iPhoneのApple app storeや AndroidなどのGoogle Playで「Symptom checker"や"medical diagnosis"と検索されたアプリの検証
Evaluation of symptom checkers for self diagnosis and triage: audit study
BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h3480 (Published 08 July 2015)
45の標準化された患者ビグネットをコンパイルし、緊急性トリアージのカテゴリー3区分としたもので、例えば肺塞栓のような緊急ケア必要なもの、中耳炎のような非緊急性なもの、ウィルス性上気道感染のような自己管理可能なものに分ける。
診断を提供する徴候チェッカーによる主要アウトカムが初期20の候補診断を正確に当てられるか?本来の意味から言えば正確に緊急状態を篩い分けられるか?
Evaluation of symptom checkers for self diagnosis and triage: audit study
BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h3480 (Published 08 July 2015)
23の徴候チェッカーは、標準化患者評価の正診率 34%(95%信頼区間 31%〜37%)、トップ20に限れば58%(55%〜62%)、適正なトリアージ助言比率としては57% (52%〜61%)
状況によりトリアージパフォーマンスばらつき
緊急事態では、助言適正比率 80%(95%信頼区間、 75%〜86%)
非緊急性では、55% (47%〜63%)
自己管理疾患では、 33% (28%〜40%)
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23の個別徴候チェッカー横断的には、適切なトリアージ助言パフォーマンスは 33% (95% 信頼区間19% to 48%) 〜78%(64% to 91%)の範囲
Symptom checker
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Description
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Maximum No of diagnoses*
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Triage options provided
|
AskMD (USA)
|
Online health and wellness platform from Sharecare (www.sharecare.com/askmd/get-started)
|
15
|
Not available
|
BetterMedicine (USA)
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Health resource from HealthGrades; symptom checker provides possible diagnoses and information about these conditions (www.bettermedicine.com/symptom-checker/)
|
46
|
Not available
|
DocResponse (USA)
|
Symptom checker started by a group of certified physicians; user can choose from internal medicine, dermatology, and orthopedic views (www.docresponse.com/)
|
5
|
Not available
|
Doctor Diagnose (USA)
|
App offered on Google Play; provides potential diagnoses and triage advice in some cases
|
3
|
Seek immediate care; call your doctor now; speak with your doctor; home care
|
Drugs.com (USA)
|
Online resource for drug and related health information; uses content from Harvard Health Publications (www.drugs.com/symptom-checker/)
|
10
|
Emergency department; primary care doctor; home care
|
EarlyDoc (Netherlands)
|
For triage criteria, uses Dutch College of General Practitioners (NHG) TriageWijzer and the Australian Triage Scale (used in Australia and New Zealand to assess urgency) (www.earlydoc.com/en/)
|
3
|
Don’t wait, and call a doctor now; call a doctor preferably today; see your doctor preferably on a weekday; your complaints don’t seem urgent
|
Esagil (USA)
|
Provides list of likely diagnoses (based on number of entered symptoms that are congruent with diagnosis); user can also enter blood and urine lab results along with symptoms (http://esagil.org/)
|
65
|
Not available
|
Family Doctor (USA)
|
Displays flow chart to track symptoms to diagnosis and triage option; created by American Academy of Physicians (http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom.html)
|
7
|
Emergency room; see your doctor; home care
|
FreeMD (USA)
|
Takes user through a series of questions in a “check-up” to finish with “what might be wrong with you” and “where to go for care”; owned by DSHI Systems, which provides triage decision support solutions from emergency medicine physicians to the US government (Department of Veteran Affairs) and private sector companies; program called TriageXpert (www.freemd.com/)
|
3
|
Emergency department; urgent care; doctor’s office; doctor e-visit; retail clinic; dentist; home care
|
Harvard Medical School Family Health Guide (USA)
|
From Harvard Health Publications; available both online and in print.† (www.health.harvard.edu/fhg/symptoms/symptoms.shtml)
|
4
|
Emergency department; general practice; home care
|
Healthline (USA)
|
Health and wellness website that licenses content to employers, health providers, and health plans (www.healthline.com/symptom-checker)
|
76
|
Not available
|
Healthwise (USA)
|
Non-profit provider for health content and patient education; symptom checker licensed to other organizations; we accessed using Province of Alberta’s website (https://myhealth.alberta.ca/health/pages/symptom-checker.aspx)
|
Not available
|
Call 911 now; seek care now; seek care today; try home care
|
Healthy Children (USA)
|
From American Academy of Pediatrics; use’s Barton D Schmitt’s “Pediatric HouseCalls Symptom Checker” triage protocol (www.healthychildren.org/English/tips-tools/symptom-checker)
|
Not available
|
Call 911 now; call your doctor now (night or day); call your doctor within 24 hours; call your doctor during weekday office hours; parent care at home
|
Isabel (UK)
|
Created by Isabel Medical Charity (http://symptomchecker.isabelhealthcare.com/suggest_diagnoses_advanced/landing_page)
|
10
|
Walk-in care; family doctor; emergency services
|
iTriage (USA)
|
Owned by Aetna; provides clinical sites in user’s region with addresses and phone numbers (www.itriagehealth.com/avatar)
|
5
|
Emergency department, urgent care, retail clinic, family practice, internal medicine, specialties, prescription medication, over the counter medication
|
Mayo Clinic (USA)
|
Health resource website (www.mayoclinic.org/symptom-checker/select-symptom/itt-20009075)
|
20
|
Not available
|
MEDoctor (USA)
|
Free differential diagnosis system (www.medoctor.com/)
|
3
|
Not available
|
NHS Symptom Checkers (UK)
|
Available through England’s National Health Services (NHS) Choices website (www.nhs.uk/symptomcheckers/pages/symptoms.aspx)
|
Not available
|
Emergency department; general practitioner; home care
|
Steps2Care (USA)
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iPhone and Android app; provides symptom care guides from Barton D Schmitt’s pediatric telephone triage guidelines and David A Thompson’s adult telephone triage guidelines
|
Not available
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Call 911 now; go to emergency room now; call doctor now or go to emergency room; call doctor within 24 hours; call doctor during office hours; self care at home
|
Symcat (USA)
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Triage tool uses data linking specific patient symptoms and physician diagnoses across visits seen in the National Ambulatory Medical Care Survey (NAMCS) (www.symcat.com/)
|
6
|
Primary care; retail clinic; emergency room; urgent care
|
Symptify (USA)
|
Online self assessment tool and other health services, including, for example, emergency contact list, consultation list (https://symptify.com/)
|
9
|
Emergency room; urgent care; home care; inconclusive
|
Symptomate (Poland)
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Uses bayesian network methodology and medical database for diagnoses (https://symptomate.com/)
|
5
|
Emergency room; specialist; general practitioner
|
WebMD (USA)
|
Medical reference and healthcare resource website (http://symptoms.webmd.com)
|
99
|
Not available
|
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