PMID- 33849654
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20240331
IS  - 1478-6362 (Electronic)
IS  - 1478-6354 (Print)
IS  - 1478-6354 (Linking)
VI  - 23
IP  - 1
DP  - 2021 Apr 13
TI  - Accuracy, patient-perceived usability, and acceptance of two symptom checkers 
      (Ada and Rheport) in rheumatology: interim results from a randomized controlled 
      crossover trial.
PG  - 112
LID - 10.1186/s13075-021-02498-8 [doi]
LID - 112
AB  - BACKGROUND: Timely diagnosis and treatment are essential in the effective 
      management of inflammatory rheumatic diseases (IRDs). Symptom checkers (SCs) 
      promise to accelerate diagnosis, reduce misdiagnoses, and guide patients more 
      effectively through the health care system. Although SCs are increasingly used, 
      there exists little supporting evidence. OBJECTIVE: To assess the diagnostic 
      accuracy, patient-perceived usability, and acceptance of two SCs: (1) Ada and (2) 
      Rheport. METHODS: Patients newly presenting to a German secondary rheumatology 
      outpatient clinic were randomly assigned in a 1:1 ratio to complete Ada or 
      Rheport and consecutively the respective other SCs in a prospective non-blinded 
      controlled randomized crossover trial. The primary outcome was the accuracy of 
      the SCs regarding the diagnosis of an IRD compared to the physicians' diagnosis 
      as the gold standard. The secondary outcomes were patient-perceived usability, 
      acceptance, and time to complete the SC. RESULTS: In this interim analysis, the 
      first 164 patients who completed the study were analyzed. 32.9% (54/164) of the 
      study subjects were diagnosed with an IRD. Rheport showed a sensitivity of 53.7% 
      and a specificity of 51.8% for IRDs. Ada's top 1 (D1) and top 5 disease 
      suggestions (D5) showed a sensitivity of 42.6% and 53.7% and a specificity of 
      63.6% and 54.5% concerning IRDs, respectively. The correct diagnosis of the IRD 
      patients was within the Ada D1 and D5 suggestions in 16.7% (9/54) and 25.9% 
      (14/54), respectively. The median System Usability Scale (SUS) score of Ada and 
      Rheport was 75.0/100 and 77.5/100, respectively. The median completion time for 
      both Ada and Rheport was 7.0 and 8.5 min, respectively. Sixty-four percent and 
      67.1% would recommend using Ada and Rheport to friends and other patients, 
      respectively. CONCLUSIONS: While SCs are well accepted among patients, their 
      diagnostic accuracy is limited to date. TRIAL REGISTRATION: DRKS.de, DRKS00017642 
      . Registered on 23 July 2019.
FAU - Knitza, Johannes
AU  - Knitza J
AUID- ORCID: 0000-0001-9695-0657
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany. johannes.knitza@uk-erlangen.de.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany. 
      johannes.knitza@uk-erlangen.de.
AD  - Universite Grenoble Alpes, AGEIS, Grenoble, France. 
      johannes.knitza@uk-erlangen.de.
FAU - Mohn, Jacob
AU  - Mohn J
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Bergmann, Christina
AU  - Bergmann C
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Kampylafka, Eleni
AU  - Kampylafka E
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Hagen, Melanie
AU  - Hagen M
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Bohr, Daniela
AU  - Bohr D
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Morf, Harriet
AU  - Morf H
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Araujo, Elizabeth
AU  - Araujo E
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Englbrecht, Matthias
AU  - Englbrecht M
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Simon, David
AU  - Simon D
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Kleyer, Arnd
AU  - Kleyer A
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Meinderink, Timo
AU  - Meinderink T
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Vorbruggen, Wolfgang
AU  - Vorbruggen W
AD  - Verein zur Forderung der Rheumatologie e.V., Wurselen, Germany.
AD  - RheumaDatenRhePort (rhadar), Planegg, Germany.
