Doktor Google hat ausgedient: Sogenannte Symptom-Checker sind besser, um Krankheiten zu identifizieren. Es ist aber Vorsicht geboten.

Definition of the problem Digital health technologies have gained significant importance in recent years. These technologies include symptom checker apps which use algorithms or artificial intelligenc...

Doktor Google hat ausgedient: Sogenannte Symptom-Checker sind besser, um Krankheiten zu identifizieren. Es ist aber Vorsicht geboten.

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Background: The National Health Service faces increasing strain. Concurrently, demand for health information, consumer empowerment and health awareness continue to grow. These trends, coupled with the ubiquity of smartphones and internet access, are positioning online symptom checkers (OSCs) as promising tools for preliminary diagnosis and triage. While there is increasing data on the demographics, motivations and perspectives of current and potential users of OSCs globally, no study has yet quantified or ranked the various factors associated with the use of OSCs in the United Kingdom (UK). Objective: The aim of this study was to assess key trends and user perceptions on the #usability and effectiveness of OSC in the UK. We also sought to identify concerns related to the privacy, security and accuracy of OSCs, and to quantify the weight of these various factors on the use of OSCs. Methods: A cross-sectional survey of UK adults was conducted using an electronic questionnaire. A convenience sample was recruited between February and March 2024 through online platforms and personal networks. The survey included questions on awareness, use, perceptions and concerns regarding OSCs, as well as respondents’ demographics. Responses were pseudo-anonymised and analysed using univariable and multivariable logistic regression models to assess relationships between demographic factors, perceived #usability, reliability and risks and OSC use. Results: The survey collected responses from 634 participants. The majority (85.7%) had used OSCs, primarily the NHS 111 service (78.6%). Younger age (below 46 years old), being female (aOR=1.79, 95%CI 1.05 – 3.06) and having children (aOR= 3.19, 95%CI 1.56 - 6.51) were associated with higher odds of using OSCs. Key motivations for using OSCs included understanding symptoms (79.0%) and determining the need for medical care (77.4%). Key concerns negatively impacting use related to privacy (aOR=0.58) and fear of replacing traditional, face-to-face consultations (aOR=0.47). The most important factor found to affect the decision to use OSCs was the perceived ease of use (adjusted odds ratio =8.17), followed by the perceived helpfulness in decision-making (aOR=2.96), and respondents’ trust in their diagnostic accuracy (aOR=2.24). Conclusions: OSCs are widely used in the UK, particularly the NHS 111 service, driven primarily by ease of use and perceived helpfulness in decision support. However, privacy and security concerns, as well as fears of OSCs replacing traditional consultations, pose significant barriers. Addressing these concerns is crucial for enhancing user trust and maximizing the benefits of OSCs in supporting self-care and improving healthcare efficiency.

Background: Symptom checkers aim to help users recognize medical symptoms and recommend actions. However, they are not yet reliable for self-triage or diagnostics. Health literacy plays a role in their use, but the process from symptom recognition to health care consultation remains unclear. Objective: This qualitative observatory study explored how laypersons use symptom checkers, focusing on the process of use, entry points and outcomes, and the role of health literacy. Laypersons are defined as individuals who are neither medical professionals nor developers of such apps. Three research questions were addressed: (1) How do such users describe the process of using symptom checkers? (2) What are entry points and possible outcomes of symptom checker app use? (3) How are health literacy and eHealth literacy expressed during the use of symptom checker apps? Methods: As part of the Ethical, Legal, and Social Implications of Symptom Checker Apps in Primary Health Care project, 15 laypersons (n=9, 60% female and n=6, 40% male; mean age 30.7, SD 13.6 years) were interviewed about their experiences with the symptom checker Ada. The interviews were analyzed using an integrative approach combining social positioning, agency, and the Rubicon model as a heuristic framework. Results: App use follows a cyclic process comprising 4 steps: motivation (influenced by biography and context), intention formation (assigning a purpose), intention implementation (recruiting resources), and evaluation (transforming interactions into health-related insights). Biographical, social, and contextual factors shape process initiation. Users use symptom checkers for 3 main purposes: understanding their condition, receiving recommendations for action, and documenting or communicating health-related information. Each purpose requires specific planning and integration into health-related behaviors drawing on personal, social, and technological resources. Evaluation depends on contextual factors, app outputs, and the outcomes of users’ health-related actions. Users assess whether the app aligns with their expectations, condition severity, and previous experiences, with health literacy playing a critical role in validation processes. Conclusions: Symptom checker use is a complex, cyclic process shaped by context, biography, and health literacy. Users are motivated by health concerns influenced by personal, social, and contextual factors, with trust and attitudes impacting initial engagement. Intention formation reflects a balance between user skills and context, where app outputs inform decisions but may not always lead to action, especially in ambiguous situations. Users rely on personal resources and social networks to integrate app use into health-related behaviors, highlighting the limitations of symptom checkers in providing social or empathetic support. Symptom checkers have the potential to serve as an interface between users and health care, but future development must address the complexity of their use to unlock this potential.

Den Symptom-Check der Techniker Krankenkasse haben wir euch schon Ende 2022 ans Herz gelegt. Versicherte der Techniker Krankenkasse können diesen über die TK-Doc-Applikation aufrufen und dazu nutzen, akute Beschwerden so weit einzugrenzen, dass mögliche Erkrankungen ermittelt und weiterführende Behandlungen empfohlen werden. Versicherte der TK haben damit nun schon mehrere Jahre die Möglichkeit, auf den Symptom-Check […]

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