The Accuracy of WebMD Symptom Checker for Diagnosis of COVID-19 in Admitted Patients in Imam Hassan Hospital of Bojnurd
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Abstract
Abstract
Background: Coronavirus has caused rapid disruption to daily life with significant morbidity and mortality. The infection spreads mainly through respiratory droplets expelled by infected individuals. Several web-based symptom checkers have been used to avoid unnecessary in-person visits during the pandemic. WebMD’s symptom checker contains a course of multiple-choice questions about symptoms. At last, a record of differential diagnoses is assembled.
Methods: This study chose 105 hospitalized patients in the isolation ward. We entered the data about symptoms and comorbidities in the WebMD symptom checker to find the most probable diagnoses proposed by the website for 66 patients whose polymerase chain reaction (PCR) test was positive and investigated the frequency of initial symptoms, present symptoms, and chief complaints.
Results: The average age was 47.41 ± 13.52. Of 66 patients, 23 were correctly diagnosed with coronavirus disease 2019 (COVID-19) as the first diagnosis with the WebMD symptom checker. In 41 cases, COVID-19 was one of the three main diagnoses. The most common initial symptoms were fever in 24%, sore throat in 12%, and myalgia in 12% of patients. The most common chief complaints were fever in 34% and dyspnea in 28% of patients. The most common present symptoms were myalgia in 81%, fever in 80%, fatigue in 75%, and dyspnea in 72% of patients.
Conclusions:WebMD symptom checkers can act as a first tool first, to diagnose and, second, to avoid in-person physician visits. Moreover, it can be used for the first diagnosis in primary care health organizations. Myalgia can be considered one of the most common present symptoms
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30. Arentz M, Yim E, Klaff L, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA 2020 Mar 19. [Epub ahead of print]
31. Krajewska J, Krajewski W, Zub K, Zatoński T. COVID-19 in otolaryngologist practice: a review of current knowledge. Eur Arch Otorhinolaryngol. 2020 Jul;277(7):1885-1897. doi: 10.1007/s00405-020-05968-y. Epub 2020 Apr 18. PMID: 32306118; PMCID: PMC7166003.
32. Yufika A, Wagner AL, Nawawi Y, Wahyuniati N, Anwar S, Yusri F, Haryanti N, Wijayanti NP, Rizal R, Fitriani D et al: Parents' hesitancy towards vaccination in Indonesia: A cross-sectional study in Indonesia. Vaccine 2020
33. Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, Holden KA, Read JM, Dondelinger F, Carson G, Merson L, Lee J, Plotkin D, Sigfrid L, Halpin S, Jackson C, Gamble C, Horby PW, Nguyen-Van-Tam JS, Ho A, Russell CD, Dunning J, Openshaw PJ, Baillie JK, Semple MG; ISARIC4C investigators. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020 May 22;369:m1985. doi: 10.1136/bmj.m1985. PMID: 32444460; PMCID: PMC7243036
2. Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. N Engl J Med 2020; 382:1199-1207.
3. Holshue ML, DeBolt C, Lindquist S, et al. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020: 382:929-936.
4. World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report – 51. March 11, 2020. https://www.who.int/docs/ default-source/coronaviruse/situationreports/20200311-sitrep-51-covid-19.pdf
5. Atluri S, Manchikanti L, Hirsch JA. Expanded Umbilical Cord Mesenchymal Stem Cells (UC-MSCs) as a Therapeutic Strategy in Managing Critically Ill COVID-19 Patients: The Case for Compassionate Use. Pain Physician. 2020 Mar;23(2): E71-E83. PMID: 32214286.
6. Mizumoto K, Kagaya K, Zarebski A, et al. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill 2020:25.
7. Gudbjartsson DF, Helgason A, Jonsson H, et al. Spread of SARS-CoV-2 in the Icelandic Population. N Engl J Med April 14, 2020. [Epub ahead of print].
8. World Health Organization. Getting your workplace ready for COVID-19. www.who.int/docs/default-source/ coronaviruse/getting-workplace-readyfor-covid-19.pdf?ua=1. Date Published 03/03/2020. {AU: if you have it, add Date Accessed mm/dd/yyyy}.
9. Bergman D, Bethell C, Gombojav N, Hassink S, Stange KC. Physical Distancing with Social Connectedness. Ann Fam Med. 2020 May;18(3):272-277. doi: 10.1370/afm.2538. PMID: 32393566; PMCID: PMC7213990.
10. Schwartz R, Urits I, Yazdi C, Kaye AD, Viswanath O. Incorporating Telemedicine into Interventional Pain Practices During the COVID-19 Pandemic. Pain Physician. 2020 Aug;23(4S): S455-S456. PMID: 32942802
11. Kassem H, Urits I, Kaye AD, Viswanath O. The Role of COVID-19 in Shaping the Experiences of Pain Medicine Fellowship Training. Pain Physician. 2020 Aug;23(4S): S463-S464. PMID: 32942806.
12. Park SH. Personal Protective Equipment for Healthcare Workers during the COVID-19 Pandemic. Infect Chemother. 2020 Jun;52(2):165-182. doi: 10.3947/ic.2020.52.2.165. PMID: 32618146; PMCID: PMC7335655.
13. Krist AH, DeVoe JE, Cheng A, Ehrlich T, Jones SM. Redesigning Primary Care to Address the COVID-19 Pandemic in the Midst of the Pandemic. Ann Fam Med. 2020 Jul;18(4):349-354. doi: 10.1370/afm.2557. PMID: 32661037; PMCID: PMC7358035.
