The Internet Is Making Us Lose Trust In Our Doctors

How well do you trust your doctor?

Is seems that, at least for parents, a level of trust might be impacted by exposure to on-line medical information.  A study presented at the 2017 Pediatric Academic Societies suggests that doctor / patient trust and the drive to a second opinion–in a digital age–might be more fragile than we thought.  In this study, 1,374 parent participants were presented with a vignette of a child who ‘has had a rash and worsening fever for 3 days.’ The participants were divided into three groups and the first two were presented with information related to the symptoms as computer screen shots.

  • Group one was presented with screen shots of clinical information on scarlet fever.
  • Group two was presented with screen shots of clinical information on Kawasaki Disease (a condition that causes inflammation in the walls of blood vessels).
  • Group three received no internet screenshots.

After which, all three groups were informed that that physician had diagnosed the child with scarlet fever and then asked to rate their level of trust in the diagnosis from 1 (Not at all) to 7 (Completely). Parents were also asked to rate their likelihood of seeking a second opinion regarding the diagnosis, from 1 (Extremely Unlikely) to 7 (Extremely Likely).

Physician and Patient Trust

With permission. Ruth Malanaik

Source: Ruth Malaniak MD

The results suggest that prior exposure to information can ‘prime’ a parent to have a unique bias. This bias can impact the trust that has been established with a physician and even change the care pathway.  And this result was supported statistically–the three cohorts significantly differed in reported trust in the doctors’ diagnosis (p < .001) and reported likelihood of seeking a second opinion.  The authors concluded:

After reading online search results, parents were more inclined to trust their doctor’s Dx (diagnosis) when online information supported their doctor Dx and less inclined when information contradicted the doctor. Parents were also more likely to seek a SO (second opinion) if internet results contradicted the doctor Dx. Although it is imperative that parents participate in the medical decision-making process, conflicting online information could in some cases delay necessary medical treatment. Physicians must be aware of the influence the internet may have on parents and ensure adequate parental education to address any possible concerns.

While this ‘artificial’ scenario may not accurately reflect everyday life or clinical practice, the results seem to indicate that exposure to clinical information on-line may ‘prime’ parents to particular point of view and predisposition to action. I’m reminded of work done by John Bargh, a social psychologist who studied how people, given prior exposure to information, can have that point of view reflected in their subsequent opinion or actions. This concept was popularized by Malcolm Gladwell in his best selling book Blink.

In this study, we can see how information obtained on-line can directly impact the caregivers’ perceptions of decisions and recommendations of a physician.  Dr. Ruth Milaniak MD, the lead investigator of this study, supports this observation and offers some important advice.

Every time I speak with my patients, I always have in the back of my mind what on-line influence may have already impacted our dialogue.  The internet is emerging as ‘the elephant exam room’ and we as clinicians need to understand this and communicate with patients and caregivers accordingly.

In an era where doctor / patient communication can be time-limited, the role of on-line support may play and increasing role. And as more and more, patients look to Dr. Google as a primary source of medical information, the key question that emerges is if that ‘digital information’ helps or hurts clinical care.

Follow me @JohnNosta for a more informed and healthy future.


Maybe the Internet Isn’t Tearing Us Apart After All


VIKINGMAIDEN88 IS TWENTY-SIX years old. She enjoys reading history and writing poetry. Her signature quote is from Shakespeare. I gleaned all this from her profile and posts on, America’s most popular online hate site. I also learned that Vikingmaiden88 has enjoyed the content on the site of the newspaper I work for, the New York Times. She wrote an enthusiastic post about a particular Times feature. I recently analyzed tens of thousands of such Stormfront profiles, in which registered members can enter their location, birth date, interests, and other information.

Stormfront was founded in 1995 by Don Black, a former Ku Klux Klan leader. Its most popular “social groups” are “Union of National Socialists” and “Fans and Supporters of Adolf Hitler.” Over the past year, according to Quantcast, roughly 200,000 to 400,000 Americans visited the site every month. A recent Southern Poverty Law Center report linked nearly one hundred murders in the past five years to registered Stormfront members.

Stormfront members are not whom I would have guessed. They tend to be young, at least according to self-reported birth dates. The most common age at which people join the site is nineteen. And four times more nineteen-year-olds sign up than forty-year-olds. Internet and social network users lean young, but not nearly that young. Profiles do not have a field for gender. But I looked at all the posts and complete profiles of a random sample of American users, and it turns out that you can work out the gender of most of the membership: I estimate that about 30 percent of Stormfront members are female. The states with the most members per capita are Montana, Alaska, and Idaho. These states tend to be overwhelmingly white. Does this mean that growing up with little diversity fosters hate?

