MP27-11 ASSESSING ONLINE SYMPTOM CHECKER ACCURACY IN DIAGNOSING MEN’S HEALTH CONDITIONS

Rutul D. Patel; Amanda R. Swanton; Martin S. Gross

doi:10.1097/JU.0000000000002024.11

INTRODUCTION AND OBJECTIVE: Many medical sites offer algorithm-based tools where patients can enter symptoms to receive potential diagnoses. The efficacy of these online symptom checkers (OSCs) in properly diagnosing male sexual health issues has not been explored. We analyzed the accuracy of the four most commonly used OSCs in diagnosing erectile dysfunction (ED) and scrotal pain (SP). METHODS: Sixty artificial vignettes were created by de-identifying recent initial outpatient consults presenting to discuss ED (30) and SP (30). ED was selected for assessment because it is a straightforward diagnosis. In contrast, SP was selected because multiple potential diagnoses are possible. The vignettes were entered into the 4 most frequently used OSCs as determined by web traffic analysis tools. The top 4 OSCs in order of use are WebMD (WMD), MedicineNet (MN), Everyday Health (EH) and Sutter Health (SH). The top 5 conditions listed in the OSC differential diagnosis were recorded and scored. If less than 5 conditions were offered, the available conditions were recorded and scored. The primary outcome was the accuracy of primary (Top 1) condition listed. The secondary outcome was frequency of the correct diagnosis appearing in the Top 3, or 5 of the suggested conditions. RESULTS: WMD and EH did not offer the correct diagnosis for any of the ED patients (Table 1) regardless of number of conditions included from the differential. MN and SH offered the correct diagnoses for 100% of the ED patients only when all of the Top 5 suggested conditions were included. On average, the OSCs had a higher success rate diagnosing ED than they did SP using Top 1 (37.5% vs. 9.17%), Top 3 (46.67% vs. 26.67%), and Top 5 (50% vs. 26.67%) of the suggested conditions. When including the top 5 conditions, MN was the most accurate OSC by correctly diagnosing 100% of the ED cases and 36.67% of the SP cases. CONCLUSIONS: WebMD, which receives nearly five times the web traffic of the next leading online symptom checker, and Everyday Health were both incapable of diagnosing ED in this series. All OSCs were routinely poor at suggesting precise diagnoses for scrotal pain, even when including 5 potential options in the differential. Patients should be cautioned regarding the accuracy of OSCs.

MP27-11 ASSESSING ONLINE SYMPTOM CHECKER ACCURACY IN DIAGNOSING MEN’S HEALTH CONDITIONS

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