Web-based Symptom Checkers – Part 2: Better to Know Than to Guess
May 18, 2011
By Frank Gillingham, MD

Physicians in practice for many years will tell you that upon hearing a diagnosis, the first question that many patients ask is: “Is it serious?” In fact, most people do not really care about what their illness is called, so long as they can expect a quick and total recovery. This is also true for travelers who fall sick or sustain an injury while traveling and want to make an educated decision on whether or not to seek medical care or cut their trip short.

A few months ago, we reviewed online symptom checkers with an eye toward efficacy and accuracy of self-diagnosis. A few standouts, such as Everyday Health, were lauded for their thoroughness and clinical acumen, while most of the others were criticized for being too general and stopping far short of identifying the actual medical problem. Perhaps the focus of our earlier review was ill-placed. What do people really want from a symptom checker? Do they really need to know the name of their illness? Does toxic epidermal necrolysis have meaning to anyone other than a physician?

On the other hand, wouldn’t someone with this or another condition with similar symptoms like to know that it is serious, and mandates immediate professional attention? We decided to take a second look at online symptom checkers, this time with an eye for those able to quickly separate conditions that required immediate professional involvement from those which did not. Not surprisingly, several of those which were dismissed in our earlier review as not being thorough enough were actually quite good at distinguishing between serious and relatively benign conditions. Others with extensive algorithms, although entertaining and impressive to medical personnel, tax the attention span of most and take much too long to arrive at a diagnosis.

Using revised criteria, symptom checkers such as those found on the Embody Health site from the Mayo Clinic and Schmitt Thompson’s (available through a licensing agreement only) make recommendations on whether or not to see a doctor after only two or three clicks. WebMD’s symptom checker works in a similar fashion—encouraging a call for help based on the initial selection of a chief symptom. The vomiting of blood, for instance, gets an immediate directive to seek medical attention.

There has been a virtual explosion of medical self-help options over the past fifteen years. The introduction of online symptom checkers is a more recent development and is replacing labor-intensive nurse hotlines in many markets. Perhaps the best symptom checkers are those that direct but do not diagnose. Knowing exactly what you have, assuming you have answered all questions appropriately, is probably not as important as knowing whether or not to see a medical professional if you happen to be a long way from home.

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About the Author

Frank Gillingham, MD