Google Health Search Trial

Study Overview
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Brief Summary
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There are large differences in knowledge between patients and healthcare providers (i.e. physicians, physician assistants and nurse practitioners), and there is a strong interest on the part of both industry and academia to reduce the gap in knowledge between patients and healthcare providers. Currently, about 1 in 20 searches on Google are health related. Among internet users, 72% reported searching for health information, and among persons who use mobile phones, 31% of cell phone users and 52% of smartphone users have looked up health or medical information. Oftentimes, patients will search on Google or other search engines in order to find health conditions that explain their symptoms prior to visiting their healthcare provider. With the launch of Google's new health search tools for mobile devices (i.e. smartphones, tablets, etc.) it is important to understand how patients use these search platforms and what their effects are on clinical encounters. The main objective of this study is to understand the accuracy of differential diagnoses generated by Google searching; the investigators hypothesize that searching on Google using a tablet or mobile device will be more accurate than not using any search tool, and that the new health search experience will improve accuracy over the standard search platform.

Official Title
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Accuracy of Differential Diagnosis From Google Health Search and Impact on Clinical Encounters

Conditions
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Diagnoses Disease

Intervention / Treatment
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* Other: Health Search
* Other: Standard Search


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patient >= 18 years of age Presenting for care at urgent care or emergency department In search of a diagnosis to explain a new symptom or group of symptoms Exclusion Criteria: Not literate, defined as lacking the ability to read and write (self-reported) Non-English Speaking (self-reported) Not mentally competent to provide consent due to inability to understand relevant information due to deficit in intelligence (e.g. mental retardation), memory (e.g., advanced dementia or significant delirium), or attention span (e.g., Attention Deficit Disorder (ADD) or mania) based on prior documentation in medical records or as judged by the researchers) Unable to use phone/tablet for any mental or physical impairment (e.g., blind) (self-reported) Exacerbation of chronic condition (self-reported)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants presenting with new symptoms to either an urgent care center or emergency department will be randomized in a 1:1:1 ratio to one of three groups. 1. Access to Health Search (i.e. Google's new health search platform for mobile devices; Health Knowledge Panels and Symptom Search Tool); 2. Access to Standard Search (i.e. prior version of Google search); 3. Usual Care. Groups 1 and 2 will use a tablet or mobile phone to search while group 3 will not.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Health Search<br>Access to Health Knowledge Panels and Symptom Search Tool. | Other: Health Search<br> <br> |
| Experimental: Standard Search<br>No access to Health Knowledge Panels and Symptom Search Tool, but access to prior version of Google search. | Other: Standard Search<br> <br> |
| No Intervention: No Search<br>No access to Health Knowledge Panels, Symptom Search Tool, prior version of Google search, or mobile device. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Accuracy of patient's pre-visit differential diagnosis after Google searching on a tablet or mobile phone. | Proportion of patient's pre-visit differential diagnosis meeting the criteria of match with clinician post-visit differential diagnosis (i.e. Two of the three conditions on the clinician's differential diagnosis were more likely to be present in the patient's pre-visit assessment when a tablet or mobile phone was present). | Assessing diagnostic accuracy from baseline to up to one hour post-clinical encounter. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Accuracy of differential diagnosis of Health Search vs. Standard Search | Proportion of patient's pre-visit differential diagnosis meeting the criteria of match with clinician post-visit differential diagnosis comparing Arm 1 (i.e. Health Search) vs. Arm 2 (i.e. Standard Search). | Assessing diagnostic accuracy from baseline to up to one hour post-clinical encounter. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Google, Knowledge Panels, Health Search, Online, Internet, Smartphone, Tablet, Digital, Mobile, Symptoms, Differential diagnosis, Diagnosis, Anxiety