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๐Ÿง‘๐Ÿผโ€๐Ÿ’ป Research - September 27, 2024

Triage Accuracy and the Safety of User-Initiated Symptom Assessment With an Electronic Symptom Checker in a Real-Life Setting: Instrument Validation Study.

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โšก Quick Summary

A recent study evaluated the accuracy and safety of the Omaolo electronic symptom checker (ESC) in a real-life setting, revealing that it achieved a remarkable 97.6% safety rate in assessments. The findings suggest that the ESC can effectively guide patients to appropriate care, enhancing the triage process in primary health care.

๐Ÿ” Key Details

  • ๐Ÿ“Š Sample Size: 877 patients
  • ๐Ÿงฉ Symptoms Assessed: Various including cough, headache, and urinary tract infections
  • โš™๏ธ Technology: Omaolo electronic symptom checker
  • ๐Ÿ† Safety Rate: 97.6% of assessments deemed safe
  • ๐Ÿ“ˆ Sensitivity: 62.6%, Specificity: 69.2%

๐Ÿ”‘ Key Takeaways

  • ๐Ÿ“Š The Omaolo ESC demonstrated a high safety rate in triage assessments.
  • ๐Ÿ’ก The mean exact match for symptom assessments was 53.7%.
  • ๐Ÿฅ When urgent treatment was needed, the ESC’s accuracy was 70.9%.
  • ๐Ÿ” The study was conducted across multiple primary health care centers in Finland.
  • ๐ŸŒ The ESC can effectively guide patients to appropriate triage destinations.
  • ๐Ÿ›ก๏ธ No patient safety issues were identified during the study.
  • ๐Ÿ“… Study published in JMIR Human Factors in 2024.

๐Ÿ“š Background

The integration of electronic symptom checkers (ESCs) into healthcare systems has gained traction as a means to enhance patient triage and care delivery. The Omaolo ESC, a medical device with a Conformitรฉ Europรฉenne marking, aims to streamline the assessment of various symptoms, providing patients with timely recommendations based on their reported issues.

๐Ÿ—’๏ธ Study

This clinical validation study was conducted in Finland, involving multiple primary health care centers where patients could walk in without prior contact. Upon arrival, patients utilized the ESC to report their symptoms, which were then compared to assessments made by triage nurses. The study analyzed data from 877 patients to evaluate the ESC’s performance.

๐Ÿ“ˆ Results

The results indicated that the ESC provided safe assessments in 97.6% of cases. The mean exact match for all symptom assessments was 53.7%, while the mean value for assessments deemed overly conservative but suitable was 66.6%. Notably, when urgent treatment was indicated, the ESC’s accuracy reached 70.9%.

๐ŸŒ Impact and Implications

The findings from this study highlight the potential of the Omaolo ESC to improve patient triage processes in primary health care settings. By effectively guiding patients to appropriate care, the ESC can enhance the overall efficiency of healthcare delivery, ensuring that individuals receive timely and suitable treatment for their conditions. This could lead to better health outcomes and a more streamlined healthcare experience for patients.

๐Ÿ”ฎ Conclusion

The study underscores the significant role that electronic symptom checkers like Omaolo can play in modern healthcare. With a high safety rate and promising accuracy in triage recommendations, the ESC represents a valuable tool for both patients and healthcare providers. Continued research and development in this area could further enhance the effectiveness of symptom assessment technologies in the future.

๐Ÿ’ฌ Your comments

What are your thoughts on the use of electronic symptom checkers in healthcare? Do you believe they can improve patient outcomes? ๐Ÿ’ฌ Share your insights in the comments below or connect with us on social media:

Triage Accuracy and the Safety of User-Initiated Symptom Assessment With an Electronic Symptom Checker in a Real-Life Setting: Instrument Validation Study.

Abstract

BACKGROUND: Previous studies have evaluated the accuracy of the diagnostics of electronic symptom checkers (ESCs) and triage using clinical case vignettes. National Omaolo digital services (Omaolo) in Finland consist of an ESC for various symptoms. Omaolo is a medical device with a Conformitรฉ Europรฉenne marking (risk class: IIa), based on Duodecim Clinical Decision Support, EBMEDS.
OBJECTIVE: This study investigates how well triage performed by the ESC nurse triage within the chief symptom list available in Omaolo (anal region symptoms, cough, diarrhea, discharge from the eye or watery or reddish eye, headache, heartburn, knee symptom or injury, lower back pain or injury, oral health, painful or blocked ear, respiratory tract infection, sexually transmitted disease, shoulder pain or stiffness or injury, sore throat or throat symptom, and urinary tract infection). In addition, the accuracy, specificity, sensitivity, and safety of the Omaolo ESC were assessed.
METHODS: This is a clinical validation study in a real-life setting performed at multiple primary health care (PHC) centers across Finland. The included units were of the walk-in model of primary care, where no previous phone call or contact was required. Upon arriving at the PHC center, users (patients) answered the ESC questions and received a triage recommendation; a nurse then assessed their triage. Findings on 877 patients were analyzed by matching the ESC recommendations with triage by the triage nurse.
RESULTS: Safe assessments by the ESC accounted for 97.6% (856/877; 95% CI 95.6%-98.0%) of all assessments made. The mean of the exact match for all symptom assessments was 53.7% (471/877; 95% CI 49.2%-55.9%). The mean value of the exact match or overly conservative but suitable for all (ESC’s assessment was 1 triage level higher than the nurse’s triage) symptom assessments was 66.6% (584/877; 95% CI 63.4%-69.7%). When the nurse concluded that urgent treatment was needed, the ESC’s exactly matched accuracy was 70.9% (244/344; 95% CI 65.8%-75.7%). Sensitivity for the Omaolo ESC was 62.6% and specificity of 69.2%. A total of 21 critical assessments were identified for further analysis: there was no indication of compromised patient safety.
CONCLUSIONS: The primary objectives of this study were to evaluate the safety and to explore the accuracy, specificity, and sensitivity of the Omaolo ESC. The results indicate that the ESC is safe in a real-life setting when appraised with assessments conducted by triage nurses. Furthermore, the Omaolo ESC exhibits the potential to guide patients to appropriate triage destinations effectively, helping them to receive timely and suitable care.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/41423.

Author: [‘Liu V’, ‘Kaila M’, ‘Koskela T’]

Journal: JMIR Hum Factors

Citation: Liu V, et al. Triage Accuracy and the Safety of User-Initiated Symptom Assessment With an Electronic Symptom Checker in a Real-Life Setting: Instrument Validation Study. Triage Accuracy and the Safety of User-Initiated Symptom Assessment With an Electronic Symptom Checker in a Real-Life Setting: Instrument Validation Study. 2024; 11:e55099. doi: 10.2196/55099

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