21. Caught in the Web: E-Diagnosis

  1. James C. Pile5,
  2. Thomas E. Baudendistel6 and
  3. Brian J. Harte7
  1. Yasuharu Tokuda1,
  2. Makoto Aoki2,
  3. Saurabh B. Kandpal3 and
  4. Lawrence M. Tierney4

Published Online: 21 MAR 2013

DOI: 10.1002/9781118483206.ch21

Clinical Care Conundrums: Challenging Diagnoses in Hospital Medicine

Clinical Care Conundrums: Challenging Diagnoses in Hospital Medicine

How to Cite

Tokuda, Y., Aoki, M., Kandpal, S. B. and Tierney, L. M. (2013) Caught in the Web: E-Diagnosis, in Clinical Care Conundrums: Challenging Diagnoses in Hospital Medicine (eds J. C. Pile, T. E. Baudendistel and B. J. Harte), John Wiley & Sons, Inc., Hoboken, NJ, USA. doi: 10.1002/9781118483206.ch21

Editor Information

  1. 5

    Departments of Hospital Medicine and Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA

  2. 6

    Department of Medicine, Kaiser Permanente Medical Center, Oakland, California, USA

  3. 7

    South Pointe Hospital, Cleveland Clinic Health System, Warrensville Heights, Ohio, USA

Author Information

  1. 1

    Department of Medicine, Mito Kyodo General Hospital, University of Tsukuba, Mito City, Japan

  2. 2

    Sakura Seiki Company, Tokyo, Japan

  3. 3

    Department of Hospital Medicine, Cleveland Clinic, Cleveland, Ohio, USA

  4. 4

    Department of Medicine, University of California, San Francisco, California, USA

Publication History

  1. Published Online: 21 MAR 2013
  2. Published Print: 15 MAR 2013

Book Series:

  1. Hospital Medicine: Current Concepts

Book Series Editors:

  1. Scott A. Flanders and
  2. Sanjay Saint

ISBN Information

Print ISBN: 9780470905654

Online ISBN: 9781118483206



  • clinical decisions;
  • e-diagnosis;
  • heart;
  • Internet search;
  • POEMS syndrome


Polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome, also known as the Crow–Fukase syndrome, is a rare multisystem disorder. The chapter presents a case study of a 52-year-old woman. The “diagnostic test” was an Internet search based on the most prominent clinical symptoms as clinicians frequently use the Internet to aid in the clinical decision process. Such a strategy can provide a powerful addition to traditional literature and MEDLINE resources. However, the efficiency of this process, e-diagnosis, is heavily dependent on the quality of the search strategy and, therefore, the cognitive faculties of the treating physician to avoid the predictable shortcoming of low specificity. Internet searches using search engines such as Google Scholar appear most useful as adjuncts to PubMed and clinical reasoning in identifying case reports when a well-constructed collection of symptoms and signs is used for searches.