ArticleBMJ health & care informatics2021
Performance of national COVID-19 'symptom checkers': a comparative case simulation study.
Article in BMJ health & care informatics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Role of digital technology in epidemic control: a scoping review on COVID-19 and Ebola.BMJ open · 2025Article
- Predictors of COVID-19 From a Statewide Digital Symptom and Risk Assessment Tool: Cross-Sectional Study.Journal of medical Internet research · 2023Article
- A Digital-First Health Care Approach to Managing Pandemics: Scoping Review of Pandemic Self-triage Tools.Journal of medical Internet research · 2023Article
- Utilization patterns and efficiency gains from use of a fully EHR-integrated COVID-19 self-triage and self-scheduling tool: a retrospective analysis.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Evaluation of Diagnostic and Triage Accuracy and Usability of a Symptom Checker in an Emergency Department: Observational Study.JMIR mHealth and uHealth · 2022Observational
- Patient Experience and Feedback After Using an Electronic Health Record-Integrated COVID-19 Symptom Checker: Survey Study.JMIR human factors · 2022Article
- Reliability of COVID-19 symptom checkers as national triage tools: an international case comparison study.BMJ health & care informatics · 2021Article
- Restricted access to the NHS during the COVID-19 pandemic: Is it time to move away from the rationed clinical response?The Lancet regional health. Europe · 2021Review
- COVID-19 in Brazil-Preliminary Analysis of Response Supported by Artificial Intelligence in Municipalities.Frontiers in digital health · 2021Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIdentifying those individuals requiring medical care is a basic tenet of the pandemic response. Here, we examine the COVID-19 community triage pathways employed by four nations, specifically comparing the safety and efficacy of national online 'symptom checkers' used within the triage pathway.
methodsA simulation study was conducted on current, nationwide, patient-led symptom checkers from four countries (Singapore, Japan, USA and UK). 52 cases were simulated to approximate typical COVID-19 presentations (mild, moderate, severe and critical) and COVID-19 mimickers (eg, sepsis and bacterial pneumonia). The same simulations were applied to each of the four country's symptom checkers, and the recommendations to refer on for medical care or to stay home were recorded and compared.
resultsThe symptom checkers from Singapore and Japan advised onward healthcare contact for the majority of simulations (88% and 77%, respectively). The USA and UK symptom checkers triaged 38% and 44% of cases to healthcare contact, respectively. Both the US and UK symptom checkers consistently failed to identify severe COVID-19, bacterial pneumonia and sepsis, triaging such cases to stay home.
conclusionOur results suggest that whilst 'symptom checkers' may be of use to the healthcare COVID-19 response, there is the potential for such patient-led assessment tools to worsen outcomes by delaying appropriate clinical assessment. The key features of the well-performing symptom checkers are discussed.
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