Accuracy, patient-perceived usability, and acceptance of two symptom checkers (Ada and Rheport) in rheumatology: interim results from a randomized controlled crossover trial.
Acceptability
Accuracy
Apps
Diagnosis
Rheumatology
Symptom checker
Usability
eHealth
Journal
Arthritis research & therapy
ISSN: 1478-6362
Titre abrégé: Arthritis Res Ther
Pays: England
ID NLM: 101154438
Informations de publication
Date de publication:
13 04 2021
13 04 2021
Historique:
received:
14
01
2021
accepted:
31
03
2021
entrez:
14
4
2021
pubmed:
15
4
2021
medline:
22
6
2021
Statut:
epublish
Résumé
Timely diagnosis and treatment are essential in the effective management of inflammatory rheumatic diseases (IRDs). Symptom checkers (SCs) promise to accelerate diagnosis, reduce misdiagnoses, and guide patients more effectively through the health care system. Although SCs are increasingly used, there exists little supporting evidence. To assess the diagnostic accuracy, patient-perceived usability, and acceptance of two SCs: (1) Ada and (2) Rheport. Patients newly presenting to a German secondary rheumatology outpatient clinic were randomly assigned in a 1:1 ratio to complete Ada or Rheport and consecutively the respective other SCs in a prospective non-blinded controlled randomized crossover trial. The primary outcome was the accuracy of the SCs regarding the diagnosis of an IRD compared to the physicians' diagnosis as the gold standard. The secondary outcomes were patient-perceived usability, acceptance, and time to complete the SC. In this interim analysis, the first 164 patients who completed the study were analyzed. 32.9% (54/164) of the study subjects were diagnosed with an IRD. Rheport showed a sensitivity of 53.7% and a specificity of 51.8% for IRDs. Ada's top 1 (D1) and top 5 disease suggestions (D5) showed a sensitivity of 42.6% and 53.7% and a specificity of 63.6% and 54.5% concerning IRDs, respectively. The correct diagnosis of the IRD patients was within the Ada D1 and D5 suggestions in 16.7% (9/54) and 25.9% (14/54), respectively. The median System Usability Scale (SUS) score of Ada and Rheport was 75.0/100 and 77.5/100, respectively. The median completion time for both Ada and Rheport was 7.0 and 8.5 min, respectively. Sixty-four percent and 67.1% would recommend using Ada and Rheport to friends and other patients, respectively. While SCs are well accepted among patients, their diagnostic accuracy is limited to date. DRKS.de, DRKS00017642 . Registered on 23 July 2019.
Sections du résumé
BACKGROUND
Timely diagnosis and treatment are essential in the effective management of inflammatory rheumatic diseases (IRDs). Symptom checkers (SCs) promise to accelerate diagnosis, reduce misdiagnoses, and guide patients more effectively through the health care system. Although SCs are increasingly used, there exists little supporting evidence.
OBJECTIVE
To assess the diagnostic accuracy, patient-perceived usability, and acceptance of two SCs: (1) Ada and (2) Rheport.
METHODS
Patients newly presenting to a German secondary rheumatology outpatient clinic were randomly assigned in a 1:1 ratio to complete Ada or Rheport and consecutively the respective other SCs in a prospective non-blinded controlled randomized crossover trial. The primary outcome was the accuracy of the SCs regarding the diagnosis of an IRD compared to the physicians' diagnosis as the gold standard. The secondary outcomes were patient-perceived usability, acceptance, and time to complete the SC.
RESULTS
In this interim analysis, the first 164 patients who completed the study were analyzed. 32.9% (54/164) of the study subjects were diagnosed with an IRD. Rheport showed a sensitivity of 53.7% and a specificity of 51.8% for IRDs. Ada's top 1 (D1) and top 5 disease suggestions (D5) showed a sensitivity of 42.6% and 53.7% and a specificity of 63.6% and 54.5% concerning IRDs, respectively. The correct diagnosis of the IRD patients was within the Ada D1 and D5 suggestions in 16.7% (9/54) and 25.9% (14/54), respectively. The median System Usability Scale (SUS) score of Ada and Rheport was 75.0/100 and 77.5/100, respectively. The median completion time for both Ada and Rheport was 7.0 and 8.5 min, respectively. Sixty-four percent and 67.1% would recommend using Ada and Rheport to friends and other patients, respectively.
CONCLUSIONS
While SCs are well accepted among patients, their diagnostic accuracy is limited to date.
TRIAL REGISTRATION
DRKS.de, DRKS00017642 . Registered on 23 July 2019.
Identifiants
pubmed: 33849654
doi: 10.1186/s13075-021-02498-8
pii: 10.1186/s13075-021-02498-8
pmc: PMC8042673
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
112Références
Ann Rheum Dis. 2018 Oct;77(10):1394-1396
pubmed: 29973350
JMIR Mhealth Uhealth. 2020 Aug 12;8(8):e19661
pubmed: 32678796
Clin Exp Rheumatol. 2003 Sep-Oct;21(5 Suppl 31):S154-7
pubmed: 14969068
Orphanet J Rare Dis. 2019 Mar 21;14(1):69
pubmed: 30898118
NPJ Digit Med. 2020 Feb 6;3:17
pubmed: 32047862
Ann Rheum Dis. 2017 Jun;76(6):948-959
pubmed: 27979873
Ann Rheum Dis. 2013 Jan;72(1):13-22
pubmed: 22532640
BMJ Open. 2020 Dec 16;10(12):e040269
pubmed: 33328258
Z Rheumatol. 2019 Oct;78(8):722-742
pubmed: 31468170
BMJ Open. 2019 Aug 1;9(8):e027743
pubmed: 31375610
RMD Open. 2019 Sep 13;5(2):e001014
pubmed: 31565245
BMJ Open. 2019 Mar 4;9(3):e024361
pubmed: 30837252
Rheumatology (Oxford). 2018 Sep 1;57(9):1592-1601
pubmed: 29850885
BMC Musculoskelet Disord. 2016 Aug 24;17(1):362
pubmed: 27553253
Ann Rheum Dis. 2011 Oct;70(10):1822-5
pubmed: 21821867
J Clin Diagn Res. 2016 Oct;10(10):YE01-YE06
pubmed: 27891446
Clin Med Insights Arthritis Musculoskelet Disord. 2016 Oct 02;9:181-187
pubmed: 27721659
Semin Arthritis Rheum. 2020 Oct;50(5):1015-1021
pubmed: 32911279
BMJ. 2015 Jul 08;351:h3480
pubmed: 26157077
JMIR Hum Factors. 2020 Jul 10;7(3):e19713
pubmed: 32540836