Blackstone warns of internet impact on US shopping malls


Blackstone, the world’s largest real estate investor, has warned that the outlook for America’s enclosed shopping malls is darkening quicker than experts expected as the growing online retail threat hammers their valuations.

More than 10 per cent of US retail sales are transacted online, according to Credit Suisse, forcing big chains to shutter thousands of stores in recent years. Retailers have announced plans to close 76m square feet of store space already this year, according to CoStar, a data provider, almost as much as that announced in the whole of 2016.

Retail woes are intensifying pressures on shopping malls, especially of the lower-end “enclosed” type in smaller American cities and towns, where tenants are moving out or demanding lower rents. The enclosed mall is the classic indoor commercial hub that emerged in the 1950s, rather than the malls built around an anchor grocery chain or department store.

“The retail industry is clearly facing headwinds. And it’s the first time we’ve seen secular rather than cyclical headwinds,” said Nadeem Meghji, head of North American real estate at Blackstone. “We’re now seeing pressures even on luxury retailers, which I didn’t expect to happen as fast as it has.”Image result for Blackstone warns of internet impact on US shopping malls

The market for second-tier enclosed malls has virtually frozen given how concerned investors are, but Mr Meghji estimated that in the past two years prices may have plunged as much as 40 per cent on average for the 1,100 enclosed regional malls in the US. Even for the top 50, prices have probably declined by 20 per cent, the Blackstone executive said.

The private equity firm’s $102bn real estate arm still owns some grocery shop-anchored malls in high-density population areas, but no longer has any exposure to the enclosed shopping mall sector.

“The internet has made the value proposition for a lot of shopping malls less relevant,” Mr Meghji said. “If you add in the factor that they actually tend to have higher operating costs due to security, electricity and so on, then they are high-cost rental spaces for retailers.”

However, Greg Maloney, chief executive for Americas retail at JLL, the real estate investment and management company, said the “doom and gloom” was overdone, pointing out that a retail property can be converted to alternative uses such as housing. He argued that overbuilding is the central challenge rather than internet shopping.

“People say the internet killed bricks-and-mortar retailers. But bricks and mortar killed itself,” he said. “People say they don’t know how we’ll survive, but we do it by adapting.”

Yet concerns about the march of online retailing are mounting in most parts of the retail industry. Sears, the department store chain founded in 1886, is emblematic of the challenges. In March it warned there was “substantial doubt” over its ability to continue operating, and its Canadian subsidiary filed for bankruptcy last month.

The US company managed to steady its shares with a fierce cost-cutting drive this year but many investors expect it to fall by the wayside. Given Sears’ long pedigree, that could deepen investor pessimism surrounding the industry, according to Larry Perkins, head of SierraConstellation Partners, a restructuring firm.

“The big names mark the tipping points, and everyone is now looking at Sears as it is such a marque name,” he said. “Its cultural significance is disproportionate, given its legacy and history.”


Deal: LG G6 is $150 off in the US

If you are in the US and planning to purchase the LG G6, you might want to check out the deal Amazon is offering: unlocked variant (black and platinum color options) for $549.99.

That is down $150 from the $699.99 price tag the device usually carries there. Officially also, LG has the unlocked variant listed for $700.

The model on offer is compatible with both GSM and CDMA networks, meaning you can use it on all major US carriers including AT&T, T-Mobile and Verizon. No information on when the deal ends. For more details, head to the Source link below.


Nokia 6, Moto E4 Join List of Amazon Prime Exclusive Phones in the US


For Prime members, the Moto E4 is up for grabs for $99.99
All the smartphones are up for pre-order right now
Nokia 6 will ship on July 10, while Moto E4 will ship on June 30
The Nokia 6 was announced for the US earlier this week, due to arrive on Amazon. Now, Amazon has now announced it as a Prime Exclusive smartphone – which means it will show offers and ads – featuring a $50 (roughly Rs. 3,200) discount on its price tag. Apart from the Nokia 6, the Moto E4 was also announced as a Prime Exclusive.

The Nokia 6 will be available at $229 (roughly Rs. 14,800) in the US through Amazon for non-Prime members, but Prime members can choose to grab it for $179 (roughly Rs. 11,500) only, complete with offers and ads. Similarly, Moto’s recently announced Moto E4 16GB will be offered at $99.99 (roughly Rs. 6,400) for Prime members ($30 off the full retail price). Verizon still gives you to best price at $69 (roughly Rs. 4,500), but you’re locked on to Verizon with that deal. Both the smartphones are up for pre-order, and the Moto E4 will be shipped on June 30, while the Nokia 6 will be shipped on July 10.Nokia 6, Moto E4 Join List of Amazon Prime Exclusive Phones in the US

Alcatel is also adding to the Prime Exclusive catalogue with the new Alcatel Idol 5S for only $199.99 (roughly Rs. 12,900) for Prime members ($80 off the full retail price), the Alcatel A50 for only $99.99 (roughly Rs. 6,400) for Prime members ($50 off the full retail price), and the Alcatel A30 Plus, available for only $79.99 (roughly Rs. 5,100) for Prime members (also $50 off the full retail price). The Alcatel phones are also up for pre-order and will ship on July 10.

