A recent US-based economic modeling study from Flo Health examines whether digital tools, like a symptom checker for endometriosis, could help address prolonged diagnostic delays, a persistent challenge in clinical practice.
The research was a collaboration with researchers at the London School of Hygiene and Tropical Medicine and York Health Economics Consortium, and published in the journal npj Digital Medicine, part of the prestigious Nature Portfolio publishing group.
Endometriosis affects around 190 million1 women of reproductive age globally (approximately 10%) and remains associated with substantial delays in diagnosis. In routine care, patients often consult an average of seven different health care professionals and wait seven years or longer to receive a diagnosis.1
Those years of delay are associated with reduced quality of life, lost wages, and high medical costs. In the United States alone, the economic burden of endometriosis is estimated to be between $78 and $119 billion annually.1
A new study led by Flo’s science team found that using a digital symptom checker for endometriosis, if used as intended, could meaningfully shorten the time to diagnosis and substantially reduce societal costs by educating on symptoms and encouraging earlier doctor visits.
For chronic conditions such as endometriosis — where symptoms often precede diagnosis by many years and disease trajectories extend over decades — long-term randomized trials are rarely feasible to evaluate the effects of interventions like digital symptom checkers. Health–economic modeling offers an established alternative by combining clinical, epidemiological, and cost data to estimate how changes in care pathways may affect health outcomes and resource use over time.
In this study, the authors used a US-based economic model to examine whether earlier symptom recognition, supported by a digital endometriosis symptom checker used alongside standard care, could influence time to diagnosis and long-term health and economic outcomes over a 40-year horizon.
The authors developed a model to simulate the diagnostic journey of 20-year-old women in the United States presenting with potential endometriosis.
Two scenarios were compared. The first represents the “standard of care,” based on the typical journey of patients seeking diagnosis, care, and treatment for endometriosis. The second represents a “digital intervention” path, in which women use Flo’s Symptom Checker to receive information and education about their symptoms and receive guidance about visiting their doctor if their symptoms match those commonly associated with endometriosis.
Although symptom checkers are nondiagnostic informational tools and nonregulated medical devices, they serve as critical catalysts earlier in the diagnostic process. By improving patient health literacy, they significantly reduce the time-to-consultation without overstepping the boundaries of professional clinical practice.
The model showed that digital symptom checkers, if used as intended, could reduce diagnostic delay by an average of 4.36 years through earlier symptom notification and explanation and more effective, timely subsequent care-seeking.
This translates to a modest improvement in quality-adjusted life years, equivalent to an addition of nearly three weeks of healthy life per patient, enabled by earlier diagnosis and treatment.
“This health economic evaluation of Flo’s digital Symptom Checker contributes to a growing body of evidence for a historically under-researched condition,” commented coauthor Laura Kelly, MPH, a senior health economist from the York Health Economics Consortium in the United Kingdom. “The findings highlight the potential for digital tools to shorten the time to diagnosis of endometriosis, leading to benefits for both patients and the wider health care system.”
Beyond the physical and emotional relief of an earlier diagnosis, the study highlighted significant economic benefits. The researchers performed a cost estimation from the societal perspective, which looked at both direct medical costs and indirect costs like lost productivity.
The model estimated that Flo’s digital Symptom Checker could save an average of $5,196 per person over a 40-year period compared with standard care. These savings come from lower direct medical costs and better productivity due to more timely diagnosis and care for symptoms.
When the researchers looked at the broader impact on society, the results were even more compelling. They calculated the “net monetary benefit,” which is a standard economic measure that combines financial savings with the monetary value of improved health.
Here, the total societal benefit was $10,089 per person.*
Flo’s study is the first economic evaluation of a digital symptom checker for endometriosis and demonstrates how technology can solve systemic health care challenges.
“An important caveat is that there are certain conditions that a symptom checker must meet to deliver the type of value our model demonstrated,“ Yihan Xu, PhD, lead research scientist and health economist at Flo and lead study author, explained.
“The accuracy of the symptom checker should be above 70%, user compliance needs to be relatively high, at least 45%, and the outcomes need to be evaluated over a time horizon of at least 10 years. This might sound technical, but these boundary conditions are important to highlight. Our model demonstrated that efficient symptom checkers that meet these conditions have the potential to deliver better health outcomes for patients while simultaneously reducing the strain on the health care system,“ she continued.
The authors emphasize that further research is needed, particularly longitudinal studies with real-world data to assess whether digital symptom checkers meaningfully change diagnostic timelines and outcomes in practice.
The study ultimately suggests that digital tools can serve as a bridge between patients and health care systems. By validating patients’ symptoms early and providing data-backed reports, apps like Flo can help dismantle the barriers that prevent timely care.
As the research shows, this can benefit both patients and the wider society.
“Endometriosis has long been a blind spot in women’s health, with diagnostic delays that are simply unacceptable,” said Liudmila Zhaunova, PhD, senior study author and director of science at Flo. “Our research validates that digital technologies can be powerful public health interventions. By putting digital tools directly into women’s hands, we can fundamentally change the trajectory of this disease.”
Reviewed by Yihan Xu, PhD, Flo lead research scientist and health economist, UK
*The incremental net monetary benefit was estimated assuming a willingness-to-pay threshold of $100,000 per quality-adjusted life year (QALY), a common benchmark for US institutional payers.
Flo also offers the OB-GYN Co-Care Pack, developed for practising healthcare professionals in women’s health who want to support patient education and symptom awareness between appointments.
The pack includes patient education materials covering reproductive health conditions such as endometriosis, alongside resources that support preventive reproductive health education and encourage patients to track cycles and symptoms over time. These tools are designed to complement clinical care by helping patients arrive at consultations with clearer insight into their symptom history.
Practising healthcare professionals can access or request the OB-GYN Co-Care Pack.
Healthcare professionals interested in related research and perspectives on digital tools in OB-GYN care and women’s health may find the following resources helpful: