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