ArticlePloS one2021
Accuracy of online symptom checkers and the potential impact on service utilisation.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
64 citing papers in PubMed, 4 syntheses or guidelines pooled it, 128 citations in OpenAlex.
- AI applications in veterinary digital health: a systematic survey.Frontiers in veterinary science · 2026Pooled it
- [Short paths to diagnosis with artificial intelligence: systematic literature review on diagnostic decision support systems].Schmerz (Berlin, Germany) · 2024Pooled it
- Triage and Diagnostic Accuracy of Online Symptom Checkers: Systematic Review.Journal of medical Internet research · 2023Pooled it
- Challenges in evaluating the accuracy of AI-containing digital triage systems: A systematic review.PloS one · 2022Pooled it
- 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
- Diagnostic Accuracy of a Mobile AI-Based Symptom Checker and a Web-Based Self-Referral Tool in Rheumatology: Multicenter Randomized Controlled Trial.Journal of medical Internet research · 2024Trial
- Evaluating digital triage symptom checker with historical triage-related adverse events.Scandinavian journal of primary health care · 2026Article
- AI-Based Diagnostic Platform Capabilities With Lyme Disease as a Use Case: Integrative Exploration.Online journal of public health informatics · 2026Article
- Increasing Large Language Model Accuracy for Care-Seeking Advice Using Prompts Reflecting Human Reasoning Strategies in the Real World: Validation Study.JMIR biomedical engineering · 2026Article
- Metacognition and diagnostic decision-making: short "blips" of knowledge and the consequences of overconfidence.Cognitive research: principles and implications · 2026Article
- Economic evaluation of a digital symptom checker for endometriosis using a Markov decision process model.NPJ digital medicine · 2026Article
- Article
- How to Evaluate the Accuracy of Symptom Checkers and Diagnostic Decision Support Systems: Symptom Checker Accuracy Reporting Framework (SCARF).JMIR human factors · 2026Article
- Cracking the code: a head-to-head comparison of expert clinicians and artificial intelligence in diagnosing rare diseases.Orphanet journal of rare diseases · 2025Article
- Evaluating the use of red flags by online symptom checkers.BMC health services research · 2025Article
- Article
- LLM enabled classification of patient self-reported symptoms and needs in health systems across the USA.NPJ digital medicine · 2025Article
- Accuracy of Dental Symptom Checker Web Application in the Singapore Military Population.International dental journal · 2025Article
- Accuracy of online symptom assessment applications, large language models, and laypeople for self-triage decisions.NPJ digital medicine · 2025Article
- Exploring Laypersons' Experiences With a Mobile Symptom Checker App as an Interface Between eHealth Literacy, Health Literacy, and Health-Related Behavior: Qualitative Interview Study.JMIR formative research · 2025Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aims of our study are firstly to investigate the diagnostic and triage performance of symptom checkers, secondly to assess their potential impact on healthcare utilisation and thirdly to investigate for variation in performance between systems.
settingPublicly available symptom checkers for patient use.
participantsPublicly available symptom-checkers were identified. A standardised set of 50 clinical vignettes were developed and systematically run through each system by a non-clinical researcher. PRIMARY AND SECONDARY OUTCOME MEASURES: System accuracy was assessed by measuring the percentage of times the correct diagnosis was a) listed first, b) within the top five diagnoses listed and c) listed at all. The safety of the disposition advice was assessed by comparing it with national guidelines for each vignette.
resultsTwelve tools were identified and included. Mean diagnostic accuracy of the systems was poor, with the correct diagnosis being present in the top five diagnoses on 51.0% (Range 22.2 to 84.0%). Safety of disposition advice decreased with condition urgency (being 71.8% for emergency cases vs 87.3% for non-urgent cases). 51.0% of systems suggested additional resource utilisation above that recommended by national guidelines (range 18.0% to 61.2%). Both diagnostic accuracy and appropriate resource recommendation varied substantially between systems.
conclusionsThere is wide variation in performance between available symptom checkers and overall performance is significantly below what would be accepted in any other medical field, though some do achieve a good level of accuracy and safety of disposition. External validation and regulation are urgently required to ensure these public facing tools are safe.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.