The quality of diagnosis and triage advice provided by free online symptom checkers and apps in Australia

Hill, Michella; Sim, Moira; Mills, Brennen

doi:10.5694/mja2.50923

Cited by 9 publications

(24 citation statements)

References 1 publication

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“…The use of case vignettes, based on real or fictitious patients, has been a common approach for rating SCs [5][6][7][8][9]. The 2 most recent non-industry-funded audit studies using this methodology rated SC triage capability as unreliable, with an average of only 49% and 58% of appraisals deemed correct [10,11]. In line with these findings, a 2020 literature review concluded that most investigated SCs offered limited benefits [12].…”

Section: Evidence On Scsmentioning

confidence: 99%

Benchmarking Triage Capability of Symptom Checkers Against That of Medical Laypersons: Survey Study

Schmieding¹,

Mörgeli²,

Schmieding³

et al. 2021

J Med Internet Res

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Background Symptom checkers (SCs) are tools developed to provide clinical decision support to laypersons. Apart from suggesting probable diagnoses, they commonly advise when users should seek care (triage advice). SCs have become increasingly popular despite prior studies rating their performance as mediocre. To date, it is unclear whether SCs can triage better than those who might choose to use them. Objective This study aims to compare triage accuracy between SCs and their potential users (ie, laypersons). Methods On Amazon Mechanical Turk, we recruited 91 adults from the United States who had no professional medical background. In a web-based survey, the participants evaluated 45 fictitious clinical case vignettes. Data for 15 SCs that had processed the same vignettes were obtained from a previous study. As main outcome measures, we assessed the accuracy of the triage assessments made by participants and SCs for each of the three triage levels (ie, emergency care, nonemergency care, self-care) and overall, the proportion of participants outperforming each SC in terms of accuracy, and the risk aversion of participants and SCs by comparing the proportion of cases that were overtriaged. Results The mean overall triage accuracy was similar for participants (60.9%, SD 6.8%; 95% CI 59.5%-62.3%) and SCs (58%, SD 12.8%). Most participants outperformed all but 5 SCs. On average, SCs more reliably detected emergencies (80.6%, SD 17.9%) than laypersons did (67.5%, SD 16.4%; 95% CI 64.1%-70.8%). Although both SCs and participants struggled with cases requiring self-care (the least urgent triage category), SCs more often wrongly classified these cases as emergencies (43/174, 24.7%) compared with laypersons (56/1365, 4.10%). Conclusions Most SCs had no greater triage capability than an average layperson, although the triage accuracy of the five best SCs was superior to the accuracy of most participants. SCs might improve early detection of emergencies but might also needlessly increase resource utilization in health care. Laypersons sometimes require support in deciding when to rely on self-care but it is in that very situation where SCs perform the worst. Further research is needed to determine how to best combine the strengths of humans and SCs.

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Section: Evidence On Scsmentioning

confidence: 99%

Benchmarking Triage Capability of Symptom Checkers Against That of Medical Laypersons: Survey Study

Schmieding¹,

Mörgeli²,

Schmieding³

et al. 2021

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…The use of telehealth has the potential to help provide appropriate pathways for people seeking health care guidance or care (reducing health care facility burden) and possibly decrease transmission of infectious disease by reducing in-person interactions between patients and providers. There is nascent but increasing evidence that semiautomated or fully automated health care triage and guidance applications can help direct users to appropriate care and decrease the inquiry and emergency department visit volume to health care systems with some degree of accuracy 34,35. In addition, remote patient monitoring and care approaches, such as the National Emergency Tele-Critical Care Network, have shown potential to offer specialty clinical expertise in medically underserved locations while also decreasing usage of on-site resources to ensure patient and provider safety (eg, personal protective equipment) 36…”

Section: Understanding the Evidence Base For Telehealth In Us Public ...mentioning

confidence: 99%

Telehealth and Public Health Practice in the United States—Before, During, and After the COVID-19 Pandemic

Neri

Whitfield

Umeakunne

et al. 2022

Journal of Public Health Management and Practice

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Telehealth is the use of electronic information and telecommunication technologies to provide care when the patient and the provider are not in the same room at the same time. Telehealth accounted for less than 1% of all Medicare Fee-for-Service outpatient visits in the United States in 2019 but grew to account for 46% of all visits in April 2020. Changes in reimbursement and licensure policies during the COVID-19 pandemic appeared to greatly facilitate this increased use. Telehealth will continue to account for a substantial portion of care provided in the United States and globally. A better understanding of telehealth approaches and their evidence base by public health practitioners may help improve their ability to collaborate with health care organizations to improve population health. The article summarizes the Centers for Disease Control and Prevention's (CDC's) approach to understanding the evidence base for telehealth in public health practice, possible applications for telehealth in public health practice, and CDC's use of telehealth to improve population health.

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“…Symptom checkers are algorithm-based programs that provide potential virtual diagnoses and triage advice [17][18][19]. Symptom checkers promise a cost-effective way of enabling rapidly scalable epidemiological data collection and analysis, with varying diagnostic accuracy [20,21].…”

Section: Introductionmentioning

confidence: 99%

Use and Users of the Web-Based Omaolo Covid-19 Symptom Self-Assesment Tool in Finland Since March 16, 2020

Jormanainen

Soininen²

2021

Studies in Health Technology and Informatics

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In Finland, it is possible to quickly produce medical symptom self-assessment tools within the existing infrastructure. The Finnish Omaolo Covid-19 web-based symptom self-assessment tool (symptom checker) was launched on March 16, 2020 after a 6-day development period. By using the web-based Omaolo Covid-19 symptom checker during the second wave of the epidemic, some 1.72 million questionnaires were recorded, out of which 1.55 million from symptomatic persons. Some 15% of the responses (245,500) were directed to seek emergency medical care based on the online screening by respondent response profiles.

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The quality of diagnosis and triage advice provided by free online symptom checkers and apps in Australia

Cited by 9 publications

References 1 publication

Benchmarking Triage Capability of Symptom Checkers Against That of Medical Laypersons: Survey Study

Benchmarking Triage Capability of Symptom Checkers Against That of Medical Laypersons: Survey Study

Telehealth and Public Health Practice in the United States—Before, During, and After the COVID-19 Pandemic

Use and Users of the Web-Based Omaolo Covid-19 Symptom Self-Assesment Tool in Finland Since March 16, 2020

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