So You Are Old, Have Symptoms, and a Fast Connection: What Next?

The answer to the question above is complex but the authors noted the following “we found that few older adult participants mentioned the credibility of the information that they were viewing”. That’s the money shot for me. 

Luger, Houston, and Suls published an original paper in JMIR “Older Adult Experience of Online Diagnosis: Results From a Scenario-Based Think-Aloud Protocol”. The objective was to identify the processes older adults engage in to diagnose symptoms online and predict the accuracy of the diagnosis.

This is a well designed study of 79 adults greater then 50 years of age. Each received a vignette of symptoms of an illness and were asked to talk aloud about their thoughts and actions while looking for a diagnosis. The authors compared accurate diagnosis to the non-accurate diagnosis.

There conclusions were:

Older adult participants tended to rely on matching strategies to interpret symptoms, but many still utilized existing medical knowledge and previous illness experiences as a guide for diagnosis. Many participants also had difficulty navigating the Internet tools, which suggests an increased need for navigation aids in Web design. Furthermore, participants who were inaccurate in their diagnosis had more difficulty with the Internet tools and confusion with the task than those who were accurate. Future work in this area may want to utilize additional study design such as eye-tracking to further understand the coordination between Web navigation, online symptom information processing, and diagnostic strategies.

We all know the data on-line self diagnosis is the new black with 35% of US adults looking online to self diagnose and learn how to manage their health. And we have seen the data on chronic illness and older individuals they are driving online searching and learning in healthcare and illness. The authors note that older Americans may not have the additional cognitive and perceptual processes necessary to do symptom diagnosis, will the next couple of generations? And if they do will we have a healthcare system that will embrace the ePatient? That is the equation learners on both sides. 

I wonder if the authors will in the future examine how these patients present their acquired data to physicians and how those physicians behave or reacts? This is such a classic learner teacher moment that the physician can ensure these patient becomes a more active and in fact improve outcomes through learning together. Improve how this group learns online and help improve the patient physician engagement dynamic surrounding acquired disease knowledge.

How can adult learning theories aid in better understanding what these patients are doing and how to change or better said improve outcomes from self diagnosis?

Finally, I penned a post on how to move learners along a continuum to knowledge and application. One of the ideas I had was that courses for seniors could be taught at local public libraries. These courses would address how to search, what to trust, how to interpret, and how to use that knowledge with your HCP. We cannot miss this opportunity to seed and manage these fertile old minds. 

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