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Article ; Online: Performance of a new symptom checker in patient triage

Forson Chan / Simon Lai / Marcus Pieterman / Lisa Richardson / Amanda Singh / Jocelynn Peters / Alex Toy / Caroline Piccininni / Taiysa Rouault / Kristie Wong / James K Quong / Adrienne T Wakabayashi / Anna Pawelec-Brzychczy

PLoS ONE, Vol 16, Iss 12, p e

Canadian cohort study.

2021  Volume 0260696

Abstract: Background Computerized algorithms known as symptom checkers aim to help patients decide what to do should they have a new medical concern. However, despite widespread implementation, most studies on symptom checkers have involved simulated patients. ... ...

Abstract Background Computerized algorithms known as symptom checkers aim to help patients decide what to do should they have a new medical concern. However, despite widespread implementation, most studies on symptom checkers have involved simulated patients. Only limited evidence currently exists about symptom checker safety or accuracy when used by real patients. We developed a new prototype symptom checker and assessed its safety and accuracy in a prospective cohort of patients presenting to primary care and emergency departments with new medical concerns. Method A prospective cohort study was done to assess the prototype's performance. The cohort consisted of adult patients (≥16 years old) who presented to hospital emergency departments and family physician clinics. Primary outcomes were safety and accuracy of triage recommendations to seek hospital care, seek primary care, or manage symptoms at home. Results Data from 281 hospital patients and 300 clinic patients were collected and analyzed. Sensitivity to emergencies was 100% (10/10 encounters). Sensitivity to urgencies was 90% (73/81) and 97% (34/35) for hospital and primary care patients, respectively. The prototype was significantly more accurate than patients at triage (73% versus 58%, p<0.01). Compliance with triage recommendations in this cohort using this iteration of the symptom checker would have reduced hospital visits by 55% but cause potential harm in 2-3% from delay in care. Interpretation The prototype symptom checker was superior to patients in deciding the most appropriate treatment setting for medical issues. This symptom checker could reduce a significant number of unnecessary hospital visits, with accuracy and safety outcomes comparable to existing data on telephone triage.
Keywords Medicine ; R ; Science ; Q
Subject code 616
Language English
Publishing date 2021-01-01T00:00:00Z
Publisher Public Library of Science (PLoS)
Document type Article ; Online
Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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