Diagnostic Performance of an App-Based Symptom Checker in Mental Disorders: Comparative Study in Psychotherapy Outpatients.
Diagnostic Performance of an App-Based Symptom Checker in Mental Disorders: Comparative Study in Psychotherapy Outpatients.
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DOI：
10.2196/32832
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发表时间：
2022-01-31
影响因子：
5.2
通讯作者：
Jungmann SM
中科院分区：
文献类型：
--
作者：
Hennemann S;Kuhn S;Witthöft M;Jungmann SM
数字技术已成为寻求健康相关信息的共同起点。基于网络或应用程序的症状检查器旨在提供快速准确的病情建议和分诊建议，但尚未在常规医疗保健环境中对精神障碍进行调查。本研究旨在测试一个广泛使用的症状检查的诊断性能的背景下，正式诊断的精神障碍相比，治疗师的诊断结构化的临床访谈的基础上。来自门诊心理治疗诊所的成年患者在入院时使用基于应用程序的症状检查器Ada-check your health（ADA; Ada Health GmbH）。准确性被评估为ADA的第一个和前5个条件建议中的1个与至少一个基于访谈的治疗师诊断的一致性。此外，还计算了3种最常见疾病类别的敏感性、特异性和评估者间可靠性（Gwet一阶一致系数[AC1]）。评价了自我报告的可用性（使用系统可用性量表评估）和ADA接受度（使用改编的反馈问卷评估）。本研究共纳入49例患者（30/49，61%为女性;平均年龄33.41岁，SD 12.79岁）。在所有患者中，51%（25/49; 95% CI 37.5 - 64.4）的病例中基于访谈的诊断与ADA的第一个条件建议相匹配，69%（34/49; 95% CI 55.4 - 80.6）的病例中与前5个条件建议中的1个相匹配。在主要障碍类别中，ADA的第一个条件建议的准确性为躯体形式和相关障碍0.82，情感障碍0.65，焦虑症0.53。评定者间的可靠性范围从低（焦虑症的AC1 = 0.15）到好（躯体形式和相关障碍的AC1 = 0.76）。ADA的可用性在系统可用性量表中被评定为高（平均值81.51，SD 11.82，评分范围0 - 100）。大约71%（35/49）的参与者更喜欢面对面的诊断，而不是基于应用程序的诊断。总的来说，我们的研究结果表明，在正式诊断精神障碍时广泛使用的症状检查器可以为临床医生提供具有中等至良好准确性的条件建议列表。然而，诊断性能是异质性的障碍类别之间，包括低评分者之间的可靠性。虽然症状检查器作为筛查工具有一定的潜力来补充诊断过程，但诊断性能应在更大的样本中进行测试，并与其他诊断工具进行比较。
Digital technologies have become a common starting point for health-related information-seeking. Web- or app-based symptom checkers aim to provide rapid and accurate condition suggestions and triage advice but have not yet been investigated for mental disorders in routine health care settings. This study aims to test the diagnostic performance of a widely available symptom checker in the context of formal diagnosis of mental disorders when compared with therapists’ diagnoses based on structured clinical interviews. Adult patients from an outpatient psychotherapy clinic used the app-based symptom checker Ada–check your health (ADA; Ada Health GmbH) at intake. Accuracy was assessed as the agreement of the first and 1 of the first 5 condition suggestions of ADA with at least one of the interview-based therapist diagnoses. In addition, sensitivity, specificity, and interrater reliabilities (Gwet first-order agreement coefficient [AC1]) were calculated for the 3 most prevalent disorder categories. Self-reported usability (assessed using the System Usability Scale) and acceptance of ADA (assessed using an adapted feedback questionnaire) were evaluated. A total of 49 patients (30/49, 61% women; mean age 33.41, SD 12.79 years) were included in this study. Across all patients, the interview-based diagnoses matched ADA’s first condition suggestion in 51% (25/49; 95% CI 37.5-64.4) of cases and 1 of the first 5 condition suggestions in 69% (34/49; 95% CI 55.4-80.6) of cases. Within the main disorder categories, the accuracy of ADA’s first condition suggestion was 0.82 for somatoform and associated disorders, 0.65 for affective disorders, and 0.53 for anxiety disorders. Interrater reliabilities ranged from low (AC1=0.15 for anxiety disorders) to good (AC1=0.76 for somatoform and associated disorders). The usability of ADA was rated as high in the System Usability Scale (mean 81.51, SD 11.82, score range 0-100). Approximately 71% (35/49) of participants would have preferred a face-to-face over an app-based diagnostic. Overall, our findings suggest that a widely available symptom checker used in the formal diagnosis of mental disorders could provide clinicians with a list of condition suggestions with moderate-to-good accuracy. However, diagnostic performance was heterogeneous between disorder categories and included low interrater reliability. Although symptom checkers have some potential to complement the diagnostic process as a screening tool, the diagnostic performance should be tested in larger samples and in comparison with further diagnostic instruments.
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影响因子：
7.4
作者：
Donker T;van Straten A;Marks I;Cuijpers P
通讯作者：
Cuijpers P
DOI：
10.1007/s00103-019-03081-y
发表时间：
2020-02
期刊：
Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
影响因子：
--
作者：
Cornejo Müller A;Wachtler B;Lampert T
通讯作者：
Lampert T
DOI：
10.1089/cpb.2006.9.494
发表时间：
2006-08-01
期刊：
CYBERPSYCHOLOGY & BEHAVIOR
影响因子：
--
作者：
Eastin, Matthew S.;Guinsler, Natalie M.
通讯作者：
Guinsler, Natalie M.
影响因子：
3.6
作者：
Cheniaux, Elie;Landeira-Fernandez, J.;Versiani, Marcio
通讯作者：
Versiani, Marcio
DOI：
10.1007/s00103-020-03192-x
发表时间：
2020-07-14
影响因子：
1.7
作者：
Baumann, Eva;Czerwinski, Fabian;Suhr, Ralf
通讯作者：
Suhr, Ralf