A Bitter Pill to Swallow? The Consequences of Patient Evaluation in Online Health Q&A Platforms

49 Pages Posted: 3 Jun 2019

See all articles by Chen Chen

Chen Chen

Boston University - Questrom School of Business

Dylan Walker

Boston University - Questrom School of Business

Date Written: March 26, 2019

Abstract

Online Health Q&A platforms (OHQPs), where patients post health-related questions, evaluate advice from multiple doctors and reward a bounty to their most preferred answer, have become a prominent channel for patients to seek and receive medical advice in China. These platforms exhibit common design features, including bounty-motivated problem solving, limited search functionality, and lack of peer-assessment, but it is unclear if these platforms promote good medical advice. We analyzed data on patients’ evaluation of 497k answers to 114k questions on one of the most popular OHQPs over a 3-month period. We assembled a panel of independent (offline) physicians and instructed them to professionally evaluate the quality of 13k answers. We found that patients chose suboptimal advice in over two thirds of all cases. The medical accuracy of patient evaluation was even worse in critical categories (cancer, heart and liver disease) and for vulnerable subpopulations (pediatrics). Given that millions of patients seek medical advice from OHQPs in China annually, the social and economic implications of this finding are troubling. To understand why, we leveraged natural language processing techniques to construct a rich set of answer features and estimated a deep learning model to determine how patients responded to features. Importantly, we identified the extent to which patients respond positively or negatively to different heurist cue features. We found strong evidence that the platform reputation metric effectively encourages patients to select suboptimal medical advice, increases the moral hazard for physicians on the platform to provide advice that is less accurate but more agreeable to patients in exchange for bounty, and that OHQPs enable or exacerbate care avoidance. We discuss several potential policy changes to address these shortcomings.

Keywords: online health, patient evaluation, care avoidance, health advice

Suggested Citation

Chen, Chen and Walker, Dylan, A Bitter Pill to Swallow? The Consequences of Patient Evaluation in Online Health Q&A Platforms (March 26, 2019). Boston University Questrom School of Business Research Paper No. 3360192. Available at SSRN: https://ssrn.com/abstract=3360192 or http://dx.doi.org/10.2139/ssrn.3360192

Chen Chen

Boston University - Questrom School of Business ( email )

595 Commonwealth Avenue
Boston, MA MA 02215
United States
9193095100 (Phone)

Dylan Walker (Contact Author)

Boston University - Questrom School of Business ( email )

595 Commonwealth Avenue
Boston, MA MA 02215
United States

HOME PAGE: http://www.dylantwalker.com

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