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U.K., U.S. COVID-19 Symptom Checkers May Delay Health Contact

TUESDAY, March 9, 2021 -- Symptom checkers could be of use for the health care COVID-19 response, but the U.S. and U.K. symptom checkers may delay health care contact for serious cases, according to a study published online March 8 in BMJ Health & Care Informatics.

Fatma Mansab, from Gibraltar Health Authority, and colleagues conducted a simulation study on current, nationwide, patient-led symptom checkers from Singapore, Japan, the United States, and the United Kingdom. Fifty-two cases were simulated to approximate typical COVID-19 presentations and COVID-19 mimickers and were presented to each of the four country's symptom checkers. The recommendations to refer for medical care or stay home were compared.

The researchers found that the symptom checkers from Singapore and Japan advised onward health care contact for the majority of simulations (88 and 77 percent, respectively) compared with 38 and 44 percent of simulations for the U.S. and U.K. symptom checkers, respectively. Symptom checkers from the United States and United Kingdom consistently failed to identify severe COVID-19, bacterial pneumonia, and sepsis, advising these cases to stay home.

"The U.K. and USA patient-led triage systems (COVID-19 Symptom Checkers) maintained a high disease-severity threshold for onward referral to health care assessment," the authors write. "Our results support the recommendation that symptom checkers should be subjected to the same level of evidenced-based quality assurance as other diagnostic tests prior to implementation."

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