Live data from Hacker News

What would a “good” WebMD look like?

blog.tjcx.me

281–290 of 323 posts

Re: What would a “good” WebMD look like?

#281
post #15

A better question might be: Why is the private sector responsible for providing accurate health information? As this article shows, the incentives for people running medical websites and the people reading them are not aligned. I'd say the UK NHS website and symptoms/medications pages hit the nail on the head - https://www.nhs.uk/conditions/ . It has no advertising and provides short, easily readable and actionable i…

That's a nice page, and I'll definitely bookmark that one. But I don't see most of the public using something like that over WebMD. WebMD is complete trash (I even block it in my Kagi search preferences), but it succeeds over sites like the NHS one because of blog SEO. WebMD is really a glorified blog with posts about every condition you might get paranoid over. I don't know how precisely they achieve this, but they'…

Here in the UK the NHS website has excellent SEO. I land there all the time

Re: What would a “good” WebMD look like?

#285
post #241

Examine.com is the closest analogue to what this site is trying to do, and as far as I know, it works. It takes a while, but if people develop trust in a product or website they value that deeply, and are even willing to throw money at it. I don't even consider trying to google a supplement; I'll just go to examine and look at the body of evidence, recommended dosages, etc. I've paid for Examine and I would pay for t…

> Here's my point of feedback / wishlist item / thing I think is missing from the world. Examine is focused on supplement That's exactly what we're doing! We released version 2 of Examine less than two weeks ago. Here's a page on how to use: https://examine.com/how-to-use/ It's still early, but the entire goal is to break down research on conditions and goals, and where they connect, relate them to interventions. Any…

Hey that's awesome to hear! I saw the redesign but haven't really poked around much yet. If that's the direction examine is pivoting though I am very, very excited for it. Will definitely be checking it out.

Re: What would a “good” WebMD look like?

#286
post #15

A better question might be: Why is the private sector responsible for providing accurate health information? As this article shows, the incentives for people running medical websites and the people reading them are not aligned. I'd say the UK NHS website and symptoms/medications pages hit the nail on the head - https://www.nhs.uk/conditions/ . It has no advertising and provides short, easily readable and actionable i…

A fairly straightforward answer is that the government's goals are not necessarily aligned with your own. You, presumably, care very much about your own personal health. You also care about other people's health, but you really, really care about your own health, and probably don't want to die earlier than you need to. The government, on the other hand, doesn't generally care about individuals, and is working on a st…

> A good government wants the population overall to be in good health, and has a budget within which it must operate. It may make more sense for the government to ignore your rare disease if detection/treatment is expensive, and that money can be better used to save, say, 10 people with a more common disease.

That happens on the research funding side (e.g. it makes more sense to spend research money on cancer or heart disease than on an obscure disorder that only 10 people have).

However, it's not true that the government will provide misinformation or otherwise get in the way of diagnosing your rare disease to save money.

There are a lot of studies about the cost/benefit tradeoff of early diagnosis and preventative screenings. The goal isn't to reduce healthcare expenditure, it's to reduce problems and deaths from unnecessary procedures and treatments. We learned a lot from previous eras of over-treatment and over-testing that led to a lot of unnecessary treatments due to false positives. The risks of over-treating can actually outweigh any benefit of excessive testing, for example.

This is counterintuitive to individuals who want to order huge numbers of tests all the time just in case something might be wrong. The problem is that a lot of diseases may have occurrence rates on the order of 1 in 10,000 or 100,000 per person-year, while the tests may only be 98% to 99% accurate. This 1 to 2 in 100 will be misdiagnosed as false positives and potentially put on expensive medications or treatments that have negative health consequences. It's a very real problem that isn't obvious from the individual level but becomes very obvious at the population level when you start looking at the details.

But no, the government isn't actually hiding information about diseases or misleading people in an attempt to reduce costs. With many conditions it's actually much more expensive to be diagnosed later in the disease than it is to be diagnosed earlier when many conditions are more receptive to treatment.

Re: What would a “good” WebMD look like?

#287
post #243

Earlier quoted context omitted.

A fairly straightforward answer is that the government's goals are not necessarily aligned with your own. You, presumably, care very much about your own personal health. You also care about other people's health, but you really, really care about your own health, and probably don't want to die earlier than you need to. The government, on the other hand, doesn't generally care about individuals, and is working on a st…

The terse version of this is to say that the government would prefer you die cheaply rather than live at great expense.

That's not really what's happening at all. It's often cheaper to get an early diagnosis or catch a condition before it progresses too far.

The government doesn't actually hide information about diagnosing or treating diseases, even rare or expensive ones. They do, however, take into account the relative risk of false positives and resulting unnecessary treatments, which often outweigh any benefit of proactive testing for rare diseases.

It's counterintuitive, but if you have a 99% accurate test for something that means you're going to end up with 1 in 100 people getting false positives and undergoing potentially expensive (out of pocket) or dangerous diagnostics and treatments. When considering rare conditions that might only occur in 1 out of 100,000 patients each year, a 99% accurate test results in 1000 unnecessary false positives just to catch the 1 true positive. At scale, this can produce a lot of problems that can actually make life worse on average for the population rather than better.

Re: What would a “good” WebMD look like?

#290
post #243

Earlier quoted context omitted.

The terse version of this is to say that the government would prefer you die cheaply rather than live at great expense.

That's not really what's happening at all. It's often cheaper to get an early diagnosis or catch a condition before it progresses too far. The government doesn't actually hide information about diagnosing or treating diseases, even rare or expensive ones. They do, however, take into account the relative risk of false positives and resulting unnecessary treatments, which often outweigh any benefit of proactive testing…

I agree that there are valid statistical reasons to limit testing, but governments ration care and allow for long wait times when they are responsible for paying the costs. Faster testing and treatment is generally believed to be one of the best things you can do to improve patient outcomes, and government healthcare systems are notoriously bad at this (even worse than private healthcare).

Long wait times don't reduce the rate of false-positives, and false diagnoses. Long wait times deter people from seeking treatment, thus reducing costs.

Post reply on HN