Patients' Utilization and Perception of an Artificial Intelligence-Based Symptom Assessment and Advice Technology in a British Primary Care Waiting Room: Exploratory Pilot Study
Patients' Utilization and Perception of an Artificial Intelligence-Based Symptom Assessment and Advice Technology in a British Primary Care Waiting Room: Exploratory Pilot Study
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DOI：
10.2196/19713
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发表时间：
2020-07-01
影响因子：
2.7
通讯作者：
Wicks, Paul
中科院分区：
文献类型：
--
作者：
Miller, Stephen;Gilbert, Stephen;Wicks, Paul
背景：当有人需要知道是否以及何时寻求医疗照顾时，有一系列的选择可以考虑。每一个都将对个人（主要考虑信任，便利性，有用性和机会成本）和更广泛的卫生系统（影响临床吞吐量，成本和系统效率）产生影响。利用人工智能的数字症状评估技术可以帮助患者以正确的紧急程度导航到正确的护理类型。然而，最近的一项综述强调了这些技术在现实世界中可用性的文献中存在的差距。目的：我们试图探索一种这样的症状评估技术Ada在初级保健环境中的可用性、可接受性和实用性。方法：在南伦敦的一家初级保健诊所就诊的新投诉患者被邀请使用Ada症状评估移动的应用程序的自定义版本。试点研究于2017年11月至2018年1月在一项有20，000名注册患者的实践中进行。参与者被要求在研究智能手机上完成Ada自我评估，并在需要时提供帮助。通过自我完成的研究问卷调查后完成的Ada self-assessment.Results：在3个月的时间内，523例患者参与了应用程序和其效用的看法。大多数为女性（n=325，62.1%），平均年龄39.79岁（SD 17.7岁），工作年龄段（15-64岁）的比例（413/506，81.6%）高于一般人群（66.0%）。参与者对Ada的易用性评价很高，大多数（511/522，97.8%）报告说它非常或非常容易。大多数人会再次使用Ada（443/503，88.1%），并同意将其推荐给朋友或亲戚（444/520，85.3%）。我们在受访者中发现了一些与年龄相关的趋势，有一个方向性的趋势是，更多的年轻受访者报告艾达提供了有用的建议（50/54，93%，18-24奥尔兹报告有用），而不是老年受访者（19/32，59%，70岁以上的成年人报告有用）。我们发现在任何可用性问题上都没有性别差异。虽然大多数受访者报告说，使用症状检查不会对他们的就医行为产生影响（425/494，86.0%），但相当多的少数人（63/494，12.8%）报告说，他们会使用较低强度的护理，如自我护理，药房或推迟预约。18-24岁患者的比例（11/50，22%）高于70岁以上患者（0/28，0%）。结论：在这项探索性试点研究中，数字症状检查器被评为高度可用和可接受的患者在初级保健环境。需要进一步的研究来确认该应用程序是否可以适当地指导患者及时护理，并了解这如何为卫生系统节省资源。还需要做更多的工作，以确保老年群体平等地享受福利。
Background: When someone needs to know whether and when to seek medical attention, there are a range of options to consider. Each will have consequences for the individual (primarily considering trust, convenience, usefulness, and opportunity costs) and for the wider health system (affecting clinical throughput, cost, and system efficiency). Digital symptom assessment technologies that leverage artificial intelligence may help patients navigate to the right type of care with the correct degree of urgency. However, a recent review highlighted a gap in the literature on the real-world usability of these technologies.Objective: We sought to explore the usability, acceptability, and utility of one such symptom assessment technology, Ada, in a primary care setting.Methods: Patients with a new complaint attending a primary care clinic in South London were invited to use a custom version of the Ada symptom assessment mobile app. This exploratory pilot study was conducted between November 2017 and January 2018 in a practice with 20,000 registered patients. Participants were asked to complete an Ada self-assessment about their presenting complaint on a study smartphone, with assistance provided if required. Perceptions on the app and its utility were collected through a self-completed study questionnaire following completion of the Ada self-assessment.Results: Over a 3-month period, 523 patients participated. Most were female (n=325, 62.1%), mean age 39.79 years (SD 17.7 years), with a larger proportion (413/506, 81.6%) of working-age individuals (aged 15-64) than the general population (66.0%). Participants rated Ada's ease of use highly, with most (511/522, 97.8%) reporting it was very or quite easy. Most would use Ada again (443/503, 88.1%) and agreed they would recommend it to a friend or relative (444/520, 85.3%). We identified a number of age-related trends among respondents, with a directional trend for more young respondents to report Ada had provided helpful advice (50/54, 93%, 18-24-year olds reported helpful) than older respondents (19/32, 59%, adults aged 70+ reported helpful). We found no sex differences on any of the usability questions fielded. While most respondents reported that using the symptom checker would not have made a difference in their care-seeking behavior (425/494, 86.0%), a sizable minority (63/494, 12.8%) reported they would have used lower-intensity care such as self-care, pharmacy, or delaying their appointment. The proportion was higher for patients aged 18-24 (11/50, 22%) than aged 70+ (0/28, 0%).Conclusions: In this exploratory pilot study, the digital symptom checker was rated as highly usable and acceptable by patients in a primary care setting. Further research is needed to confirm whether the app might appropriately direct patients to timely care, and understand how this might save resources for the health system. More work is also needed to ensure the benefits accrue equally to older age groups.