To Gather Drug Information, a Health Startup Turns to Consumers(nytimes.com)
nytimes.com
To Gather Drug Information, a Health Startup Turns to Consumers
http://www.nytimes.com/2014/09/24/technology/to-gather-drug-information-a-health-start-up-turns-to-consumers.html
4 comments
First, congrats on the launch! Secondly, have you considered giving the consumer the ability to compare (side by side) drugs that are used for the same condition? For example, anxiety meds. Being able to compare side effects on the same screen instead of having to start a new search or click and try to remember what you just saw.
We launched today at http://www.iodine.com
The team is monitoring this thread. Happy to answer questions!
The team is monitoring this thread. Happy to answer questions!
Congratulations on the launch.
I am not sure if some of the drug types are appropriate though.
Antibiotics for example. If someone was prescribed an antibiotic for an infection, read your site and decided to stop taking it after a few days to avoid a side effect while waiting for an appointment with their doctor to find a suitable replacement, then it may increase resistance. Worse, they might stop the treatment and not bother finding any alternative if they feel "better enough".
I agree that discussions on medications are good for the majority of cases but antibiotics should be considered firmly in the domain of the specialists who "should" take into account local resistance rates, etc.
I am not sure if some of the drug types are appropriate though.
Antibiotics for example. If someone was prescribed an antibiotic for an infection, read your site and decided to stop taking it after a few days to avoid a side effect while waiting for an appointment with their doctor to find a suitable replacement, then it may increase resistance. Worse, they might stop the treatment and not bother finding any alternative if they feel "better enough".
I agree that discussions on medications are good for the majority of cases but antibiotics should be considered firmly in the domain of the specialists who "should" take into account local resistance rates, etc.
Hi Tom this is a great q. I'm the MD on the team here at Iodine.
As you know, many people already stop taking their antibiotics without finishing the full course. According to our internal research, people get most freaked out about side effects when they didn't expect them or didn't know they might happen, and when they didn't know it was a common or normal response to a medication. It's our hypothesis that surfacing this data (much of which does already exist online) will actually help with what clinicians refer to as "anticipatory guidance" -- helping people know what to expect -- and that this could reassure people when they do have a side effect, and help them realize that it's temporary. Good anticipatory guidance doesn't always happen in the exam room due to time constraints, etc. In a couple studies we cited in an Iodine blog post recently, docs spend an average of 12 seconds talking with patients about side effects of a new med, and 50% of these new med convos don't mention expected side effects at all. http://www.iodine.com/blog/11-questions-to-ask-about-medicat....
Additionally, our content will develop with more info about how to take a med, including this really important caveat about antibiotics. Another one I can think of is acetaminophen and its really important risk/warning about liver failure.
We still have a lot of work to do at Iodine, but we think we've got a good start. And overall, we think that more transparency is better, even when it comes to antibiotics, to help people have more informed conversations with their doctors about this stuff.
As you know, many people already stop taking their antibiotics without finishing the full course. According to our internal research, people get most freaked out about side effects when they didn't expect them or didn't know they might happen, and when they didn't know it was a common or normal response to a medication. It's our hypothesis that surfacing this data (much of which does already exist online) will actually help with what clinicians refer to as "anticipatory guidance" -- helping people know what to expect -- and that this could reassure people when they do have a side effect, and help them realize that it's temporary. Good anticipatory guidance doesn't always happen in the exam room due to time constraints, etc. In a couple studies we cited in an Iodine blog post recently, docs spend an average of 12 seconds talking with patients about side effects of a new med, and 50% of these new med convos don't mention expected side effects at all. http://www.iodine.com/blog/11-questions-to-ask-about-medicat....
Additionally, our content will develop with more info about how to take a med, including this really important caveat about antibiotics. Another one I can think of is acetaminophen and its really important risk/warning about liver failure.
We still have a lot of work to do at Iodine, but we think we've got a good start. And overall, we think that more transparency is better, even when it comes to antibiotics, to help people have more informed conversations with their doctors about this stuff.
Have you looked at ways to track what drugs people take and when? To examine interactions and efficacy?
Do you guys have a developers API that people can access to easily access information gathered in your DB/submit, etc. A basic developers API?
How do you handle the large bias in internet-based surveying (Internet users aren't demographically representative)? What about the general problem of recall-based reporting (people may report taking meds when they didn't)?
Great questions! For background, I was part of the Flu Trends and Consumer Surveys teams before I left Google to start Iodine.
Google Consumer Surveys attempts to create a representative sample of the internet population according to the breakdown from the Current Population Survey (CPS) published by the Census. This is done at survey delivery time. Additionally, after the survey is performed, the stats are reweighted by this distribution since the targeting system isn't always able to deliver a fully representative sample due to other constraints (publisher volume, survey volume, etc).
