The Consistency of Medical Information on Internet

Author conducted the review of several Internet based information sources which combine symptoms and underlying causes (diagnoses, diseases). The base was the experience with the Mayo Clinic portal for patients https://www.mayoclinic.org/symptoms2 . It was found that the view to this information is not consistent in relation to the other-way-around view in https://www.mayoclinic.org/diseases-conditions , where in one symptom description all related diseases (diagnoses) should be listed. The symptom mentioned can be seen in “diseases view” (diagnosis “Amyloidosis”). The opposite “symptoms view” for “weight loss” does not yield diagnosis “amyloidosis” in the list of dozens of diagnoses listed. In Mayo Clinic portal this inconsistency is overall practice: the same applies for “amyloidosis” also for the symptom “leg swelling” etc, but also for other diagnoses and symptoms. Author further examined other popular health portals: WebMD 3, MSD-Priručnici 4 (Croatia), PatientsLikeMe6 and NHS5. Based on this research the finding was unanimous: there is obvious lack of consistency between categories symptoms and diseases/conditions. In addition, in almost every source mentioned, inconsistencies in terminology were observed. Author concludes that the cause of this shortcoming are obviously two separate sources of information: separate databases for diagnoses and another for symptoms. Therefore, the author finally recommends fixing these shortcomings. Implementing such improvements, “diagnosing wandering” can be substantially reduced, being advantageous for obtaining straightforward path in diagnostic process in many cases

Auditory evoked potentials and vestibular evoked myogenic potentials in evaluation of brainstem lesions in multiple sclerosis

OBJECTIVE: The aim of this study was to determine the roles of magnetic resonance imaging (MRI), auditory evoked potentials (AEP) and vestibular evoked myogenic potentials (VEMP) in the evaluation of brainstem involvement in multiple sclerosis (MS). ----- PATIENTS AND METHODS: Altogether 32 patients with the diagnosis of MS participated in the study. The following data was collected from all patients: age, gender, Expanded Disability Status Scale (EDSS) score, brainstem functional system score (BSFS) (part of the EDSS evaluating brainstem symptomatology), and involvement of the brainstem on the brain MRI. AEP and ocular VEMP (oVEMP) and cervical VEMP (cVEMP) were studied in all patients. ----- RESULTS: BSFS, MRI, AEP, oVEMP and cVEMP involvement of the brainstem was evident in 9 (28.1%), 14 (43.8%), 7 (21.9%), 12 (37.5%) and 10 (31.0%) patients, respectively. None of the tests used showed statistically significant advantage in the detection of brainstem lesions. When combining oVEMP and cVEMP 18 (56.3%) patients showed brainstem involvement. This combination showed brainstem involvement in greater percentage than BSFS or AEP, with statistical significance (p=0.035 and p=0.007, respectively). ----- CONCLUSION: VEMP is a reliable method in detection of brainstem involvement in MS. It is comparable with MRI, but superior to clinical examination or AEP