Doctor app and the cyberchondria

Raise your hand if you never look in internet for information about symptoms, distress, therapies. Health is, indeed, one of the most consulted topics through the web. We shouldn’t be surprised if several apps replying to this demand have arisen, to provide medical information and diagnostic suggestions. However, they present some risks.

Most successful apps allow users to indicate their symptoms and discuss with the app through chatbots technics, replying to more and more in-depth questions. At the end of this prolonged interaction, the app provides user with diagnostic suggestions and information relevant to the indicated pathology. Sometimes, the app suggests doctors, primary cares or specialists to be consulted under payment.

The most successful app is Ada, free for iOS and Android, that counts more than four million users. It is available in English, German, Portuguese and Spanish. Created by an Anglo-German Company, it collected over 40 million financing for its expansion.

Babylon is very popular too, for iOS and Android (also available as web app on their site). Born in England, the app is free, even if Babylon offers medical visits under payment, ranging from 50£/year for a general practitioner to 39-49£ for a therapist or a specialist.

Founded in Oslo and based in London, Your.Md, is a web, iOS and Android app which uses the NHS Choice knowledge base, cooperating with NHS and partnering with BMJ Practice. In addition to the symptoms checked and the health themes index (NHS Health Index), it provides addresses and contacts of doctors and care organisations.

All these apps underline that they do not make diagnosis but provide information and suggestions (this way they do not need to be MD-certified). As a matter of fact, they indicate pathologies and sometimes suggest an in-depth path. From one side they are surely more efficient and reliable than a research engine, but on the other hand the risk that people play to “make the doctor” is very high.

They should be considered as a triage instrument, aimed to avoid useless access to the health system. The question is: how much are they reliable, notwithstanding the grants and collaborations they boast about?

We must consider that the differential diagnostic path is based on symptoms reported by the patients, with no objective validation from a doctor, vital parameters and diagnostic examinations.

A study of 2015 (before the birth of above apps) published on BMJ analized 23 symptoms checker and observed a correctness percentage of 34 which grow to 59 for the most frequent diagnosis.

The basic question is if these apps are convenient for the patients, the health systems and the doctors. The risk to generate entropy and feed the Cyberchondria is very high, even if the need to receive information and suggestions about our own health is very strong and ignore these phenomena is not the right solution.

Ideally, these apps should be systematized, certified, made functional to the aims and needs of the health system. It is easier to say than to make, but the risk to suffer instead of governing this unstoppable process is too high. Therefore, it is worth the effort to move this way.

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