Clinical review
Reviewer: Jeremy Steinberg, GP, FRNZCGP
Date of review: October 2019
Version: 3.5.3
Comments: I could not find any published research on the accuracy of the symptom checker, so I assessed the app using 10 cases taken from two medical casebooks ('Acute medicine' and 'Surgery' from the Clinical Cases Uncovered series). A spread of case difficulties was chosen in a non-rigorous fashion. The app version assessed was 3.5.3.
The app got the correct diagnosis in 2/10 of the cases (20%; 95% CI, 0–46%), and the correct triage in 4/10 (40%; 95% CI, 8–72%).
A common theme for the failed cases was that several key questions weren’t asked, such as risk factors for endocarditis in the persistent fever case (infective endocarditis). Sometimes the diagnosis given did not fit with the answers. For example, for the infective endocarditis case, the patient had fevers for several weeks, and Your.MD said they had pseudogout. Pseudogout doesn’t tend to cause fevers and it wouldn’t last for several weeks.
The app often didn’t understand answers (eg, sore nipple for the Paget’s disease question or cut wrist for the ulnar nerve laceration question) or misinterpreted them (such as interpreting bulging eyes as puffy eyelids for the Grave’s disease question). It appeared that the database was quite limited.
| Correct diagnosis | Your.MD diagnosis accuracy | Your.MD triage accuracy |
| Atrial fibrillation | Fail | Correct |
| Gastric ulcer | Correct | Correct |
| Pulmonary embolism | Correct | Correct |
| Diabetic ketoacidosis | Fail | Correct |
| Infective endocarditis | Fail | Fail |
| Delirium due to hypercalcaemia | Fail | Fail |
| Grave’s disease | Fail | Fail |
| Paget’s disease of nipple | Fail | Fail |
| Branchial cyst | Fail | Fail |
| Ulnar nerve laceration | Fail | Fail |
New Zealand relevance: The health article section is sourced from the NHS and as such is not always relevant to the New Zealand patient.
Safety concerns: There are definitely safety concerns when using this app. There is an apparent high rate of inaccurate diagnoses and triage scores. Do not reply on this app for your diagnosis. If you have concerns about your health, contact your doctor or call HealthLine 0800 611 116. Read more about using symptom checkers safely.
Note: The health tracking part of the app was fair, but was not reviewed in detail.
