The research found that triage advice, that is when and where to seek healthcare, provided more accurate results than for diagnoses. Image is in the public domain.
Summary: Turning to Google for medical advice or self-diagnosis may be doing more harm than good. A new study reveals online symptom checkers are only accurate about one-third of the time.
Source: Edith Cowan University
Many people turn to ‘Dr. Google’ to self-diagnose their health symptoms and seek medical advice, but online symptom checkers are only accurate about a third of the time, according to new Edith Cowan University (ECU) research published in the Medical Journal of Australia today.
The study analysed 36 international mobile and web-based symptom checkers and found they produced the correct diagnosis as the first result just 36 percent of the time, and within the top three results 52 percent of the time.
The research also found that the advice provided on when and where to seek health care was accurate 49 percent of the time.
It has been estimated that Google’s health related searches amount to approximately 70,000 every minute. Close to 40 percent of Australians look for online health information to self-treat.
Lead author and ECU Masters student Michella Hill said the findings should give people pause for thought.
“While it may be tempting to use these tools to find out what may be causing your symptoms, most of the time they are unreliable at best and can be dangerous at worst,” she said.
Online symptom checkers ask users to list their symptoms before presenting possible diagnoses. Triage advice is about whether—or how quickly—the user should see a doctor or go to hospital.
The ‘cyberchondria’ effect
According to Ms Hill, online symptom checkers may be providing a false sense of security.
“We’ve all been guilty of being ‘cyberchondriacs’ and googling at the first sign of a niggle or headache,” she said.
“But the reality is these websites and apps should be viewed very cautiously as they do not look at the whole picture—they don’t know your medical history or other symptoms.
“For people who lack health knowledge, they may think the advice they’re given is accurate or that their condition is not serious when it may be.”
When to see a doctor
The research found that triage advice, that is when and where to seek healthcare, provided more accurate results than for diagnoses.
“We found the advice for seeking medical attention for emergency and urgent care cases was appropriate around 60 percent of the time, but for non-emergencies that dropped to 30 to 40 percent,” Ms Hill said.
“Generally the triage advice erred on the side of caution, which in some ways is good but can lead to people going to an emergency department when they really don’t need to.”
According to Ms Hill, online symptom checkers can have a place in the modern health system.
“These sites are not a replacement for going to the doctor, but they can be useful in providing more information once you do have an official diagnosis,” she said.
“We’re also seeing symptom checkers being used to good effect with the current COVID-19 pandemic. For example, the UK’s National Health Service is using these tools to monitor symptoms and potential ‘hot spot’ locations for this disease on a national basis.”
Lack of quality control
Ms Hill points to the lack of government regulation and data assurance as being major issues behind the quality of online symptom checkers.
“There is no real transparency or validation around how these sites are acquiring their data,” she said.
“We also found many of the international sites didn’t include some illnesses that exist in Australia, such as Ross River fever and Hendra virus, and they don’t list services relevant to Australia.”
The quality of diagnosis and triage advice provided by free online symptom checkers and apps in Australia
Objectives To investigate the quality of diagnostic and triage advice provided by free website and mobile application symptom checkers (SCs) accessible in Australia.
Design 36 SCs providing medical diagnosis or triage advice were tested with 48 medical condition vignettes (1170 diagnosis vignette tests, 688 triage vignette tests).
Main outcome measures Correct diagnosis advice (provided in first, the top three or top ten diagnosis results); correct triage advice (appropriate triage category recommended).
Results The 27 diagnostic SCs listed the correct diagnosis first in 421 of 1170 SC vignette tests (36%; 95% CI, 31–42%), among the top three results in 606 tests (52%; 95% CI, 47–59%), and among the top ten results in 681 tests (58%; 95% CI, 53–65%). SCs using artificial intelligence algorithms listed the correct diagnosis first in 46% of tests (95% CI, 40–57%), compared with 32% (95% CI, 26–38%) for other SCs. The mean rate of first correct results for individual SCs ranged between 12% and 61%. The 19 triage SCs provided correct advice for 338 of 688 vignette tests (49%; 95% CI, 44–54%). Appropriate triage advice was more frequent for emergency care (63%; 95% CI, 52–71%) and urgent care vignette tests (56%; 95% CI, 52–75%) than for non‐urgent care (30%; 95% CI, 11–39%) and self‐care tests (40%; 95% CI, 26–49%).
Conclusion The quality of diagnostic advice varied between SCs, and triage advice was generally risk‐averse, often recommending more urgent care than appropriate.