"That's just Future Medicine" - a qualitative study on users' experiences of symptom checker apps

Regina Müller; Malte Klemmt; Roland Koch; Hans-Jörg Ehni; Tanja Henking; Elisabeth Langmann; Urban Wiesing; Robert Ranisch

doi:10.1186/s12910-024-01011-5

"That's just Future Medicine" - a qualitative study on users' experiences of symptom checker apps

BMC Med Ethics. 2024 Feb 16;25(1):17. doi: 10.1186/s12910-024-01011-5.

Authors

Regina Müller¹, Malte Klemmt², Roland Koch³, Hans-Jörg Ehni⁴, Tanja Henking⁵, Elisabeth Langmann⁴, Urban Wiesing⁴, Robert Ranisch⁶

Affiliations

¹ Institute of Philosophy, University Bremen, Bremen, Germany. regina.mueller@uni-bremen.de.
² Institute of General Practice and Palliative Care, Hannover Medical School, Hannover, Germany.
³ Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany.
⁴ Institute of Ethics and History of Medicine, University Tübingen, Tübingen, Germany.
⁵ Institute of Applied Social Science, University of Applied Science Würzburg- Schweinfurt, Würzburg, Germany.
⁶ Faculty of Health Science Brandenburg, University of Potsdam, Potsdam, Germany.

Abstract

Background: Symptom checker apps (SCAs) are mobile or online applications for lay people that usually have two main functions: symptom analysis and recommendations. SCAs ask users questions about their symptoms via a chatbot, give a list with possible causes, and provide a recommendation, such as seeing a physician. However, it is unclear whether the actual performance of a SCA corresponds to the users' experiences. This qualitative study investigates the subjective perspectives of SCA users to close the empirical gap identified in the literature and answers the following main research question: How do individuals (healthy users and patients) experience the usage of SCA, including their attitudes, expectations, motivations, and concerns regarding their SCA use?

Methods: A qualitative interview study was chosen to clarify the relatively unknown experience of SCA use. Semi-structured qualitative interviews with SCA users were carried out by two researchers in tandem via video call. Qualitative content analysis was selected as methodology for the data analysis.

Results: Fifteen interviews with SCA users were conducted and seven main categories identified: (1) Attitudes towards findings and recommendations, (2) Communication, (3) Contact with physicians, (4) Expectations (prior to use), (5) Motivations, (6) Risks, and (7) SCA-use for others.

Conclusions: The aspects identified in the analysis emphasise the specific perspective of SCA users and, at the same time, the immense scope of different experiences. Moreover, the study reveals ethical issues, such as relational aspects, that are often overlooked in debates on mHealth. Both empirical and ethical research is more needed, as the awareness of the subjective experience of those affected is an essential component in the responsible development and implementation of health apps such as SCA.

Trial registration: German Clinical Trials Register (DRKS): DRKS00022465. 07/08/2020.

Keywords: (Self-)Triage; Bioethics; Digital health; Health apps; Interview study; Medical ethics; Symptom checker; mHealth.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Communication
Humans
Mobile Applications*
Physicians*
Qualitative Research
Telemedicine*