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Beyond Dr. Google: the evidence on consumer-facing digital tools for diagnosis
Michael L Millenson1,2, Jessica L Baldwin3,4, Lorri Zipperer5
1Health Quality Advisors LLC, Highland Park, IL 60035, USA.
Diagnosis (Berlin, Germany)
|July 23, 2018
Summary
Direct-to-consumer (DTC) health apps offer personalized diagnosis but evidence on their performance is limited. More rigorous evaluations are needed to ensure safety and effectiveness for patients and clinicians.
Area of Science:
- Digital Health
- Health Informatics
- Medical Diagnostics
Background:
- Over a third of adults use online resources for health diagnosis.
- Direct-to-consumer (DTC) interactive diagnostic apps are rapidly increasing.
- Limited evidence exists on the performance and evaluation methods of these apps.
Purpose of the Study:
- To conduct a scoping review of the evidence on DTC interactive diagnostic apps.
- To assess the performance and evaluation methodologies of these rapidly evolving digital health tools.
Main Methods:
- Scoping review of peer-reviewed and gray literature from January 1, 2014, to June 30, 2017.
- Categorized evaluations by app type (symptom checkers, sensor-driven apps, crowdsourcing).
- Analyzed clinical areas, evaluation methodologies, and reported app characteristics and performance.
Main Results:
- Symptom checkers and sensor-driven apps were most frequently evaluated, primarily in dermatology and general diagnostics.
- Evaluations varied significantly in methodology and conclusions; about half described app features, half assessed performance.
- App functionality, accuracy, safety, and effectiveness varied widely, with limited evidence on real-world clinical use and risks.
Conclusions:
- The evidence base for DTC diagnostic apps is sparse, uneven, and inconclusive regarding safety and effectiveness.
- No studies examined clinical risks and benefits in real-world consumer use.
- Rigorous, standardized evaluations are crucial for informing stakeholders about these evolving digital health technologies.
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