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Impacts of Symptom Checker Apps and Similar Tools on Health Care Professionals in General Practice – A Scoping Review
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Description: Introduction Patients evaluating symptoms and deducing the necessity and urgency of seeing a physician is a core moment in medical care. A novelty in this process is the plethora of artificial intelligence-based or algorithm-based tools such as symptom checker apps (SCA) that are spreading on the market. They might have the most immediate affect on emergency care and primary care as those parts of health services that are directly accessible for patients. To date, it remains unclear, how SCA and similar tools are transforming working worlds of health care professionals, which work-related psychosocial demands and resources (Bakker et al. 2003) are connected to this transformation and how this is related to perceived stress for health care professionals (GDA 2014). Objectives This scoping review aims to systematically explore the existing knowledge on the impacts of symptom checkers or similar services on health care professionals in general practice and to identify gaps in knowledge. The following question was formulated: What is known from the literature about the impact of SCA and similar tools on health care professionals in general practice, especially with regards to work content and work organization, professional-patient-interaction/relationship, their professional self-image, job satisfaction, and perceived stress? Inclusion criteria Articles concerning the impacts of SCA and similar tools on health care professionals in general practice will be included. We will follow the PCC scheme (population – concept – context) (Peters et al. 2015) to define inclusion and exclusion criteria. Population: The relevant population of our scoping review is health care professionals, not patients, without focus on specific countries. Concept: We will apply “impact of symptom checkers and similar tools” as relevant concept. We will include studies that focus on any artificial intelligence-based or algorithm-based SCA or similar services and tools offering self-diagnosis/pre-diagnosis that were designed for (potential) patients. We will exclude all health apps/services that do not provide patients’ self-diagnosis such as diagnostics apps for clinicians, nurses and veterinary surgeons; diagnostics apps with scan-technology or sensors; non diagnostic m-health applications (e.g. symptom monitoring, self-management of conditions, disease-management, medical decision making, telemedicine, medical information and coaching; motivation, fitness). Impacts will not be restricted to but can include work content/work, organization/service use, job satisfaction of health care professionals, perceived stress of health care professionals, professional–patient relationship and communication, professional self-image. We will exclude studies e.g. regarding diagnostic accuracy or accuracy of disposition, costs and cost-effectiveness, clinical effectiveness, safety, or patients’ usage of new technologies. Context: We will focus on general practice as relevant context. We will include empirical studies, reviews and publications that discuss the topic in general as well as discussion papers, editorials, book chapters etc. To be included in the scoping review, the publication should be published 2000-2021, should be in English, German, French, Turkish or Russian language, and the full text paper should be obtainable. Methods The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews (Peters et al. 2015). As we expect limited research with regards to our specific research interest, we have conceptualized the search strategy rather open. The following databases will be searched as they showed to be the most promising after preliminary testing: PubMed (Medline) and CINAHL. Search strings consisting of search terms and MeSH terms will be built and the titles and abstracts in the respective databases will be searched accordingly. Titles and abstracts will be screened against the background of the inclusion criteria. The reference lists of sources included will be screened to identify additional literature. To ensure quality control, the whole process will be conducted and constantly discussed by two independent reviewers. Duplicates will be removed in the literature management programme Citavi and the software Rayyan will be used to screen the sources. Key information of the data will be charted and managed in Microsoft Excel and results will be synthesized in text, tables, and graphics. Conflict of Interest The authors declare that there is no conflict of interest. Literature Bakker AB, Demerouti E, de Boer E, Schaufeli WB. Job demands and job resources as predictors of absence duration and frequency. J. Vocat. Behav. 2003, 62, 341–356. Gemeinsame Deutsche Arbeitsschutzstrategie (GDA). Occupational Safety and Health in Practice. Recommendations for Implementing Psychosocial Risk Assessment; Management of the GDA Mental Health Working Programme, c/o Federal Ministry of Labour and Social A_airs: Berlin, Germany, 2014. Peters MDJ, Godfrey CM, McInerney, Khalil H, Parker D, and Baldini Soares C. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015. 13(3):141-146.