Patient Perspectives on the Usefulness of an Artificial Intelligence-Assisted Symptom Checker: Cross-Sectional Survey Study
Patient Perspectives on the Usefulness of an Artificial Intelligence-Assisted Symptom Checker: Cross-Sectional Survey Study
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DOI：
10.2196/14679
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发表时间：
2020-01-30
影响因子：
7.4
通讯作者：
Singh, Hardeep
中科院分区：
文献类型：
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作者：
Meyer, Ashley N. D.;Giardina, Traber D.;Singh, Hardeep
背景：越来越多的患者寻求基于网络的症状检查器来获得诊断。然而，对于使用这些资源的患者的特征，他们使用这些资源的理由以及他们是否认为这些资源准确和有用知之甚少。目的：本研究旨在使用人工智能（AI）辅助的在线症状检查器来检查患者的体验。在2018年3月2日至2018年3月15日期间，对伊莎贝尔症状监测仪的美国用户在使用后6个月内进行了一项在线调查。用户特征，经验的症状检查器使用，经验与医生讨论结果，和以前的个人历史经历的诊断错误collected.Results：共获得了329个可用的响应。平均应答者年龄为48.0岁（SD 16.7）;大多数为女性（230/304，75.7%）和白色（271/304，89.1%）。患者最常使用症状检查器来更好地了解其症状的原因（232/304，76.3%），其次是决定是否寻求护理（101/304，33.2%）或（例如，初级或紧急护理：63/304，20.7%），获得医疗建议而不去看医生（48/304，15.8%），更好地理解他们的诊断（39/304，12.8%）。大多数患者报告收到了关于其健康问题的有用信息（274/304，90.1%），一半患者报告了积极的健康影响（154/302，51.0%）。大多数患者认为它是一种有用的诊断工具（253/301，84.1%），作为一种提供见解的工具，使他们更接近正确的诊断（231/303，76.2%），并报告他们会再次使用它（278/304，91.4%）。与医生讨论结果的患者（103/213，48.4%）更多的人认为医生感兴趣（42/103，40.8%）比不感兴趣了解工具的结果（24/103，23.3%），更多的医生认为开放（62/103，60.2%）比不开放（21/103，20.4%）讨论结果。与以前没有经历过诊断错误的患者相比（漏诊或延迟诊断：123/304，40.5%），既往发生过诊断错误的患者（181/304，59.5%）更倾向于使用症状检查器来确定他们应该去哪里寻求护理（15/123，12.2% vs 48/181，26.5%; P =.002），但他们不太经常感到医生对讨论该工具的结果感兴趣（20/34，59% vs 22/69，32%; P =.04）。尽管对症状检查器的准确性一直存在担忧，但大量患者用户组认为AI辅助症状检查器对诊断有用。正式的验证研究评估症状检查器在现实世界的实践中的准确性和有效性，可以提供更多有用的信息，他们的好处。
Background: Patients are increasingly seeking Web-based symptom checkers to obtain diagnoses. However, little is known about the characteristics of the patients who use these resources, their rationale for use, and whether they find them accurate and useful.Objective: The study aimed to examine patients' experiences using an artificial intelligence (AI)-assisted online symptom checker.Methods: An online survey was administered between March 2, 2018, through March 15, 2018, to US users of the Isabel Symptom Checker within 6 months of their use. User characteristics, experiences of symptom checker use, experiences discussing results with physicians, and prior personal history of experiencing a diagnostic error were collected.Results: A total of 329 usable responses was obtained. The mean respondent age was 48.0 (SD 16.7) years; most were women (230/304, 75.7%) and white (271/304, 89.1%). Patients most commonly used the symptom checker to better understand the causes of their symptoms (232/304, 76.3%), followed by for deciding whether to seek care (101/304, 33.2%) or where (eg, primary or urgent care: 63/304, 20.7%), obtaining medical advice without going to a doctor (48/304, 15.8%), and understanding their diagnoses better (39/304, 12.8%). Most patients reported receiving useful information for their health problems (274/304, 90.1%), with half reporting positive health effects (154/302, 51.0%). Most patients perceived it to be useful as a diagnostic tool (253/301, 84.1%), as a tool providing insights leading them closer to correct diagnoses (231/303, 76.2%), and reported they would use it again (278/304, 91.4%). Patients who discussed findings with their physicians (103/213, 48.4%) more often felt physicians were interested (42/103, 40.8%) than not interested in learning about the tool's results (24/103, 23.3%) and more often felt physicians were open (62/103, 60.2%) than not open (21/103, 20.4%) to discussing the results. Compared with patients who had not previously experienced diagnostic errors (missed or delayed diagnoses: 123/304, 40.5%), patients who had previously experienced diagnostic errors (181/304, 59.5%) were more likely to use the symptom checker to determine where they should seek care (15/123, 12.2% vs 48/181, 26.5%; P=.002), but they less often felt that physicians were interested in discussing the tool's results (20/34, 59% vs 22/69, 32%; P=.04).Conclusions: Despite ongoing concerns about symptom checker accuracy, a large patient-user group perceived an AI-assisted symptom checker as useful for diagnosis. Formal validation studies evaluating symptom checker accuracy and effectiveness in real-world practice could provide additional useful information about their benefit.