How are Self-Triage and Symptom Checkers Tools Being Used During the COVID-19 pandemic?

Background
Symptom checkers tend to have lower diagnostic accuracy when compared to healthcare professionals and suggest more risk-averse triage advice. There is little evidence to suggest that symptom checkers threaten patient safety, though assessment of this is lacking. COVID-19 symptom checker literature is still in its infancy; however, these tools have been used to avoid in-person appointments, identify new symptoms and monitor outbreaks.

Methods
Medline, Google Scholar and Google were searched between July and August 2020. The search was restricted to include studies in the last five years, studies published in English and included electronically published studies ahead of print.

Results
31 search results were identified with 5 removed due to duplication. 26 records were screened resulting in exclusion of 4 records. Full-text articles were assessed for eligibility with a further 4 excluded. 18 articles met the eligibility criteria however, 4 were grey literature and not specifically referenced. A summative table was synthesised with some of the digital symptom checkers (both COVID-19 or otherwise) currently available.

Key Messages

For a COVID-19 symptom checker to be accurate and reliable, one study suggested that both sensitivity and specificity need to be balanced. Studies show symptom checkers have been useful during lockdown – regional flare-ups monitored, novel symptoms identified and patients have accessed advice without risking exposure. Over 16 days, one COVID-19 symptom checker suggested ‘self-care’ to 240 patients, meaning that 240 appointments were potentially avoided. However, research is lacking in terms of compliance, health outcomes and patient safety.