Evidence map›Paper›PMID 40345692›Full record

SynthesisBMJ open2025

Patient-facing online triage tools and clinician decision-making: a systematic review.

Armina Paule, Gary A Abel, Jo Parsons, Helen Atherton

Abstract readSystematic Review
In one paragraph

Synthesis in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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

4 authors.

Armina PauleApplied Health, Warwick Medical School, University of Warwick, Coventry, UK armina.paule@warwick.ac.uk.ORCID http://orcid.org/0009-0005-8373-8303
Gary A AbelDepartment of Health and Community Science, University of Exeter, Exeter, UK.ORCID http://orcid.org/0000-0003-2231-5161
Jo ParsonsBirmingham Centre for Evidence and Implementation Science (BCEIS), University of Birmingham, Birmingham, UK.
Helen AthertonPrimary Care Research Centre, University of Southampton, Southampton, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the role of using outputs from patient-facing online triage tools in clinical decision-making in primary care.

designSystematic review. DATA SOURCES: Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Scopus were searched for literature published between 1 January 2002 and 31 December 2022 and updated for literature published up to end of November 2024. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies of any design are included where the study investigates how primary care clinicians make clinical decisions in response to patient concerns reported using online triage tools. DATA EXTRACTION AND SYNTHESIS: Data were extracted, and quality assessment was conducted using the Mixed Methods Appraisal Tool. Narrative synthesis was used to analyse the findings.

results14 studies were included, which were conducted in the UK (n=9), Sweden (n=3) and Spain (n=2). There were no studies that examined clinical decision-making as an outcome. Outcomes relating to the impact on clinical decision-making were grouped into three categories: patient clinical outcomes (n=9), primary care practitioner experience (n=11) and healthcare system outcomes (n=14). Studies reported faster clinical decisions made in response to patient concerns. Other studies reported clinicians offering unnecessary urgent appointments as patients learnt to 'game' the system. Clinicians felt confident managing patient requests as they can access additional information (such as a photo attachment). Moreover, clinicians' time was freed up from appointments with limited clinical value. Contrarily, online triage was perceived as an additional step in the workflow.

conclusionClinicians should be aware that their decision-making processes are likely to differ when using online triage tools. Developers can use the findings to improve the usability of the tools to aid clinical decision-making. Future research should focus on patient-facing online triage tools in general practice and the process of clinical decision-making. PROSPERO REGISTRATION NUMBER: CRD42022373944.

Indexed as

Clinical Decision-MakingTriageHumansPrimary Health CareDigital TechnologyPrimary CarePrimary Health CareTriage

Identifiers

PMID40345692
PMCPMC12067807

What OpenQuestion holds

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LicenceCC BY-NC
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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.