Nokia 6 specifications
Nokia 6, the best-specced of the Nokia Android phones released so far, runs Android 7.0 Nougat and sports a 5.5-inch full-HD (1080×1920 pixels) display with Corning Gorilla Glass protection and a fingerprint sensor right below the display. The smartphone is powered by Snapdragon 430 processor coupled with Adreno 505 GPU and 3GB of RAM. In terms of optics, Nokia 6 comes with a 16-megapixel rear sensor and an 8-megapixel camera at front for taking selfies.
The US variant of the Android phone from Nokia comes with 32GB inbuilt storage, which is expandable via microSD card (up to 256GB). The Nokia 6 houses a 3000mAh battery, features a 6000 series aluminium body, and has inbuilt dual speakers and Dolby Atmos support. Connectivity options on the smartphone include Wi-Fi, GPS, Bluetooth, NFC, USB OTG, FM, 3G, and 4G.

Moto E4 specifications
Coming to the specifications, the Moto E4 runs on Android 7.1 Nougat and comes with a single-SIM slot (Nano). It sports a 5-inch HD (720×1280 pixels) display, and is powered by the 1.4GHz Snapdragon 425 processor or a Snapdragon 427 SoC (depending upon the carrier in the US) paired with 2GB of RAM. The smartphone offers 16GB of inbuiltl storage option with the option to expand further using a microSD card slot.

As for the optics, the Moto E4 has an 8-megapixel rear camera with autofocus, f/2.2 aperture, and single-LED flash support. At the front, there is a 5-megapixel sensor with f/2.2 aperture, fixed focus, single-LED flash, and a beautification mode for better selfies. It packs a 2800mAh removable battery, and connectivity options include Wi-Fi 802.11n, Micro-USB port, GPS, Bluetooth v4.1, and 4G support. The dimensions are at 144.5×72 x9.3mm, and the smartphone weighs 150 grams. Sensors on board include proximity, light, accelerometer, and magnetometer. In the US, it will be available in Liquorice Black, and Fine Gold colour variants.


HTC’s U Ultra starts shipping this Friday in the US

HTC’s U Ultra — memorably dubbed a “compendium of bad ideas” by The Verge’s Vlad Savov — will start shipping to customers in the US on March 10th. This information comes from HTC’s official store via PhoneArenaThe $749 handset is also still available to pre-order, and comes unlocked and in three colors (Sapphire Blue, Brilliant Black, and Ice White).

The U Ultra has some decent specs, including 4GB of RAM, a Snapdragon 821 processor, and a 5.7-inch Quad HD Screen. However, HTC has made some questionable choices, including giving the device a 3,000 mAh battery (too small for a screen that beefy), tacking a “second display” onto the top of the device (like LG’s V10), and removing the headphone jack to boot. This might have seemed like the future for mobiles following the launch of the iPhone 7 and 7 Plus, but as we saw at Mobile World Congress, phone makers (thankfully) aren’t giving up on the 19th century port yet.


New update hitting unlocked HTC 10 in US

HTC has started pushing out a new update to its 10 smartphone in the United Sates. Hitting unlocked units, it’s a security update that arrives as version 2.50.617.2 and weighs in at around 277MB.

View image on Twitter

View image on Twitter

It’s not exactly clear which month’s security update it is – the tweet clearly says July, but in the comments that follow, users report June update. Also, there’s no information on what other changes are included.Image result for New update hitting unlocked HTC 10 in US

Have you received the update? Share any changes you found with the rest of us in the comments section below.


The case for BlackBerry at $45 US a share


An automobile running Blackberry QNX software is shown during the Milken Institute Global Conference in Beverly Hills, Calif., in this May 2, 2017, photo. (Mike Blake/Reuters)

BlackBerry Ltd. shares have been on a hot streak — rising more than 60 per cent in recent weeks — and one technology analyst thinks some of the company’s new products have the potential to help push the stock to $45 US in three years.

In a recent report, Gus Papageorgiou, associate director of technology research at Macquarie Capital Partners, pointed to two BlackBerry products — its Radar system for monitoring truck trailers and containers, and the QNX operating software system used to run vehicle systems — as drivers of the company’s future.

