Internet-based remote health self-checker symptom data as an adjuvant to a national syndromic surveillance system

Alex Elliot*, E. O. Kara, P. Loveridge, Z. Bawa, Roger Morbey, M. Moth, S. Large, Gillian Smith

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Syndromic surveillance is an innovative surveillance tool used to support national surveillance programmes. Recent advances in the use of internet-based health data have demonstrated the potential usefulness of these health data; however, there have been limited studies comparing these innovative health data to existing established syndromic surveillance systems. We conducted a retrospective observational study to assess the usefulness of a national internet-based 'symptom checker' service for use as a syndromic surveillance system. NHS Direct online data were extracted for 1 August 2012 to 1 July 2013; a time-series analysis on the symptom categories self-reported by online users was undertaken and compared to existing telehealth syndromic data. There were 3·37 million online users of the internet-based self-checker compared to 1·43 million callers to the telephone triage health service. There was a good correlation between the online and telephone triage data for a number of syndromic indicators including cold/flu, difficulty breathing and eye problems; however, online data appeared to provide additional early warning over telephone triage health data. This assessment has illustrated some potential benefit of using internet-based symptom-checker data and provides the basis for further investigating how these data can be incorporated into national syndromic surveillance programmes.

Original languageEnglish
Pages (from-to)3416-3422
Number of pages7
JournalEpidemiology and Infection
Issue number16
Publication statusPublished - 1 Dec 2015

Bibliographical note

Publisher Copyright:
© Cambridge University Press 2015.


  • Internet; public health
  • syndromic surveillance
  • telehealth


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