{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T03:05:30Z","timestamp":1767236730960,"version":"3.37.3"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006785","name":"Google","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006785","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Digit. Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Patient online health searching is now commonplace, however, the accuracy of patient generated differentials for new symptoms and potential for patient anxiety are concerns. We aimed primarily to determine the accuracy of patient generated differentials for new symptoms with and without online searching, and secondarily, to evaluate the impact of searching on anxiety levels. In the waiting room prior to seeing a clinician, 300 patients with new symptoms were randomly assigned 1:1:1 to Google searching with health related features including a symptom search tool vs Google searching with health related features disabled vs no searching. Participants were 18 years or older and presenting to the emergency department of an urban academic medical center with new low-acuity symptoms that were not due to exacerbation of a chronic condition. Search groups received access on a tablet\/smartphone to Google searching with or without health related features. Both search groups could access any websites; health related features led the patient to common diagnoses and physician-validated information. The primary outcome was accuracy of the patient generated differential assessed by matching at least two of the top three diagnoses on the clinician\u2019s differential. A secondary outcome was anxiety by a visual analogue scale. Patients were a median of 33.1 (IQI 26.2\u201345.9) years old, 60% women, 63% black, 82% had a high school education or less, and 45.7% reported having performed an online search prior to presentation. Search group patients spent a median of 3.82 (2.53\u20135.72) minutes searching online. Similar proportions of patients in each group matched at least two of three clinician diagnoses: 27.0% and 28.3% for Google searching with and without health related features vs 23.8% in the no search group. Patients in the search groups had a similar odds of matching \u22652\/3 diagnoses as the no search group [OR (95% CI): 1.23 (0.70\u20132.13), <jats:italic>p<\/jats:italic>\u2009=\u20090.47]. Anxiety was unchanged with online searching. In conclusion, brief online searching in the waiting room did not improve accuracy of patient generated differential diagnoses for new symptoms. The absence of an increase in patient anxiety provides reassurance for subsequent work to refine and investigate online symptom search tools.<\/jats:p>","DOI":"10.1038\/s41746-019-0183-0","type":"journal-article","created":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T11:03:16Z","timestamp":1573470196000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["A randomized controlled trial of online symptom searching to inform patient generated differential diagnoses"],"prefix":"10.1038","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7021-7622","authenticated-orcid":false,"given":"Seth S.","family":"Martin","sequence":"first","affiliation":[]},{"given":"Emmanuel","family":"Quaye","sequence":"additional","affiliation":[]},{"given":"Sarah","family":"Schultz","sequence":"additional","affiliation":[]},{"given":"Oluwaseun E.","family":"Fashanu","sequence":"additional","affiliation":[]},{"given":"Jane","family":"Wang","sequence":"additional","affiliation":[]},{"given":"Mustapha O.","family":"Saheed","sequence":"additional","affiliation":[]},{"family":"Prem Ramaswami","sequence":"additional","affiliation":[]},{"given":"Hermes","family":"de Freitas","sequence":"additional","affiliation":[]},{"given":"Berthier","family":"Ribeiro-Neto","sequence":"additional","affiliation":[]},{"given":"Kapil","family":"Parakh","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2019,11,11]]},"reference":[{"key":"183_CR1","unstructured":"Pew Research Center. 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P.M., H.D.F., B.R.N., and K.P. were employees of Google. S.S.M. received grant\/research support for this trial from Google. Outside of this trial, S.S.M. has received grants\/research support from Apple, Stanford MedX\/Nokia, iHealth, the Maryland Innovation Initiative, National Institutes of Health, American Heart Association, PJ Schafer Cardiovascular Research Fund, Wallace H. Coulter Translational Research Partnership, David and June Trone Family Foundation, Aetna Foundation, and Akcea Therapeutics. He has served on scientific advisory boards for Quest Diagnostics, Amgen, Sanofi, Regeneron, Novo Nordisk, Esperion, and Akcea Therapeutics, all outside the subject matter of this manuscript. E.Q., S.S., O.E.F., J.W., and M.O.S. declare no competing non-financial interests or competing financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"110"}}