More and more people rely on information obtained from
online resources, and that is a normal process. On the pages of this blog,
there are links to several free self-administrated tests for Alzheimer’s. They
do not target to perform clinical diagnostics on the patients with potential
early symptoms of the disease, and in most cases, there is a disclaimer that
you cannot use it as valid tool and make serious assessment, based on the
received results.
Specialists are also voicing their
opinion that most online tests for Alzheimer's disease, freely distributed on
the Internet, are both unreliable and unethical.
An expert panel found that 16 freely
accessible online tests for Alzheimer's disease scored poorly on scales of
overall scientific validity, reliability and ethical factors, according to new
data reported at the Alzheimer's Association International Conference 2013 in
Boston.
"As many as 80 percent of
Internet users, including a growing proportion of older adults, seek health
information and diagnoses online," said Julie Robillard, Ph.D., a
postdoctoral fellow at the National Core for Neuroethics at the University of
British Columbia in Vancouver, British Columbia, Canada, who presented the data
at AAIC 2013.
"Self-diagnosis behavior in
particular is increasingly popular online, and freely accessible quizzes that
call themselves ‘tests' for Alzheimer's are available on the Internet. However,
little is known about the scientific validity and reliability of these
offerings and ethics-related factors including research and commercial conflict
of interest, confidentiality and consent. Frankly, what we found online was
distressing and potentially harmful," Robillard added.
According to the Alzheimer's
Association 2013 Alzheimer's Disease Facts and Figures report, more than 5
million Americans are living with Alzheimer's disease. By 2050, the number of
people with Alzheimer's could reach 13.8 million. Other estimates suggest that
number could be high as 16 million.
"The number of people with
Alzheimer's is projected to rise significantly as more and more people age into
greater risk for developing the disease," said Maria Carrillo, Ph.D.,
Alzheimer's Association vice president of medical and scientific Relations.
"Especially in that context, active promotion of healthy aging is a
priority for the Alzheimer's Association, as is the delivery of accurate,
reliable and ethical information and services."
Alzheimer's disease is the
sixth-leading cause of death in the United States and is the only leading cause
of death without a way to prevent, cure or even slow its progression.
Robillard and colleagues at the
University of British Columbia used information-mining techniques to retrieve
16 online tests for Alzheimer disease. Unique monthly visitors for the parent
sites hosting the online tests ranged from 800 to 8.8 million.
A panel of experts including
geriatricians, human-computer interaction specialists, neuropsychologists and
neuroethicists reviewed the tests, specifically evaluating the scientific
validity and reliability of the assessments, their human-computer interaction
features and ethics-related factors. The tests were evaluated on a scale from 1
(very poor) to 10 (excellent).
The researchers found that most of the
tests (12 of 16) scored "poor" or "very poor" for overall
scientific validity and reliability. These tests "are not useful for the
diagnosis of Alzheimer's disease," Robillard said.
All 16 tests scored "poor"
or "very poor" on the evaluation criteria for ethical factors.
According to Robillard, ethical issues with the tests included overly dense or
absent confidentiality and privacy policies, failure to disclose commercial
conflicts of interests, failure to meet the stated scope of the test and
failure to word the test outcomes in an appropriate and ethical manner.
The majority of tests (10 of the 16)
scored "fair" for appropriateness of human-computer interface for an
older adult population. According to the researchers, this suggests that the
visual aspects of the tests and the motor tasks required would be suitable for
older users.
"Freely accessible diagnostic
tests that lack scientific validity and conform poorly to guidelines around
consent, conflict of interest and other ethical considerations have the
potential to harm a vulnerable population and negatively impact their
health," Robillard said. "Further evidence and informed policy are
needed to promote the greatest benefits from tools and information available on
the Internet."
"As many as 80 percent of
Internet users, including a growing proportion of older adults, seek health
information and diagnoses online," Julie Robillard, a postdoctoral fellow
at the National Core for Neuroethics at the University of British Columbia in
Canada, said in an Alzheimer's Association news release.
Alzheimer's Society comments on this
recent report:
“It
is understandable that people sometimes might want to turn to the internet for
help if they are worried about their health. But what this research shows once
more is that people need to be careful when considering online tests for Alzheimer's.
Scientifically unsound tests could potentially give a false diagnosis while
offering no emotional support, which could be devastating for the person
carrying it out. If people are worried about their memory, or any
cognitive problem, it is important that they go and see their doctor. Only then
can they get a proper diagnosis which will open the door to information,
support and potentially treatments which can enable people to live well with
dementia.”
The Pew Research Center estimates that
approximately 72 percent of American internet users scour the web for health information
at least once a year. But, experts continue to urge caution, reminding people
that, in the digital age especially, you can’t believe everything you read.
So, should you stop using the online
information on the health-related issues in general, and for Alzheimers, in
particular? Do not think so. Just use the following guidelines, when you
perform your investigation, self-evaluation, or simply research:
* If it is published online, it is not
necessary to be true and valid. Apply critical thinking and healthy skepticism to
everything you read.
* Do not limit your research by a
single, or even few resources, trying to get as much information on the topic
as available.
* Give more weight to the sites, which
information is considered as reliable, for example www.alz.org for all Alzheimer’s related issues.
* Taking self-tests for Alzheimer’s signs for yourself or for
your family member, please accept the results in adequate proportions. These are
not clinical tests, and you should not be worried on a single poor score.
Repeat the test again, check other tests as well. If you have any suspicion
that your memory indeed degrades, arrange visit to your doctor.
* If you suspect a family member or friend is developing
Alzheimer's, take a look at these 10 warning signs of Alzheimer's Disease, put
together by the Alzheimer's Association:
1. Memory changes
that disrupt daily life
2. Challenges in
planning or solving problems
3. Difficulty
completing familiar tasks at home, at work, or at leisure
4. Confusion with
time or place
5. Trouble
understanding visual images and spatial relationships
6. New problems with
words in speaking or writing
7. Misplacing things
and losing the ability to retrace steps
8. Decreased or poor
judgment
9. Withdrawal from
work or social activities
10. Changes in mood
and personality
If you have questions or need
clarification, you may call the Alzheimer's Association's 24-hour hotline at
(800) 272-3900.
Sources
and Additional Information:
