• Meyer Ashley N D AND 0000-0001-7993-8584 Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Cente, Traber D Giardina, Christiane Spitzmueller, Umber Shahid, Taylor M T Scott, and Hardeep Singh.
• Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, United States.
• J. Med. Internet Res. 2020 Jan 30; 22 (1): e14679.

BackgroundPatients 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.ObjectiveThe study aimed to examine patients' experiences using an artificial intelligence (AI)-assisted online symptom checker.MethodsAn 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.ResultsA 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).ConclusionsDespite 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.©Ashley N D Meyer, Traber D Giardina, Christiane Spitzmueller, Umber Shahid, Taylor M T Scott, Hardeep Singh. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.01.2020.

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