14. World Health Organization (WHO) The WHO guidelines Infection prevention and control of epidemic- and pandemic-prone acute respiratory infections in health care. Geneva: WHO; 2014. [Google Scholar]
15. Centers for Disease Control and Prevention (CDC) Coronavirus disease 2019 (COVID-19): N95 respirators. [Assessed 1 June 2020]. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/index.html.
16. Koo BK, Bang JH, Kim SY, Kim EJ, Park SW. Glove-wall system for respiratory specimen collection and COVID-19 mass screening. Infect Chemother. 2020;52:219–221. [PMC free article] [PubMed] [Google Scholar]
17. Truog RD, Mitchell C, Daley GQ. The toughest triage - allocating ventilators in a pandemic. N Engl J Med. 2020. 10.1056/NEJMp2005689. [Epub ahead of print]. [PubMed]
18. Anderson RM, Heesterbeek H, Klinkenberg D, et al. How will country-based mitigation measures influence the course of the COVID-19 epidemic? Lancet. 2020;395(10228):931–934. doi: 10.1016/S0140-6736(20)30567-5 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
19. Tasnim S, Hossain MM, Mazumder H. Impact of Rumors and Misinformation on COVID-19 in Social Media. J Prev Med Public Health 2020 May;53(3):171-174 [FREE Full text] [CrossRef] [Medline]
20. John Leon Singh H, Couch D, Yap K. Mobile Health Apps That Help With COVID-19 Management: Scoping Review. JMIR Nurs. 2020 Aug 6;3(1): e20596. doi: 10.2196/20596. PMID: 32897271; PMCID: PMC7467120
21. Judson TJ, Odisho AY, Neinstein AB, Chao J, Williams A, Miller C, Moriarty T, Gleason N, Intinarelli G, Gonzales R. Rapid design and implementation of an integrated patient self-triage and self-scheduling tool for COVID-19. J Am Med Inform Assoc. 2020 Jun 1;27(6):860-866. doi: 10.1093/jamia/ocaa051. PMID: 32267928; PMCID: PMC7184478.
22. Singapore COVID-19 Symptom Checker. [2020-04-9]. https://sgcovidcheck.gov.sg/
23. https://symptoms.webmd.com/
24. Powley L, McIlroy G, Simons G, Raza K. Are online symptoms checkers useful for patients with inflammatory arthritis? BMC Musculoskelet Disord. 2016 Aug 24;17(1):362. doi: 10.1186/s12891-016-1189-2. PMID: 27553253; PMCID: PMC4995741.
25. Shen C, Nguyen M, Gregor A, Isaza G, Beattie A. Accuracy of a Popular Online Symptom Checker for Ophthalmic Diagnoses. JAMA Ophthalmol. 2019 Jun 1;137(6):690-692. doi: 10.1001/jamaophthalmol.2019.0571. PMID: 30973602; PMCID: PMC6567837.
26. Semigran HL, Linder JA, Gidengil C, Mehrotra A. Evaluation of symptom checkers for self-diagnosis and triage: audit study. BMJ. 2015;351:h3480. doi:10.1136/bmj.h3480 [Europe PMC free article] [Abstract] [CrossRef] [Google Scholar]
27. Diagnostic Accuracy of Web-Based COVID-19 Symptom Checker: Comparison Study, Nicolas Munsch et al, J Med Internet Res. 2020 Oct; 22(10): e21299.
28. Bisson LJ, Komm JT, Bernas GA, Fineberg MS, Marzo JM, Rauh MA, Smolinski RJ, Wind WM. How Accurate Are Patients at Diagnosing the Cause of Their Knee Pain with the Help of a Web-based Symptom Checker? Orthop J Sports Med. 2016 Feb 19;4(2):2325967116630286. doi: 10.1177/2325967116630286. PMID: 26962542; PMCID: PMC4765835.
29. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585. PMID: 32031570; PMCID: PMC7042881.
30. Arentz M, Yim E, Klaff L, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA 2020 Mar 19. [Epub ahead of print]
31. Krajewska J, Krajewski W, Zub K, Zatoński T. COVID-19 in otolaryngologist practice: a review of current knowledge. Eur Arch Otorhinolaryngol. 2020 Jul;277(7):1885-1897. doi: 10.1007/s00405-020-05968-y. Epub 2020 Apr 18. PMID: 32306118; PMCID: PMC7166003.
32. Yufika A, Wagner AL, Nawawi Y, Wahyuniati N, Anwar S, Yusri F, Haryanti N, Wijayanti NP, Rizal R, Fitriani D et al: Parents' hesitancy towards vaccination in Indonesia: A cross-sectional study in Indonesia. Vaccine 2020
33. Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, Holden KA, Read JM, Dondelinger F, Carson G, Merson L, Lee J, Plotkin D, Sigfrid L, Halpin S, Jackson C, Gamble C, Horby PW, Nguyen-Van-Tam JS, Ho A, Russell CD, Dunning J, Openshaw PJ, Baillie JK, Semple MG; ISARIC4C investigators. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020 May 22;369:m1985. doi: 10.1136/bmj.m1985. PMID: 32444460; PMCID: PMC7243036
| Files | ||
| Issue | Vol 6, No 3 (2022) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/htaa.v6i3.12429 | |
| Keywords | ||
| Covid-19, WebMD, Symptom checker, diagnosis | ||
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How to Cite
1.
Forouzanian S, Ghodrati F, Ghafouri M, Taghavi MR, Shokrian Z. The Accuracy of WebMD Symptom Checker for Diagnosis of COVID-19 in Admitted Patients in Imam Hassan Hospital of Bojnurd. Health Tech Ass Act. 2023;6(3).
