@文章{信息:doi/10.2196/38364，作者="Fraser, Hamish S F和Cohan, Gregory和Koehler, Christopher和Anderson, Jared和Lawrence, Alexis和Pate{\~{n}}a, John和Bacher, Ian和Ranney, Megan L"，标题="急诊室症状检查器诊断和分诊准确性和可用性评估:观察性研究"，期刊="JMIR Mhealth Uhealth"，年="2022"，月="Sep"，日="19"，卷="10"，数="9"，页="e38364"，关键词="移动健康;移动健康;症状检查;诊断;背景:症状检查是为患者提供临床决策支持的应用程序，每年有数千万人使用。它们旨在提供诊断和分类建议，并协助用户寻求适当的护理水平。很少有证据表明，患者在紧急情况下直接使用它们的诊断和分类准确性。目的:本研究的目的是确定在急诊科(ED)患者使用症状检查器诊断和分类的准确性和可用性。方法:我们招募了在城市急诊科就诊的讲英语患者的便利样本。每位患者在急诊科评估前都使用了Ada Health的领先症状检查器。通过比较症状检查员的诊断和3名独立急诊医生查看患者输入的症状数据的诊断，以及来自急诊科评估的最终诊断，来评估诊断的准确性。 The Ada diagnoses and triage were also critiqued by the independent physicians. The patients completed a usability survey based on the Technology Acceptance Model. Results: A total of 40 (80{\%}) of the 50 participants approached completed the symptom checker assessment and usability survey. Their mean age was 39.3 (SD 15.9; range 18-76) years, and they were 65{\%} (26/40) female, 68{\%} (27/40) White, 48{\%} (19/40) Hispanic or Latino, and 13{\%} (5/40) Black or African American. Some cases had missing data or a lack of a clear ED diagnosis; 75{\%} (30/40) were included in the analysis of diagnosis, and 93{\%} (37/40) for triage. The sensitivity for at least one of the final ED diagnoses by Ada (based on its top 5 diagnoses) was 70{\%} (95{\%} CI 54{\%}-86{\%}), close to the mean sensitivity for the 3 physicians (on their top 3 diagnoses) of 68.9{\%}. The physicians rated the Ada triage decisions as 62{\%} (23/37) fully agree and 24{\%} (9/37) safe but too cautious. It was rated as unsafe and too risky in 22{\%} (8/37) of cases by at least one physician, in 14{\%} (5/37) of cases by at least two physicians, and in 5{\%} (2/37) of cases by all 3 physicians. Usability was rated highly; participants agreed or strongly agreed with the 7 Technology Acceptance Model usability questions with a mean score of 84.6{\%}, although ``satisfaction'' and ``enjoyment'' were rated low. Conclusions: This study provides preliminary evidence that a symptom checker can provide acceptable usability and diagnostic accuracy for patients with various urgent conditions. A total of 14{\%} (5/37) of symptom checker triage recommendations were deemed unsafe and too risky by at least two physicians based on the symptoms recorded, similar to the results of studies on telephone and nurse triage. Larger studies are needed of diagnosis and triage performance with direct patient use in different clinical environments. ", issn="2291-5222", doi="10.2196/38364", url="https://mhealth.www.mybigtv.com/2022/9/e38364", url="https://doi.org/10.2196/38364", url="http://www.ncbi.nlm.nih.gov/pubmed/36121688" }