“That’s just Future Medicine” - a qualitative study on users’ experiences of symptom checker apps

BMC Medical Ethics 25 (1):1-19 (2024)
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Abstract

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.

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Author's Profile

Regina Müller
Institute of Philosophy, University of Bremen, Germany

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Epistemic Injustice and Illness.Ian James Kidd & Havi Carel - 2016 - Journal of Applied Philosophy 34 (2):172-190.
Epistemic Injustice in Healthcare: A Philosophical Analysis.Ian James Kidd & Havi Carel - 2014 - Medicine, Health Care and Philosophy 17 (4):529-540.
Testimonial injustice in medical machine learning.Giorgia Pozzi - 2023 - Journal of Medical Ethics 49 (8):536-540.
Mobile health ethics and the expanding role of autonomy.Bettina Schmietow & Georg Marckmann - 2019 - Medicine, Health Care and Philosophy 22 (4):623-630.

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