The Radar system can monitor the load status of a truck trailer, its location, and whether the doors are open or closed, among other things. That can help shipping companies better manage their trailers. Papageorgiou says some early customers are reporting a 17 per cent reduction in the number of trailers they require, along with opportunities to charge customers who hold on to trailers too long.

  • BlackBerry awarded $815M in arbitration with QualcommAn automobile running Blackberry QNX software is shown during the Milken Institute Global Conference in Beverly Hills, Calif., in this May 2, 2017, photo.

Meanwhile, BlackBerry QNX currently dominates the infotainment software market for vehicles with an estimated market share of 50 per cent, Papageorgiou’s report says. The software runs in about 60 million vehicles.

Last year, Ford Motor Co. signed a deal with BlackBerry to ramp up the installation of QNX in its vehicles. Ford and BlackBerry also reached an agreement to shift up to 400 workers to the automaker to bolster its efforts to develop a self-driving car.

“I think these are very healthy markets where they have advantages,” Papageorgiou said in a recent interview with Dianne Buckner for CBC News Network’s On the Money. “The business they’re getting into is highly recurring software business with high margins, so I think there is potential here.”

Searching for reinvention

A former leader in the smartphone business, BlackBerry’s fortunes tumbled amidst strong competition in the handset market. The battered company has since been trying to reinvent itself with a new focus on software.

“I think they’re finally delivering some promising business lines,” Papageorgiou said.

  • BlackBerry’s software shift ‘100 per cent complete,’ but branding challenge remains

The company’s stock has been on the rise of late, hitting levels not seen in four years. Since the end of March, it has gone from under $10 on the TSX to close Thursday at $15.12. On Nasdaq, the stock closed at $11.22 US, up from about $7 US at the end of March.

Papageorgiou said the Radar and QNX innovations could contribute $2 billion or more in software revenue in three years, and earnings per share of about $1.80. Based on a price-earning multiple of 25, that translates to a stock price of $45, he says.

For the more immediate future, Macquarie’s take on BlackBerry’s stock is decidedly more modest. The firm bumped its 12-month target for the issue from $10.50 US and $14 Cdn to a new goal of $11.80 US and $16.20 Cdn.

Given the volatile nature of the technology market, it’s not clear cut that things will play out in favour of BlackBerry. A recent article in Forbes pointed out that both Apple and Google’s parent company, Alphabet, have been showing interest in the automotive market.

Apple has been reported to be working on its own operating systems for a self-driving car, while Alphabet has launched its own Android Automotive infotainment system. Both firms have massive resources to throw at automotive projects.


LG X venture is now available for purchase in US

As scheduled, the LG X venture is now available for purchase in US. It’s listed on AT&T’s website for $11/month on a 30-month agreement. Alternatively, you can also grab a unit for $330 outright.

To refresh, here are the device’s key specifications: Snapdragon 435 SoC, 5.2-inch 1080p display, 2GB/32GB memory configuration, 16MP/5MP camera combo, and Android Nougat.

The X venture packs in a large 4,100mAh battery, and features IP68 water and dust protection. It is also 14 MIL-STD 810G certified for extreme temperatures.

Nokia 9 FCC Listing Hints at HMD Global US Expansion Plans


Nokia 9, which has previously been spotted with the codename ‘HMD Global TA-1004’ on benchmark websites as well as on a leaked official teaser video, has now made an appearance on the FCC website. The FCC listing is a significant development since this means HMD Global – the custodians of the Nokia mobile phone brand – is looking to launch the Nokia 9 in the US market. The leak does not give away much in the form of specifications and other details, but at least confirms the Nokia Android phone is headed to one of the most important markets for flagship handsets.Nokia 9 FCC Listing Hints at HMD Global US Expansion Plans

According to the FCC listing, the smartphone will support both GSM and WCDMA technologies, and will support NFC as well as Bluetooth 4.2 LE. According a report by Phones Daily, the Nokia 9 will have a 5.3-inch display and support dual-SIM cards. The smartphone will also pack a Snapdragon 835 processor coupled with 4/6GB RAM and 64GB built-in storage, as per the report.

Contrary to the new leak, the Nokia 9 was earlier suggested to sport a bigger 5.5-inch QHD display. Importantly, an 8GB RAM variant of the Nokia 9 has been spotted in benchmark listing. The phone has been tipped to feature dual 13-megapixel cameras at the back with dual-LED flash support as well. At front, a 13-megapixel camera is expected as well. While the battery capacity on the device has not been disclosed, it is expected to support Qualcomm Quick Charge 4.0.