ArticleNPJ digital medicine2019
A randomized controlled trial of online symptom searching to inform patient generated differential diagnoses.
Article in NPJ digital medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed.
- Impact of a Symptom Checker App on Patient-Physician Interaction Among Self-Referred Walk-In Patients in the Emergency Department: Multicenter, Parallel-Group, Randomized, Controlled Trial.Journal of medical Internet research · 2025Trial
- eHealth literacy in emergency care: a scoping review.BMC health services research · 2026Article
- Comparative Analysis of Knee Osteoarthritis Treatment Information on Popular Social Media Platforms.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Article
- Article
- Evaluation of Diagnostic and Triage Accuracy and Usability of a Symptom Checker in an Emergency Department: Observational Study.JMIR mHealth and uHealth · 2022Observational
- Triage Errors in Primary and Pre-Primary Care.Journal of medical Internet research · 2022Article
- Triage Accuracy of Symptom Checker Apps: 5-Year Follow-up Evaluation.Journal of medical Internet research · 2022Article
- Benchmarking Triage Capability of Symptom Checkers Against That of Medical Laypersons: Survey Study.Journal of medical Internet research · 2021Article
- Assessment of Diagnosis and Triage in Validated Case Vignettes Among Nonphysicians Before and After Internet Search.JAMA network open · 2021Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patient online health searching is now commonplace, however, the accuracy of patient generated differentials for new symptoms and potential for patient anxiety are concerns. We aimed primarily to determine the accuracy of patient generated differentials for new symptoms with and without online searching, and secondarily, to evaluate the impact of searching on anxiety levels. In the waiting room prior to seeing a clinician, 300 patients with new symptoms were randomly assigned 1:1:1 to Google searching with health related features including a symptom search tool vs Google searching with health related features disabled vs no searching. Participants were 18 years or older and presenting to the emergency department of an urban academic medical center with new low-acuity symptoms that were not due to exacerbation of a chronic condition. Search groups received access on a tablet/smartphone to Google searching with or without health related features. Both search groups could access any websites; health related features led the patient to common diagnoses and physician-validated information. The primary outcome was accuracy of the patient generated differential assessed by matching at least two of the top three diagnoses on the clinician's differential. A secondary outcome was anxiety by a visual analogue scale. Patients were a median of 33.1 (IQI 26.2-45.9) years old, 60% women, 63% black, 82% had a high school education or less, and 45.7% reported having performed an online search prior to presentation. Search group patients spent a median of 3.82 (2.53-5.72) minutes searching online. Similar proportions of patients in each group matched at least two of three clinician diagnoses: 27.0% and 28.3% for Google searching with and without health related features vs 23.8% in the no search group. Patients in the search groups had a similar odds of matching ≥2/3 diagnoses as the no search group [OR (95% CI): 1.23 (0.70-2.13),
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