Of course, this only helps with ensuring that the stats represent Internet users. However, there are many reasons to believe that this sample is a reasonable proxy for many types of questions. For examples, see:
http://www.google.com/insights/consumersurveys/static/consum...
http://www.people-press.org/files/legacy-pdf/11-7-12%20Googl...
http://fivethirtyeight.blogs.nytimes.com/2012/11/10/which-po...
Additionally, there can be a bias in many traditional survey platforms (RDD telephone surveys being the current gold standard) due to the adoption of mobile phones among other things.
With respect to recall-reporting problem, for a subset of users, we asked not only about the medication but what they were taking the medication for. We do this in the form of an open ended question and it helps increase our confidence in what the user reports. Details of our exact methodology are forthcoming!
Google Consumer Surveys attempts to create a representative sample of the internet population according to the breakdown from the Current Population Survey (CPS) published by the Census. This is done at survey delivery time. Additionally, after the survey is performed, the stats are reweighted by this distribution since the targeting system isn't always able to deliver a fully representative sample due to other constraints (publisher volume, survey volume, etc).
Of course, this only helps with ensuring that the stats represent Internet users. However, there are many reasons to believe that this sample is a reasonable proxy for many types of questions. For examples, see:
http://www.google.com/insights/consumersurveys/static/consum...
http://www.people-press.org/files/legacy-pdf/11-7-12%20Googl...
http://fivethirtyeight.blogs.nytimes.com/2012/11/10/which-po...
Additionally, there can be a bias in many traditional survey platforms (RDD telephone surveys being the current gold standard) due to the adoption of mobile phones among other things.
With respect to recall-reporting problem, for a subset of users, we asked not only about the medication but what they were taking the medication for. We do this in the form of an open ended question and it helps increase our confidence in what the user reports. Details of our exact methodology are forthcoming!
How do you think doctors are going to react to their patients following the data from Iodine? There's a lot of room to misinterpret, especially when dealing with psychiatric drugs. Advil, Immodium, and Nyquil are pretty simple for people to report on: the thing that hurts stops == this drug worked (maybe).
Also, the one thing on the front page that made the largest impact on me is the brand name prevalence. If Iodine gets popular, that's going to have a direct effect on brand name sales. Would you be interested in doing more upfront comparisons between generic and brand names?
People will still buy brand name if it makes them feel better/safer/whatever of course, but a 200mg tablet of ibuprofen should have the same effects no matter who makes it (allergies/reactions from dyes and coatings not-withstanding). Shouldn't we be trying to educate patients about the science of it as well? That the same dosage of Advil vs. Generic is equivalent and teach people to save money?
>The investor enthusiasm for health ventures, said Halle Tecco, managing director of Rock Health, is fueled by the belief that the health care industry is both huge and technologically backward, and thus ripe for an assault with clever software and data-driven decision-making.
From my own experience, this could not be more correct.
I've been on three sides of the healthcare industry: nursing, surgical services, and now software. There is just a lot of old stuff piled on top of even older stuff. Some of that is reliable and necessary. Other times, it's a wonder the thing even works in the first place.
It's a wasteland of opportunity, so grab your hazard suit and start coding because me, my doctor and my optometrist personally think healthcare software currently sucks. :)
Also, the one thing on the front page that made the largest impact on me is the brand name prevalence. If Iodine gets popular, that's going to have a direct effect on brand name sales. Would you be interested in doing more upfront comparisons between generic and brand names?
People will still buy brand name if it makes them feel better/safer/whatever of course, but a 200mg tablet of ibuprofen should have the same effects no matter who makes it (allergies/reactions from dyes and coatings not-withstanding). Shouldn't we be trying to educate patients about the science of it as well? That the same dosage of Advil vs. Generic is equivalent and teach people to save money?
>The investor enthusiasm for health ventures, said Halle Tecco, managing director of Rock Health, is fueled by the belief that the health care industry is both huge and technologically backward, and thus ripe for an assault with clever software and data-driven decision-making.
From my own experience, this could not be more correct.
I've been on three sides of the healthcare industry: nursing, surgical services, and now software. There is just a lot of old stuff piled on top of even older stuff. Some of that is reliable and necessary. Other times, it's a wonder the thing even works in the first place.
It's a wasteland of opportunity, so grab your hazard suit and start coding because me, my doctor and my optometrist personally think healthcare software currently sucks. :)
The early feedback we've been getting from doctors and pharmacists has been very positive. We believe (and many of them agree) that a users subjective experience of a medication is an important part of the overall equation, especially with non-compliance being as high as it is.
With respect to brand vs generic, keep an eye on our blog for a post on this soon but here is a preview:
https://twitter.com/zimmeee/status/514807668163088384
With respect to brand vs generic, keep an eye on our blog for a post on this soon but here is a preview:
https://twitter.com/zimmeee/status/514807668163088384