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Dr Google beats Dr Bing
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By Michael Woodhead, 6minutes editor
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Google now has a new rival when it comes to online searches for health information. Microsoft's rival Bing search engine is reported to have launched an integral 'Bing Health' search function this week.
There is no special Bing Health website - you just type in the search term into Bing, which some commentators are claiming beats Google hands down when it comes to health searches. I disagree.
Maybe it's just personal preference and familiarity with the interface, but I thought that Google did the better job when did a 'test drive' search for a health term I picked at random, in this case onychomycosis.
My little trial of the two search engines returned an overlapping list of similar websites. I liked Google, however, because it included Australian websites, whereas Bing's results were all American. Both search engines have the option for an Australian-specific search, however. Bing's search offers a pop-up preview pane for each website, when you move your cursor over it, but I just find this a gimmicky distraction.
Bing also claims to offer a betters service with its feature that suggests related terms - but in the case of onychomycosis, I don't see the usefulness of being pointed to related searches for tinea pedis or paronchyia. Bing also offers a tab that takes you to a 'reference' or summary page that gives some background on your search term. Not a bad idea, and Google does on a separate health topics page within its dedicated 'Google Health' site (health.google.com).
I also like the way Google puts a date on the website where available, and offers the option of 'related articles' when you want to explore a topic further.
So for the time being I think I will stick with Dr Google, and perhaps just use Dr Bing for a second opinion.
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Polypill may be a bit less poly
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By Michael Woodhead, 6minutes editor
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Last week the Australian Institute of Health and Welfare released a report showing that the burden of risk factors for cardiovascular disease is still substantial.
It painted a pretty gloomy picture, showing that about half the population have risk factors such as high cholesterol levels, obesity and physical inactivity, while 20-35% of adults have hypertension or are smokers.
The report authors say GPs are doing their bit, with health checks and the prescription of treatments such as antihypertensives. But with another report out this month suggesting that soon there will be three million Australian with diabetes, you have to wonder whether it's time for Santa to bring every middle-aged Australian a jar of polypills to put in the Christmas stocking.
Its proponents tell us that a polypill for all men over 55 that can address multiple cardiovascular risk factors has the potential to reduce heart disease by 80%. But the more I read about the ingredients, the more uneasy I feel about this idea. Any regime that contains low dose aspirin will have me looking very closely at the balance of benefit and risk, given the recent meta analysis that questioned the use of aspirin for primary prevention of heart disease in otherwise health people.
Likewise with folate, another possible componenet of a polypill. Last month a study in JAMA found that a folate supplementation program for CHD patients in Norway was associated with higher rates of cancer and all cause mortality.
That means the polypill is looking more like a duopill - an ACE inhibitor and a statin. Let's not talk about the cough and muscle pains that might involve.
At this rate it looks like encouraging everyone to get a dog and a pedometer might be a better public health intervention.
As we report in 6minutes today, people who take their dog for walkies are much more likelyto get their recommended 150 minutes of physical activity a week. That would be a start.
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One flu over the cuckoo's nest
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By Michael Woodhead, 6minutes editor
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As Christmas and the end of the year approaches I find myself looking back and reviewing the events of year. 2009 was of course the year of the surgical mask, the symbol of the swine flu pandemic that spread rapidly, but whose severity proved to be much milder than the panic and fear induced by warnings from the likes of Dr Margaret Chan, head of the WHO.
Contrary to her predictions that the second wave could "strike with a vengeance" and be the "biggest of all outbreaks the world has faced in the 21st century", a study this week suggests that the number of deaths from the H1N1 influenza pandemic is "considerably below that associated with seasonal influenza".
Questions are also being asked about the hugely expensive antiviral drug and vaccine stockpiles that panicky government ministers ordered to deal with the threat of a pandemic. Today in the BMJ, Professor Chris Del Mar and colleagues show that the neuraminidase inhibitors such as Tamiflu probably have little benefit in preventing the more serious complications of influenza in otherwise healthy people.
Perhaps that is some consolation to the GPs who battled unsuccessfully with state health departments to release their stocks of antivirals when the pandemic was at its peak in June.
The there's the pandemic vaccine. This week we have also heard from Dr David Fisman, a specialist in infectious diseases from the University of Toronto, that the huge H1N1 influenza vaccination campaign may have come too late to have any substantial effect on the disease - at least in the northern hemisphere. He says H1N1 is in natural decline because so many people have been infected and the 'reproductive number' - the number of people each infected person passes the virus to - is less than one, so the epidemic can't sustain itself, and fades away.
That's not to say that H1N1 vaccination is no longer of benefit, but it might explain some of the apparent apathy among the public to take up the vaccine, despite repeated calls from government health experts to do so.
Another reason for cynicism might be the revelations such as those seen in Science this week that Dutch government and WHO advisers on influenza have close links to the manufacturers.
If we have indeed spent hundreds of millions of dollars on questionable interventions to tackle an illusory threat, then surely we should have some sort of review to try and avoid this in years to come.
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