Table 2.
Accuracy of diagnosis decision and triage advice for all symptom checkers, stratified by severity of standardized patient (SP) vignette and by frequency of the condition’s diagnosis
| Type of vignette or diagnosis | No of vignettes (%) | Diagnosis | Triage | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Listed first | Listed in top 3 | Listed in top 20 | |||||||||||||
| Rate* | % (95% CI) | P value | Rate* | % (95% CI) | P value | Rate* | % (95% CI) | P value | Rate* | % (95% CI) | P value | ||||
| All vignettes | 45 (100) | 262/770 | 34 (31 to 37) | — | 394/770 | 51 (47 to 54) | — | 449/770 | 58 (55 to 62) | — | 301/532 | 57 (52 to 61) | — | ||
| Type of SP vignette: | |||||||||||||||
| Emergent | 15 (33) | 64/263 | 24 (19 to 30) | <0.001 | 104/263 | 40 (34 to 46) | <0.001 | 132/263 | 50 (44 to 56) | 0.003 | 147/183 | 80 (75 to 86) | <0.001 | ||
| Non-emergent | 15 (33) | 98/260 | 38 (32 to 44) | 148/260 | 57 (51 to 63) | 157/260 | 60 (54 to 66) | 96/175 | 55 (47 to 63) | ||||||
| Self care | 15 (33) | 100/247 | 40 (34 to 47) | 142/247 | 57 (51 to 63) | 160/247 | 65 (59 to 71) | 58/174 | 33 (26 to 40) | ||||||
| Type of diagnosis†: | |||||||||||||||
| Common | 26 (58) | 174/457 | 38 (34 to 43) | 0.004 | 254/457 | 56 (52 to 61) | <0.001 | 283/457 | 62 (57 to 66) | 0.01 | 162/313 | 52 (46 to 57) | 0.01 | ||
| Uncommon | 19 (42) | 88/313 | 28 (23 to 33) | 140/313 | 45 (38 to 49) | 166/313 | 53 (47 to 59) | 139/219 | 63 (57 to 70) | ||||||
*Number of correct SP evaluations divided by applicable SP evaluations. Some SP vignettes could not be applied to a given symptom checker (see text). For example, an adult SP vignette could not be evaluated if it was a pediatric symptom checker.
†Based on annual number of ambulatory care visits in United States, 2009-10 (see supplementary appendix for further description).