"A patient like me" - An algorithm-based program to inform patients on the likely conditions people with symptoms like theirs have

Medicine (Baltimore). 2019 Oct;98(42):e17596. doi: 10.1097/MD.0000000000017596.

Abstract

To date, consumer health tools available over the web suffer from serious limitations that lead to low quality health- related information. While health data in our world are abundant, access to it is limited because of liability and privacy constraints.The objective of the present study was to develop and evaluate an algorithm-based tool which aims at providing the public with reliable, data-driven information based and personalized information regarding their symptoms, to help them and their physicians to make better informed decisions, based on statistics describing "people like you", who have experienced similar symptoms.We studied anonymized medical records of Maccabi Health Care. The data were analyzed by employing machine learning methodology and Natural Language Processing (NLP) tools. The NLP tools were developed to extract information from unstructured free-text written by Maccabi's physicians.Using machine learning and NLP on over 670 million notes of patients' visits with Maccabi physicians accrued since 1993, we developed predictors for medical conditions based on patterns of symptoms and personal characteristics.The algorithm was launched for Maccabi insured members on January 7, 2018 and for members of Integrity Family Care program in Alabama on May 1, 2018.The App. invites the user to describe her/ his main symptom or several symptoms, and this prompts a series of questions along the path developed by the algorithm, based on the analysis of 70 million patients' visits to their physicians.Users started dialogues with 225 different types of symptoms, answering on average 22 questions before seeing how people similar to them were diagnosed. Users usually described between 3 and 4 symptoms (mean 3.2) in the health dialogue.In response to the question "conditions verified by your doctor", 82.4% of responders (895/1085) in Maccabi reported that the diagnoses suggested by K's health dialogues were in agreement with their doctor's final diagnosis. In Integrity Health Services, 85.4% of responders (111/130) were in agreement with the physicians' diagnosis.While the program achieves very high approval rates by its users, its primary achievement is the 85% accuracy in identifying the most likely diagnosis, with the gold standard being the final diagnosis made by the personal physician in each individual case. Moreover, the machine learning algorithm continues to update itself with the feedback given by users.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Algorithms*
  • Appendectomy
  • Appendicitis / diagnosis*
  • Appendicitis / surgery
  • Decision Making*
  • Diagnosis, Computer-Assisted / methods*
  • Female
  • Humans
  • Machine Learning*
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Smartphone