Digital symptom checkers for COVID-19: a scoping review and pilot study of the ENTIRE quality appraisal tool for health informatics studies

Abstract

Background The COVID-19 pandemic has generated an explosion of digital health applications to support citizens, professionals, healthcare organizations and governments.This scoping review aims to describe the scope and type of studies on COVID-19 digital symptom checkers in the early pandemic, and to pilot the ENTIRE quality appraisal tool for health informatics studies. ResultsThe search strategy included three concepts: symptom checkers, digital, and COVID-19 and was conducted in Medline, Web of Science and ABI/INFORM Collection.The ENTIRE tool was built adapting items from the Mixed methods appraisal tool, the STAtement on the Reporting of Evaluation studies in Health Informatics guidelines, and from the mobile Health on the Net Code.Of the 4379 unique publications, 29 studies met the inclusion criteria, reporting on 26 COVID-19 symptom checkers.Most studies (75%, 23/29) were observational, and 38% (11/29) had no clear evaluation criterion.Few studies reported the evaluation of usability, and results observed in high-quality studies were mitigated, indicating a low added value of COVID-19 symptom checkers.With the ENTIRE tool, 17/29 studies obtained a score of 6 or more out of 10 (high-quality). ConclusionStudies on digital symptom checkers were not frequent, and mostly driven by academic institutions and healthcare organizations.The ENTIRE tool was useful to assess the quality of studies: all studies with a quality score below 6 had unclear results.This review confirms the need for further developing standard methods for evaluating the quality of studies on digital health interventions.

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