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How symptom checkers may level the slippery slope of self-diagnosis

Posted on 05-21-16 in Health and Wellness, Medicine

How symptom checkers may level the slippery slope of self-diagnosis

Visiting the doctor or an emergency room can take a lot of time and can certainly be hard on the wallet. With co-payments, out-of-pocket expenses and insurance deductibles, an acute visit can be quite costly. Urgent care and emergency room wait times can be upward of two to three hours, potentially resulting in lost work wages.

Many people wait until the last minute to visit a health care professional and sometimes waiting to the last minute can cost them their health or even their lives. Many serious medical conditions need immediate attention — such as a myocardial infarction, stroke or meningitis — which may mimic other benign diseases like heartburn, a conversion disorder or a migraine headache, respectively.

Individuals commonly research their current signs and symptoms on the internet to determine whether they should see a health care professional. It is also common for individuals to self-diagnose their condition, which can lead down a slippery slope. Many disorders mimic each other and, without the proper medical education and training, a lay person will not understand the differences between these conditions, potentially delaying a doctor visit, which could result in an increase in morbidity and even mortality.

Self-diagnosis can be dangerous

Unless someone is a trained medical professional, self-diagnosis can be dangerous and even deadly. Using the internet to self-diagnose may lead individuals to thinking they have just a headache when, in fact, they have meningitis or encephalitis and will need immediate intervention to prevent the infection from spreading and possibly leading to death.

On the other hand, individuals may have a benign condition, such as a swollen lymph node from a virus, but because of diligent internet medical research, they may believe they have lymphoma, a cancer of the lymph nodes. This can lead people to excessive worry, causing extreme and unnecessary stress.

Although it can be an inconvenience for people to go to the physician just to be told they have a run-of-the-mill virus that will simply run its course, delaying medical attention could also cause a serious condition to worsen. Even though doctors spend countless hours educating their patients on when to visit the emergency room, and 24/7 nurse hotlines are available, self-diagnosis is still a common problem in health care.

Symptom checkers can be helpful

Although simply searching your symptoms on the internet to self diagnose may be dangerous, a Harvard study was recently performed which showed that official “symptom checker” software programs have been shown to be helpful in determining how soon a patient should seek medical care. Isabel, iTriage, Mayo Clinic, Symcat,, Steps2Care and Symptify are a few common symptom checkers that were evaluated in the Harvard study.

“Symptom checkers are hosted by medical schools (including Harvard Medical School), hospital systems, insurance companies, and government agencies (including the United Kingdom’s National Health Service). This type of software asks users to list their symptoms, using methods such as multiple-choice checklists and free text entry. Once a program has collected the information, the computer returns a list of potential illnesses that might cause the listed symptoms and suggests whether the patient should seek care immediately, visit a doctor in the next few days, or use self-care methods, such as resting at home,” according to the Harvard study.

This computer algorithm concluded that these symptom checkers were best used in emergency or critical cases as they correctly recommended emergency care in 80 percent of urgent cases compared to providing accurate nonemergency triage advice in 58 percent of cases. The goal of these symptom checkers is not to nail down the specific diagnosis between infectious brain diseases such as meningitis versus encephalitis but rather to inform patients as to which symptoms warrant immediate physician care.

Additionally, it seems that these symptom checkers are overly cautious, recommending more people to seek medical care when not necessary, which goes against new health care reform to minimize unnecessary health care costs. There is also a lot of variation between different symptom checkers; some are more accurate at making the correct diagnosis, whereas others were best at recommending the appropriate level of care for a given patient case.

These symptom checkers are new and most likely will not go away, according to the authors of the Harvard study. “Symptom checkers are part of a larger trend of both patients and practitioners using online platforms for a range of health care tasks, such as patient-doctor chat sessions and algorithmic tools used to aid the diagnosis and triage of patients,” according to the researchers.

Medicine is integrating innovative technology to reduce costs and minimize error. This first generation of symptom checkers is still under investigation and is still being studied and improved so that they reach their full potential in directing patients to receive the right care. Although self-diagnosis may be a slippery slope, these symptom checkers may become beneficial to both patients and physicians, and will hopefully lower morbidity and mortality rates while reducing health care costs.

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About the author

Kristen Fuller, M.D., is a senior staff writer at the Sovereign Health Group and enjoys writing about evidence-based topics in the cutting-edge world of medicine. She is a physician and author, who also teaches, practices medicine in the urgent care setting and contributes to medicine board education. She is also an outdoor and dog enthusiast. For more information and other inquiries about this article, contact the author at