Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Sep 15, 2022)
Date Submitted: Sep 5, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Online Symptom Checkers: Recommendations for a vignette-based clinical evaluation standard
ABSTRACT
The use of patient-facing online symptom checkers (OSCs) has expanded in recent years, but their accuracy, safety, and impact on patient behaviours and healthcare systems remains unclear. The lack of a standardised process of clinical evaluation has resulted in significant variation in approaches to OSC validation and objective evaluation of outcomes. The aim of this paper is to characterise a set of congruent requirements for a standardised vignette-based clinical evaluation process of OSCs. Discrepancies in the findings of comparative studies to date suggest that different steps in OSC evaluation methodology can significantly influence outcomes. A standardised process with a clear specification for vignette-based clinical evaluation is urgently needed to guide developers and to facilitate the objective comparison of OSCs. We propose 15 recommendation requirements for an OSC evaluation standard. A third-party evaluation process and protocols for prospective real-world evidence studies should also be prioritised to quality assure OSC assessment.
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