Patient Perspectives on the Usefulness of an Artificial Intelligence–Assisted Symptom Checker: Cross-Sectional Survey Study

Abstract

Background Patients are increasingly seeking Web-based symptom checkers to obtain diagnoses. However, little is known about the characteristics of the patients who use these resources, their rationale for use, and whether they find them accurate and useful. Objective The study aimed to examine patients’ experiences using an artificial intelligence (AI)–assisted online symptom checker. Methods An online survey was administered between March 2, 2018, through March 15, 2018, to US users of the Isabel Symptom Checker within 6 months of their use. User characteristics, experiences of symptom checker use, experiences discussing results with physicians, and prior personal history of experiencing a diagnostic error were collected. Results A total of 329 usable responses was obtained. The mean respondent age was 48.0 (SD 16.7) years; most were women (230/304, 75.7%) and white (271/304, 89.1%). Patients most commonly used the symptom checker to better understand the causes of their symptoms (232/304, 76.3%), followed by for deciding whether to seek care (101/304, 33.2%) or where (eg, primary or urgent care: 63/304, 20.7%), obtaining medical advice without going to a doctor (48/304, 15.8%), and understanding their diagnoses better (39/304, 12.8%). Most patients reported receiving useful information for their health problems (274/304, 90.1%), with half reporting positive health effects (154/302, 51.0%). Most patients perceived it to be useful as a diagnostic tool (253/301, 84.1%), as a tool providing insights leading them closer to correct diagnoses (231/303, 76.2%), and reported they would use it again (278/304, 91.4%). Patients who discussed findings with their physicians (103/213, 48.4%) more often felt physicians were interested (42/103, 40.8%) than not interested in learning about the tool’s results (24/103, 23.3%) and more often felt physicians were open (62/103, 60.2%) than not open (21/103, 20.4%) to discussing the results. Compared with patients who had not previously experienced diagnostic errors (missed or delayed diagnoses: 123/304, 40.5%), patients who had previously experienced diagnostic errors (181/304, 59.5%) were more likely to use the symptom checker to determine where they should seek care (15/123, 12.2% vs 48/181, 26.5%; P=.002), but they less often felt that physicians were interested in discussing the tool’s results (20/34, 59% vs 22/69, 32%; P=.04). Conclusions Despite ongoing concerns about symptom checker accuracy, a large patient-user group perceived an AI-assisted symptom checker as useful for diagnosis. Formal validation studies evaluating symptom checker accuracy and effectiveness in real-world practice could provide additional useful information about their benefit.

Patients’ Utilization and Perception of an Artificial Intelligence–Based Symptom Assessment and Advice Technology in a British Primary Care Waiting Room: Exploratory Pilot Study

“…Studies of other symptom checkers also report a high degree of perceived utility. In a convenience sample of 304 US users of the Isabel symptom checker, 90.1% (274/304) agreed or strongly agreed that it gave them useful information, and a similar proportion said they would use the tool again [ 29 ].…”

“…In terms of reducing the burden on primary care, some 12.8% (63/494) of respondents in this study predicted that they would have used a less urgent care option such as a pharmacist or self-care had they used Ada before visiting the doctor. It remains to be seen how many patients would actually follow advice on where to go next, but in the survey of US Isabel symptom checker users, about half (14/26, 54%) of those advised to go to the emergency department reported that they did so [ 29 ]. Another recent paper reported broadly similar findings from over 150,000 encounters with the Buoy Health symptom checker: 18.8% of patients who had planned to visit primary care reduced the urgency of care they would seek, and 2.6% increased the urgency of their intended level of care [ 30 ].…”

Young Adults’ Perspectives on the Use of Symptom Checkers for Self-Triage and Self-Diagnosis: Qualitative Study

“…In assessing symptom checker benefits, it is important to understand user perspectives on the platform after actual use rather than simply assessing their accuracy in fictitious situations [ 14 , 15 ]. A study that examined patients’ experiences using the symptom checker “Isabel” found that the platform was most commonly used to better understand the causes of symptoms, followed by deciding whether or not to seek care [ 14 ]. Most of the patients in that study (274/304, 90.1%) reported receiving useful information for their health problems and reported that they would use the symptom checker again (278/304, 91.4%) [ 14 ].…”

“…A study that examined patients’ experiences using the symptom checker “Isabel” found that the platform was most commonly used to better understand the causes of symptoms, followed by deciding whether or not to seek care [ 14 ]. Most of the patients in that study (274/304, 90.1%) reported receiving useful information for their health problems and reported that they would use the symptom checker again (278/304, 91.4%) [ 14 ]. These findings are in line with another study that examined perspectives on use of the “Ada” symptom checker, which showed that most of the participants (443/503, 88.1%) would recommend the platform to a relative [ 16 ].…”

Will online symptom checkers improve health care in Australia?

“…People see value in symptom checkers, but while self‐reported outcomes are important, they are not necessarily associated with safety or improved health service efficiency.…”