FAU - von der Decken, Cay Benedikt
AU  - von der Decken CB
AD  - RheumaDatenRhePort (rhadar), Planegg, Germany.
AD  - Medizinisches Versorgungszentrum Stolberg, Stolberg, Germany.
AD  - Klinik fur Internistische Rheumatologie, Rhein-Maas Klinikum, Wurselen, Germany.
FAU - Kleinert, Stefan
AU  - Kleinert S
AD  - RheumaDatenRhePort (rhadar), Planegg, Germany.
AD  - Rheumatologische Schwerpunktpraxis, Drs. Kleinert, Rapp, Ronneberger, Schuch U. 
      Wendler, Rheumatology, Erlangen, Germany.
FAU - Ramming, Andreas
AU  - Ramming A
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Distler, Jorg H W
AU  - Distler JHW
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Vuillerme, Nicolas
AU  - Vuillerme N
AD  - Universite Grenoble Alpes, AGEIS, Grenoble, France.
AD  - Institut Universitaire de France, Paris, France.
AD  - LabCom Telecom4Health, University of Grenoble Alpes & Orange Labs, Grenoble, 
      France.
FAU - Fricker, Achim
AU  - Fricker A
AD  - Qinum GmbH, Cologne, Germany.
FAU - Bartz-Bazzanella, Peter
AU  - Bartz-Bazzanella P
AD  - RheumaDatenRhePort (rhadar), Planegg, Germany.
AD  - Klinik fur Internistische Rheumatologie, Rhein-Maas Klinikum, Wurselen, Germany.
FAU - Schett, Georg
AU  - Schett G
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Deutsches Zentrum fur Immuntherapie (DZI), Friedrich-Alexander-University 
      Erlangen-Nurnberg and Universitatsklinikum Erlangen, Erlangen, Germany.
FAU - Hueber, Axel J
AU  - Hueber AJ
AD  - Department of Internal Medicine 3, Friedrich-Alexander-University 
      Erlangen-Nurnberg (FAU) and Universitatsklinikum Erlangen, Ulmenweg 18, 91054, 
      Erlangen, Germany.
AD  - Section Rheumatology, Sozialstiftung Bamberg, Bamberg, Germany.
FAU - Welcker, Martin
AU  - Welcker M
AD  - RheumaDatenRhePort (rhadar), Planegg, Germany.
AD  - MVZ fur Rheumatologie Dr. Martin Welcker GmbH, Planegg, Germany.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20210413
PL  - England
TA  - Arthritis Res Ther
JT  - Arthritis research & therapy
JID - 101154438
SB  - IM
MH  - Cross-Over Studies
MH  - Humans
MH  - Prospective Studies
MH  - *Rheumatology
PMC - PMC8042673
OTO - NOTNLM
OT  - Acceptability
OT  - Accuracy
OT  - Apps
OT  - Diagnosis
OT  - Rheumatology
OT  - Symptom checker
OT  - Usability
OT  - eHealth
COIS- JK has received research support from Novartis Pharma GmbH. Qinum and 
      RheumaDatenRhePort developed and hold rights for Rheport. WV, CD, SK, PB, and MW 
      are members of RheumaDatenRhePort. AF, WV, CD, and PB were involved in the 
      development of Rheport. JK is a member of the scientific board of 
      RheumaDatenRhePort.
EDAT- 2021/04/15 06:00
MHDA- 2021/06/22 06:00
PMCR- 2021/04/13
CRDT- 2021/04/14 05:42
PHST- 2021/01/14 00:00 [received]
PHST- 2021/03/31 00:00 [accepted]
PHST- 2021/04/14 05:42 [entrez]
PHST- 2021/04/15 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2021/04/13 00:00 [pmc-release]
AID - 10.1186/s13075-021-02498-8 [pii]
AID - 2498 [pii]
AID - 10.1186/s13075-021-02498-8 [doi]
PST - epublish
SO  - Arthritis Res Ther. 2021 Apr 13;23(1):112. doi: 10.1186/s13075-021-02498-8.