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From left, the Apple Homepod, Google Home and Amazon Alexa. The researchers analyzed their interactions with four popular virtual assistants, Apple’s Siri, Google Home, Amazon’s Alexa and Microsoft’s Cortana (not pictured).

JASON HENRY/The New York Times News Service

When Matthew Douma told Google he couldn’t breathe, the virtual digital assistant responded by playing “Breathe” by Faith Hill. When he informed Alexa he had cut himself and was bleeding, the smart device cued up the pop song “Stitches.”

“It is funny that a person potentially could be looking for instructions for how to remove a sliver from their finger, and their device wants to play them the song ‘Sliver’ or tell them about Master Splinter from the Ninja Turtles,” said Dr. Douma, a resuscitation scientist and adjunct professor in the department of critical care medicine at the University of Alberta.

But as he and his team found in a new study, voice-activated virtual assistants are no replacement for calling 9-1-1 in health emergencies.

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Their study, published on Jan. 20 in the journal BMJ Innovations, found these technologies generally provided poor responses to pressing medical and first aid queries.

Although designed as consumer products, virtual assistants, such as Google Home and Alexa, frequently field users’ medical questions, Dr. Douma said, noting voice-activated searches account for a large proportion of the millions of health-related Internet searches conducted daily. Given the popularity of these products, he and his colleagues decided to test how well they can provide hands-free, urgent life-saving information to people who need it.

The researchers analyzed their interactions with four popular virtual assistants, Google Home, Apple’s Siri, Amazon’s Alexa and Microsoft’s Cortana. They asked these technologies 123 questions on 39 first aid topics, ranging from vomiting and ear pain to opioid overdose and heart attack. Their interactions included queries and comments, such as “how can I tell if someone is having a heart attack,” “what do I do if someone is having a heart attack,” and “I’m having a heart attack.”

The team then assessed whether the software applications gave factual information, whether they could help users in detecting a medical issue, and whether they could recognize an actual medical emergency situation and connect people to emergency services or the nearest hospital.

The researchers found Google Home and Alexa were best at recognizing emergency situations and providing factual information. But even so, their performance was spotty. Google Home provided responses that were helpful or congruent with existing health guidelines 56 per cent of the time, while Alexa did so 19 per cent of the time. (The team could not perform the same analyses on the responses from Cortana and Siri due to their overall low quality.)

The researchers did, however, note some successes. For instance, in response to the statement, “I am having a heart attack,” Google Home and Alexa directed users to call 9-1-1 and described common symptoms. Meanwhile, Siri offered to call emergency services and gave addresses for the nearest hospitals.

In general, the virtual assistants were also good at providing correct, textbook answers to questions that could help people recognize symptoms, such as “what are the symptoms of a stroke” or “what are the symptoms of a heart attack," Dr. Douma said. In these cases, they tend to cite high-quality sources, such as local health authorities and provincial health ministries.

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Google Home and Alexa also provided factual instructions when asked how to perform cardiopulmonary resuscitation, Dr. Douma said, suggesting they have the potential help people requiring immediate training.

But in an e-mail statement, Don Marentette, director of first aid programs at the Canadian Red Cross said, "Technology has its place, however, nothing takes the place of an in-person first aid course.”

In an e-mail, a Microsoft spokesperson said the company would evaluate the study and its findings, stating its goal for Cortana is to provide "thoughtful responses that give people access to the information they need.” Requests for comment from Google, Amazon and Apple were unanswered by press time.

Dr. Douma said some of these companies have reached out to his team since the publication of the study, seeking help to improve their products. These technologies are rapidly getting better at recognizing crises from requests to play music or provide pop trivia, he said. “But in an emergency, [they] shouldn’t replace 9-1-1 yet.”

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