The Journal of mHealth Vol 2 Issue 4 (August) - Page 19

Industry News users should be cautious and not take the information they receive from online symptom checkers as gospel,” said senior author Ateev Mehrotra, associate professor of health care policy and medicine at HMS and Beth Israel Deaconess Medical Center. Published in the BMJ, the study, led by researchers at Harvard Medical School (HMS), created standardised lists of symptoms from 45 clinical vignettes that are used to teach and test medical students and then input those symptoms into 23 different symptom checkers. Overall, the software algorithms that the researchers studied listed the correct diagnosis first in 34 percent of cases. The correct diagnosis was included in the top three diagnoses in the list in 51 percent of cases and in the top 20 in 58 percent. Overall, the 23 symptom checkers provided correct triage advice in 58 percent of cases, with the checkers performing much better in more critical cases, correctly recommending emergency care in 80 percent of urgent cases.By comparison, other studies have found that Internet search engines for urgent symptoms led to content that suggested emergency medical treatment only 64 percent of the time. with the most accurate diagnoses (Isabel, iTriage, Mayo Clinic, and Symcat) were not on the list of the programs that did the best job of recommending the appropriate level of care for a given case (Healthychildren.org, Steps2Care, and Symptify). Symptom checkers are part of a larger trend of both patients and practitioners using online platforms for a range of health care tasks, such as patient-doctor chat sessions and algorithmic tools used to aid the diagnosis and triage of patients, the researchers said. The symptom checkers that were evaluated tended to be overly cautious, encouraging users to seek care for situations where staying at home might be reasonable. The researchers noted that this tendency toward conservative advice encouraged people to seek unnecessary care—an outcome that health care reform strives to minimise in order to reduce costs. “The tools are not likely to go away,” said first author Hannah Semigran, HMS research assistant in health care policy. “With symptom trackers, we’re looking at the first generation of a new technology. It’s important to continue to track their performance to see if they can reach their full potential in helping patients get the right care.” In many cases, getting the exact diagnosis may not be as important as getting the correct advice about whether—or how quickly—to go to the doctor. The study which was funded by the U.S. National Institutes of Health highlights a growing requirement for supporting evidence to help patients and consumers select and use online and digital health products and services. As more and more people choose to use digital tools to help them better understand their own health requirements then the healthcare industry will have to find ways to communicate which tools are effective. Going forward, we are likely to see many more studies of this nature, which will help in this process. “It’s not nearly as important for a patient with fever, headache, stiff neck, and confusion to know whether they have meningitis or encephalitis as it is for them to know that they should get to an ER quickly,” Mehrotra said. The researchers found a great deal of variation between checkers, but none was without limitations; for example, checkers Source: Harvard Gazette n MIT Turns Hacking Medicine Program into an Institute to Study Digital Health Medical devices and information technologies have flooded the airwaves with health-related data, but the underlying question of whether the on slaught of digital-health products has made people healthier remains. Now a new institute spun out from the Massachusetts Institute of Technology is aiming to help answer that question. and telemedicine programs that seemed out of reach 20 years ago. Billions of dollars were spent last year on digital-health products, and billions more were invested in start-up companies making wearable sensors, big-data platforms, analytics, fitness trackers, apps Information about how the technology may be shaping people’s health and is being answered in bits and pieces by health-system players who have their Continued on page 18 The Journal of mHealth 17