Cyberchondria: the dark side of digital health

Digital transformation has a significant impact on our lives. Thanks to low costs and easy accessibility of digital platforms, people all over the world are in constant interaction with technical devices and online applications. Without them, many of us would perhaps even feel incomplete and less competent. These developments also affect healthcare practices, as concepts, such as digital health, mHealth, telehealth have become commonplace in the healthcare context. There are clear advantages to the emergence of mobile technology in health care, research, and development – it may save costs, enhance effectiveness and even save lives. However, there are also downsides that we cannot ignore. One of the downsides of this ‘revolutionizing of health care’ is ‘Cyberchondria’: the habit of excess online searching for medical information related to health conditions and symptoms. Cyberchondria is a clear example of how information technology may negatively affect the minds and well-being of the public.

Nowadays, many people with concerns and questions regarding their health can easily search online about their symptoms through different search engines and apps. They can self-diagnose and even treat or medicate themselves. But how is this response bad? Well, although some people will come to understand their conditions better and feel informed by health information online, others might increasingly become more confused and anxious. Those in the first category may benefit from feeling empowered by the information, but to others, the excess of information may have negative impact on health-related behaviour and decisions. For example, in some countries, people can get access to and take medicines without prescriptions. In these countries, pharmacists often sell drugs in an unregulated system. Such over-the-counter transactions are obviously riskier, especially in the context of cyberchondria. People might be driven by biases and distortions of the information gathered from the Internet and be much more likely to end up with misleading ideas regarding their diagnosis, and the appropriate drugs and treatment methods available. In some cases, the practice of one’s self health management through ‘Dr Google’ leads to medical complications. There is research evidence stating that the false security and often unsubstantiated know-better attitude stemming from gathering health information from various online sources is driven by the practice of cyberchondria and influences the decision to (not) visit doctors. This raises further concerns about health risks. But it might not just be the individual patients who could suffer the consequences.

Worse still, cyberchondria also has an adverse effect on the implementation and monitoring of Sustainable Development Goals (SDGs). The SDGs are aspirational, but monitoring and measuring their impact and progress is a complex task, especially in an environment, in which continuous data collection is a challenge amidst socio-cultural, political, and geographical difficulties. As mentioned, false security and know-better attitude is driven by the practice of cyberchondria and influences cyberchondriacs’ choices to avoid visits and consultations with medical professionals. While the accessibility of the Internet has fuelled self-diagnosis and self-treatment practices, it has also created problems for proper health monitoring. In particular, patients’ diagnosis, underlying diseases and other important health parameters are not recorded in appropriate health databases, which would serve for the monitoring of patients’ health developments. The plans and policies of the healthcare system, based on the feedback mechanism driven by such databases, thus, inherently face an issue of bias – privileging some groups while disadvantaging others. Failure to record continuous and comprehensive data may then create recursive biases in every process of the healthcare system, research, national data registry, and the SDGs implementation and monitoring: specific demographic categories may be overlooked in the monitoring process, which could lead to inefficiently or unfairly allocated funds, and that would then exacerbate the inequalities which caused the discrepancies.

It is becoming obvious that cyberchondria can have immensely negative implications and hamper the quality of one’s life and healthcare. Even on the individual level, the use of wrong medicine or its unbalanced doses are serious problems. Further concerns arise about the implications of cyberchondria in the context of digital health platforms and the wide use of mobile health technologies. Digital health platforms might be a set off for cyberchondriacs which, in turn, could magnify biases during data collection and monitoring. This could then not only affect the community level research but also national and international platforms. Current literature seems to have a gap in terms of academic research linking cyberchondria and its associated biases and data loss in the health care monitoring system. The World Health Organization (WHO) recognises similar issues of missing data during tracking and monitoring superbugs (microbes that are resistant to most of the antibiotics) from a local level to a global level in the field of Antimicrobial Resistance (AMR). Further, WHO argues that AMR shall be an important part of a lot of health-related indicators in the SDGs. As AMR is one of the repercussions of cyberchondria, especially in medically underprivileged communities, it may also be worthwhile to look at the consequences of cyberchondria in the data monitoring and SDGs indicators.