来促进诊断需要长期评估以及验证，以确定患者最终的正确诊断。
