TY - JOUR A1 - Müller, Regina A1 - Klemmt, Malte A1 - Koch, Roland A1 - Ehni, Hans-Jörg A1 - Henking, Tanja A1 - Langmann, Elisabeth A1 - Wiesing, Urban A1 - Ranisch, Robert T1 - “That’s just Future Medicine” - a qualitative study on users’ experiences of symptom checker apps JF - BMC Medical Ethics N2 - Background Symptom checker apps (SCAs) are mobile or online applications for lay people that usually have two main functions: symptom analysis and recommendations. SCAs ask users questions about their symptoms via a chatbot, give a list with possible causes, and provide a recommendation, such as seeing a physician. However, it is unclear whether the actual performance of a SCA corresponds to the users’ experiences. This qualitative study investigates the subjective perspectives of SCA users to close the empirical gap identified in the literature and answers the following main research question: How do individuals (healthy users and patients) experience the usage of SCA, including their attitudes, expectations, motivations, and concerns regarding their SCA use? Methods A qualitative interview study was chosen to clarify the relatively unknown experience of SCA use. Semi-structured qualitative interviews with SCA users were carried out by two researchers in tandem via video call. Qualitative content analysis was selected as methodology for the data analysis. Results Fifteen interviews with SCA users were conducted and seven main categories identified: (1) Attitudes towards findings and recommendations, (2) Communication, (3) Contact with physicians, (4) Expectations (prior to use), (5) Motivations, (6) Risks, and (7) SCA-use for others. Conclusions The aspects identified in the analysis emphasise the specific perspective of SCA users and, at the same time, the immense scope of different experiences. Moreover, the study reveals ethical issues, such as relational aspects, that are often overlooked in debates on mHealth. Both empirical and ethical research is more needed, as the awareness of the subjective experience of those affected is an essential component in the responsible development and implementation of health apps such as SCA. Trial registration German Clinical Trials Register (DRKS): DRKS00022465. 07/08/2020. Y1 - 2024 U6 - https://doi.org/10.1186/s12910-024-01011-5 SN - 1472-6939 VL - 25 IS - 1 PB - Springer Science and Business Media LLC ER - TY - JOUR A1 - Wetzel, Anna-Jasmin A1 - Preiser, Christine A1 - Müller, Regina A1 - Joos, Stefanie A1 - Koch, Roland A1 - Henking, Tanja A1 - Haumann, Hannah T1 - Unveiling Usage Patterns and Explaining Usage of Symptom Checker Apps: Explorative Longitudinal Mixed Methods Study JF - Journal of Medical Internet Research N2 - Background Symptom checker apps (SCA) aim to enable individuals without medical training to classify perceived symptoms and receive guidance on appropriate actions, such as self-care or seeking professional medical attention. However, there is a lack of detailed understanding regarding the contexts in which individuals use SCA and their opinions on these tools. Objective This mixed methods study aims to explore the circumstances under which medical laypeople use SCA and to identify which aspects users find noteworthy after using SCA. Methods A total of 48 SCA users documented their medical symptoms, provided open-ended responses, and recorded their SCA use along with other variables over 6 weeks in a longitudinal study. Generalized linear mixed models with and those without regularization were applied to consider the hierarchical structure of the data, and the models’ outcomes were evaluated for comparison. Qualitative data were analyzed through Kuckartz qualitative content analysis. Results Significant predictors of SCA use included the initial occurrence of symptoms, day of measurement (odds ratio [OR] 0.97), self-rated health (OR 0.80, P<.001), and the following International Classification in Primary Care-2–classified symptoms, that are general and unspecified (OR 3.33, P<.001), eye (OR 5.56, P=.001), cardiovascular (OR 8.33, P<.001), musculoskeletal (OR 5.26, P<.001), and skin (OR 4.76, P<.001). The day of measurement and self-rated health showed minor importance due to their small effect sizes. Qualitative analysis highlighted four main themes: (1) reasons for using SCA, (2) diverse affective responses, (3) a broad spectrum of behavioral reactions, and (4) unmet needs including a lack of personalization. Conclusions The emergence of new and unfamiliar symptoms was a strong determinant for SCA use. Specific International Classification in Primary Care–rated symptom clusters, particularly those related to cardiovascular, eye, skin, general, and unspecified symptoms, were also highly predictive of SCA use. The varied applications of SCA fit into the concept of health literacy as bricolage, where SCA is leveraged as flexible tools by patients based on individual and situational requirements, functioning alongside other health care resources. Y1 - 2024 U6 - https://doi.org/10.2196/55161 SN - 1438-8871 VL - 26 PB - JMIR Publications Inc. ER - TY - JOUR A1 - Langmann, Elisabeth A1 - Henking, Tanja A1 - Joos, Stefanie A1 - Klemmt, Malte A1 - Müller, Regina A1 - Preiser, Christine A1 - Ranisch, Robert A1 - Koch, Roland A1 - Rieger, Monika A. A1 - Wetzel, Anna-Jasmin A1 - Wiesing, Urban A1 - Ehni, Hans-Jörg T1 - Handlungsempfehlungen zum Einsatz von Symptom-Checker-Apps im Gesundheitskontext – basierend auf den Ergebnissen aus dem Projekt CHECK.APP JF - Ethik in der Medizin N2 - Digitale Gesundheitstechnologien haben in den letzten Jahren enorm an Bedeutung gewonnen. Hierzu zählen auch Symptom-Checker Apps, die auf Basis von Algorithmen oder künstlicher Intelligenz Nutzer:innen die Möglichkeit bieten, durch die Eingabe von Symptomen eine Analyse und Empfehlungen zum weiteren Vorgehen zu erhalten. Trotz ihrer weiten Bekanntheit zeigen Forschungsergebnisse ein gemischtes Bild bei der Genauigkeit der Ergebnisse, sodass aktuell ihr Nutzen noch eingeschränkt ist. Das interdisziplinäre Projekt CHECK.APP untersuchte ethische, rechtliche und soziale Aspekte im Zusammenhang mit Symptom-Checker Apps. Die daraus resultierenden und hier vorgestellten Empfehlungen richten sich an verschiedene Akteur:innen, einschließlich Nutzer:innen, Ärzt:innen, Entwickler:innen und öffentlicher Institutionen. Wichtig sind demnach eine kritische Haltung gegenüber Symptom-Checker Apps bei der Nutzung, die Förderung von Gesundheitskompetenz und eHealth-Literacy, sowie Transparenz, etwa hinsichtlich der Datengrundlage und der Erfahrungswerte bezüglich der Nutzung dieser Apps. Es besteht zudem ein Bedarf an verlässlichen und unabhängigen Informationsangeboten, durch die sich Nutzer:innen und Ärzt:innen über aktuelle Entwicklungen in der Digitalisierung des Gesundheitswesens informieren können. Gleichzeitig sind Entwickler:innen dazu aufgefordert, klare Vorgaben hinsichtlich Transparenz, Qualitätssicherung und Barrierefreiheit zu befolgen. Darüber hinaus wird dem Gesetzgeber empfohlen, die Freiwilligkeit der Nutzung von Symptom-Checker Apps sicherzustellen und Bedingungen zu schaffen, unter denen die Gesundheitskompetenz der Bevölkerung gestärkt wird. Dabei zeigen die vorgestellten Empfehlungen Wege auf, wie Symptom-Checker Apps verantwortungsvoll eingesetzt werden können, um den potenziellen Nutzen zu maximieren und Risiken zu minimieren. Y1 - 2025 U6 - https://doi.org/10.1007/s00481-025-00851-y SN - 0935-7335 VL - 2025 PB - Springer Science and Business Media LLC ER -