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@article{Wallace:2022:10.1038/s41746-022-00667-w,
author = {Wallace, W and Chan, C and Chidambaram, S and Hanna, L and Iqbal, FM and Acharya, A and Normahani, P and Ashrafian, H and Markar, SR and Sounderajah, V and Darzi, A},
doi = {10.1038/s41746-022-00667-w},
journal = {npj Digital Medicine},
title = {The diagnostic and triage accuracy of digital and online symptom checker tools: a systematic review},
url = {http://dx.doi.org/10.1038/s41746-022-00667-w},
volume = {5},
year = {2022}
}

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TY - JOUR
AB - Digital and online symptom checkers are an increasingly adopted class of health technologies that enable patients to input their symptoms and biodata to produce a set of likely diagnoses and associated triage advice. However, concerns regarding the accuracy and safety of these symptom checkers have been raised. This systematic review evaluates the accuracy of symptom checkers in providing diagnoses and appropriate triage advice. MEDLINE and Web of Science were searched for studies that used either real or simulated patients to evaluate online or digital symptom checkers. The primary outcomes were the diagnostic and triage accuracy of the symptom checkers. The QUADAS-2 tool was used to assess study quality. Of the 177 studies retrieved, 10 studies met the inclusion criteria. Researchers evaluated the accuracy of symptom checkers using a variety of medical conditions, including ophthalmological conditions, inflammatory arthritides and HIV. 50% of the studies recruited real patients, while the remainder used simulated cases. The diagnostic accuracy of the primary diagnosis was low across included studies (range: 19% to 37.9%) and varied between individual symptom checkers, despite consistent symptom data input. Triage accuracy (range: 48.8% to 90.1%) was typically higher than diagnostic accuracy. Overall, the diagnostic and triage accuracy of symptom checkers are variable and of low accuracy. Given the increasing push towards adopting this class of technologies across numerous health systems, this study demonstrates that reliance upon symptom checkers could pose significant patient safety hazards. Large scale primary studies, based upon real world data, are warranted to demonstrate adequate performance of these technologies in a manner that is and non-inferior to current best practice. Moreover, an urgent assessment of how these systems are regulated and implemented is required.
AU - Wallace,W
AU - Chan,C
AU - Chidambaram,S
AU - Hanna,L
AU - Iqbal,FM
AU - Acharya,A
AU - Normahani,P
AU - Ashrafian,H
AU - Markar,SR
AU - Sounderajah,V
AU - Darzi,A
DO - 10.1038/s41746-022-00667-w
PY - 2022///
SN - 2398-6352
TI - The diagnostic and triage accuracy of digital and online symptom checker tools: a systematic review
T2 - npj Digital Medicine
UR - http://dx.doi.org/10.1038/s41746-022-00667-w
UR - http://hdl.handle.net/10044/1/98530
VL - 5
ER -

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