“Do I really not need to go to the doctor?” Unveiling usage patterns and predicting usage of Symptom Checker Apps: an explorative longitudinal study (Preprint)

Author:

Wetzel Anna-JasminORCID,Preiser ChristineORCID,Müller ReginaORCID,Joos StefanieORCID,Koch RolandORCID,Henking TanjaORCID,Haumann Hannah

Abstract

BACKGROUND

Symptom Checker Applications (SCA) aim to enable individuals without medical training to classify perceived symptoms and receive guidance on appropriate actions, such as self-care or seeking professional medical attention. However, there is a lack of detailed understanding regarding the contexts in which individuals use SCAs and their opinions on these tools.

OBJECTIVE

This mixed-methods study aims to explore the circumstances under which medical laypeople utilize SCAs and to identify which aspects users find noteworthy after using SCA.

METHODS

A total of n=48 SCA users documented their medical symptoms, provided open-ended responses, and recorded their SCA use along with other variables over six weeks in a longitudinal study. General Linear Mixed Models (GLMM) with and without regularization were applied to consider the hierarchical structure of the data, and the models' outcomes were evaluated for comparison. Qualitative data were analyzed through Kuckartz's qualitative content analysis

RESULTS

Significant predictors of SCA use included the initial occurrence of symptoms, day of measurement, self-rated health and the following ICPC-2 classified symptom: general and unspecified, eye, cardiovascular, musculoskeletal and skin. The day of measurement and self-rated health showed minor importance due to their small effect sizes. Qualitative analysis highlighted four main themes: (1) reasons for utilizing SCA, diverse (2) affective responses, a broad spectrum of (3) behavioral reactions and (4) unmet needs including a lack of personalization.

CONCLUSIONS

The emergence of new and unfamiliar symptoms was a strong determinant for SCA utilization. Specific ICPC rated symptom clusters, particularly those related to cardiovascular, eye, skin, general, and unspecified symptoms, were also highly predictive of SCA use. The varied applications of SCAs fit into the concept of health literacy as bricolage, where SCAs are leveraged as flexible tools by patients based on individual and situational requirements, functioning alongside other healthcare resources.

CLINICALTRIAL

German Clinical Trials Register (DRKS) DRKS00022465

Publisher

JMIR Publications Inc.

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