Evidence map›Paper›PMID 35576570›Full record

ArticleJMIR research protocols2022

Ethical, Legal, and Social Implications of Symptom Checker Apps in Primary Health Care (CHECK.APP): Protocol for an Interdisciplinary Mixed Methods Study.

Anna-Jasmin Wetzel, Roland Koch, Christine Preiser, Regina Müller, Malte Klemmt, Robert Ranisch, Hans-Jörg Ehni, Urban Wiesing, Monika A Rieger, Tanja Henking and 1 more

Open access · goldAbstract read
In one paragraph

Article in JMIR research protocols, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
5.6field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 20 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Anna-Jasmin Wetzel *Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany.ORCID https://orcid.org/0000-0002-7127-5867
Roland Koch *Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany.ORCID https://orcid.org/0000-0002-6500-928X
Christine PreiserInstitute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany.ORCID https://orcid.org/0000-0002-5549-6336
Regina MüllerInstitute of Ethics and History of Medicine, University Tübingen, Tübingen, Germany.ORCID https://orcid.org/0000-0001-6821-6770
Malte KlemmtInstitute of Applied Social Science, University of Applied Science Würzburg-Schweinfurt, Würzburg, Germany.ORCID https://orcid.org/0000-0001-9820-8253
Robert RanischFaculty of Health Science Brandenburg, University of Potsdam, Potsdam, Germany.ORCID https://orcid.org/0000-0002-1676-1694
Hans-Jörg EhniInstitute of Ethics and History of Medicine, University Tübingen, Tübingen, Germany.ORCID https://orcid.org/0000-0001-5900-2228
Urban WiesingInstitute of Ethics and History of Medicine, University Tübingen, Tübingen, Germany.ORCID https://orcid.org/0000-0003-4957-4323
Monika A RiegerInstitute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany.ORCID https://orcid.org/0000-0002-7855-3663
Tanja HenkingInstitute of Applied Social Science, University of Applied Science Würzburg-Schweinfurt, Würzburg, Germany.ORCID https://orcid.org/0000-0003-0595-1940
Stefanie JoosInstitute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany.ORCID https://orcid.org/0000-0002-5810-529X
Technical University of Applied Sciences Würzburg-Schweinfurt · DEUniversity Children's Hospital Tübingen · DEUniversity of Potsdam · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSymptom checker apps (SCAs) are accessible tools that provide early symptom assessment for users. The ethical, legal, and social implications of SCAs and their impact on the patient-physician relationship, the health care providers, and the health care system have sparsely been examined. This study protocol describes an approach to investigate the possible impacts and implications of SCAs on different levels of health care provision. It considers the perspectives of the users, nonusers, general practitioners (GPs), and health care experts.

objectiveWe aim to assess a comprehensive overview of the use of SCAs and address problematic issues, if any. The primary outcomes of this study are empirically informed multi-perspective recommendations for different stakeholders on the ethical, legal, and social implications of SCAs.

methodsQuantitative and qualitative methods will be used in several overlapping and interconnected study phases. In study phase 1, a comprehensive literature review will be conducted to assess the ethical, legal, social, and systemic impacts of SCAs. Study phase 2 comprises a survey that will be analyzed with a logistic regression. It aims to assess the user degree of SCAs in Germany as well as the predictors for SCA usage. Study phase 3 will investigate self-observational diaries and user interviews, which will be analyzed as integrated cases to assess user perspectives, usage pattern, and arising problems. Study phase 4 will comprise GP interviews to assess their experiences, perspectives, self-image, and concepts and will be analyzed with the basic procedure by Kruse. Moreover, interviews with health care experts will be conducted in study phase 3 and will be analyzed by using the reflexive thematical analysis approach of Braun and Clark.

resultsStudy phase 1 will be completed in November 2021. We expect the results of study phase 2 in December 2021 and February 2022. In study phase 3, interviews are currently being conducted. The final study endpoint will be in February 2023.

conclusionsThe possible ethical, legal, social, and systemic impacts of a widespread use of SCAs that affect stakeholders and stakeholder groups on different levels of health care will be identified. The proposed methodological approach provides a multifaceted and diverse empirical basis for a broad discussion on these implications.

trial registrationGerman Clinical Trials Register (DRKS) DRKS00022465; https://tinyurl.com/yx53er67. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/34026.

Indexed as

appmobile appprimary careself-diagnosis, self-triage, digitalization in primary care, general practitionerssymptom checkersymptom checker apps

Identifiers

PMID35576570
PMCPMC9152714
OpenAlexW4280553129

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.