Millions of emergencies are MISSED through NHS online symptom checker

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Harvard study casts doubt on the ability of online symptom checker
Up to one in eight emergencies are missed by the NHS Choices tool
Study evaluated 23 leading health websites found dangerous illnesses are often missed - overall they picked up just 80% of emergencies

By Ben Spencer Medical Correspondent For The Daily Mail

Published: 02:00 EST, 9 July 2015 | Updated: 11:52 EST, 9 July 2015

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Up to one in eight emergencies are missed by the flagship NHS Choices symptom checker website, research suggests.

The study, conducted by experts at Harvard Medical School in the US, casts doubt on the safety of relying on the internet for spotting illnesses.

Health bosses in Britain want the NHS to lead the world through its use of technology and claim it will drive up standards and also save money.

But the new research, which evaluated 23 leading health websites, found that dangerous diseases and health emergencies were often missed on ‘symptom checker’ websites.

A new study has cast doubt over the safety of relying on the internet for diagnosing illnesses. Harvard scientists evaluated 23 leading health websites and found that they only spotted 80 per cent of emergencies

Up to one in eight emergencies were missed by the flagship NHS Choices symptom checker website, the study found. Professor Ateev Mehrotra, said: 'In many cases, users should be cautious and not take the information they receive from online symptom checkers as gospel'

The study, published last night in the British Medical Journal, found that online programs often give patients the wrong advice about what action to take.

To test the symptom checkers, researchers created standardised lists of symptoms from 45 clinical vignettes that are used to teach and test medical students.

They then input those symptoms into 23 different symptom checkers.

Overall, the software algorithms that the researchers studied listed the correct diagnosis first in 34 percent of cases.

The correct diagnosis was included in the top three diagnoses in the list in 51 per cent of cases and in the top 20 in 58 per cent.

In many cases, getting the exact diagnosis may not be as important as getting the correct advice about whether -or how quickly - to go to the doctor.

'It's not nearly as important for a patient with fever, headache, stiff neck and confusion to know whether they have meningitis or encephalitis as it is for them to know that they should get to an ER quickly,' Professor Mehrotra said.

The NHS Choices site was one of the 23 sites from around the globe that the team analysed.

The website, run by the British health service, asks patients a number of questions about their symptoms and then advises them about what action to take - whether it is calling 999, going to A&E, or visiting a GP.

In many cases, users should be cautious and not take the information they receive from online symptom checkers as gospel

Professor Ateev Mehrotra

But the Harvard team found that the NHS Choices site correctly identified 87 per cent of emergencies - missing 13 per cent.

Overall the site gave the correct advice in only 52 per cent of cases.

NHS Choices performed better than the other sites assessed - overall the websites picked up just 80 per cent of emergencies.

Professor Ateev Mehrotra, who led the research, warned that internet advice should always be treated with caution.

‘These tools may be useful in patients who are trying to decide whether they should get to a doctor quickly, but in many cases, users should be cautious and not take the information they receive from online symptom checkers as gospel,’ he said.

His team found there was a great deal of variation between checkers, but none were without limitations.

For example, checkers with the most accurate diagnoses (Isabel, iTriage, Mayo Clinic, and Symcat) were not on the list of the programmes that did the best job of recommending the appropriate level of care for a given case (Healthychildren.org, Steps2Care and Symptify).

NHS leaders in Britain are determined to harness the power of the internet, as a cheap way to improve healthcare.

Among the other symptom checkers studied was that by the Mayo Clinic. This site was found to be among the checkers offering the most accurate diagnoses. But researchers said none of the sites were without limitations, for example, though accurate, the Mayo Clinic's tool did not offer the best advise for care

Just this week Professor Bruce Keogh, medical director of NHS England, launched a new digital strategy which will encourage increased use of computer software and mobile phone apps.

He said: ‘The NHS stands on the cusp of a revolution in innovation.

‘At its heart, innovation is the will to better, to find solutions for existing needs or new problems through more effective products, processes, technology or even the way we deliver services.’

And last month the NHS also announced an increased use of web-enabled devices such as Fitbit watches.

Tim Kelsey, National Director for Patients and Information at NHS England, said at the time: ‘The NHS is embracing the offering of digital services to patients, with more than 55 million patients set to benefit from progress.

‘As well as giving patients more choice and control, better use of technology can save money.’

The Harvard experts said that specially-designed health sites are still much better than simply typing symptoms into a search engine such as Google.

But researcher Hannah Semigran said: ‘The tools are not likely to go away.

‘With symptom trackers, we’re looking at the first generation of a new technology.

'It’s important to continue to track their performance to see if they can reach their full potential in helping patients get the right care.’

A spokesman for NHS Choices said: ‘A team of clinicians regularly review the content of the symptom checkers based on clinical evidence and any recommendations from national guidance and update the checker accordingly.

‘The development processes used within the NHS Symptom Checker are accredited by NICE.’