Widman L E, Tong D A
University of Oklahoma Health Sciences Center, Oklahoma City, USA.
Arch Intern Med. 1997 Jan 27;157(2):209-12.
The Internet is a novel, rapidly growing means of worldwide public communication.
We reviewed all unsolicited electronic mail and other communications from nonmedical individuals requesting medical information over a 12-month period from the physician at 1 established site on the World Wide Web. This site was the only Internet site with a primary focus on cardiac arrhythmias.
Seventy unsolicited inquiries were received from 39 patients and 20 family members (the sources of 11 inquiries are unknown) from 20 states, Washington, DC, and 9 foreign countries (locations of 15 inquiries are unknown). Follow-up was obtained in 22 cases. The inquiries concerned cardiological conditions in 67 cases (96%) and cardiac electrophysiologic conditions and procedures in 52 cases (74%). The goals of the inquiries were diagnosis (15), therapy (48), prognosis (1), and patient education (6). On follow-up of 22 cases, the people initiating the inquiries stated that they were reassured (16), consulted a general cardiologist (1), consulted a cardiac electrophysiologist (4), or visited a tertiary care electrophysiology center (1).
The increasing use of the Internet by the general public seeking specific medical information for themselves and for their families suggests a widespread, unmet need for objective medical advice. This study demonstrates that the public can choose accurately whom to ask for subspecialty advice in the area of cardiovascular diseases. Professional societies and regulatory agencies should develop physician guidelines for providing medical advice over the Internet.
互联网是一种新颖且迅速发展的全球公共交流手段。
我们回顾了在12个月期间,从万维网上一个既定网站的医生那里收到的所有非邀约电子邮件以及其他来自非医学人士的请求医疗信息的通信。该网站是唯一主要关注心律失常的互联网网站。
收到了来自20个州、华盛顿特区以及9个外国的39名患者和20名家庭成员(11条询问的来源不明)的70条非邀约询问(15条询问的地点不明)。对22例进行了随访。询问涉及心脏病情况的有67例(96%),涉及心脏电生理情况及程序的有52例(74%)。询问的目的是诊断(15例)、治疗(48例)、预后(1例)以及患者教育(6例)。在对22例的随访中,发起询问的人表示他们得到了安心(16例)、咨询了普通心脏病专家(1例)、咨询了心脏电生理专家(4例)或者前往了三级医疗电生理中心(1例)。
普通公众越来越多地使用互联网为自己和家人寻求特定医疗信息,这表明对客观医疗建议存在广泛的、未得到满足的需求。本研究表明,公众能够准确选择在心血管疾病领域向谁寻求专科建议。专业协会和监管机构应制定医生在互联网上提供医疗建议的指南。