How accurate are digital symptom assessment apps for suggesting conditions and urgency advice? A clinical vignettes comparison to GPs.
How accurate are digital symptom assessment apps for suggesting conditions and urgency advice? A clinical vignettes comparison to GPs.
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数字症状评估应用程序在建议条件和紧急建议方面的准确性如何？临床小插图与GPS进行了比较。
DOI：
10.1136/bmjopen-2020-040269
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发表时间：
2020-12-16
期刊：
影响因子：
2.9
通讯作者：
Novorol C
中科院分区：
文献类型：
--
作者：
Gilbert S;Mehl A;Baluch A;Cawley C;Challiner J;Fraser H;Millen E;Montazeri M;Multmeier J;Pick F;Richter C;Türk E;Upadhyay S;Virani V;Vona N;Wicks P;Novorol C
比较8个流行的症状评估应用程序的情况覆盖范围、建议条件的准确性和紧急建议的适当性。Vignettes研究。200个初级保健小插曲。对于八个应用程序和七个全科医生(GP)：覆盖的广度和条件-建议和紧急建议的准确性衡量的Vignettes的黄金标准。(1)APP所涵盖的情况的比例，即不排除因为用户太小/太老或怀孕，或没有建模的情况；(2)在建议的前3种情况中，初步诊断正确的小插曲的比例；(3)“安全”紧急建议的比例(即，在黄金标准级别，更保守，或不超过一个级别的保守)。条件-建议覆盖率变化很大，一些应用程序没有为许多用户提供建议：按字母顺序，Ada：99.0%；巴比伦：51.5%；浮标：88.5%；K Health：74.5%；Mediktor：80.5%；Symptomate：61.5%；Your.MD：64.5%；WebMD：93.0%。前三位的建议准确率分别为：GPS(平均)：82.1%±5.2%；ADA：70.5%；巴比伦：32.0%；浮标：43.0%；K Health：36.0%；Mediktor：36.0%；症状：27.5%；WebMD：35.5%；Your.MD：23.5%。一些应用程序排除了特定的用户统计数据或条件，在排除相应的小插曲后，它们的性能通常更好。对于安全紧急建议，测试的全科医生的平均得分为97.0%±2.5%。在提供建议的小插曲中，只有三款应用的安全性能在GPS-Ada的1SD以内：97.0%；巴比伦：95.1%；症状：97.8%。1个APP的安全性能在GPS-Your的2个SD以内。MD：92.6%。三个应用程序的安全性能超过2SDPS-浮标：80.0%(p<；0.001)；K Health：81.3%(p<；0.001)；Mediktor：87.3%(p=1.3×10-3)。数字症状评估应用程序的效用取决于覆盖率、准确性和安全性。虽然没有一个数字工具的表现优于全科医生，但有些接近，软件迭代改进的本质提供了可扩展的改进。
To compare breadth of condition coverage, accuracy of suggested conditions and appropriateness of urgency advice of eight popular symptom assessment apps. Vignettes study. 200 primary care vignettes. For eight apps and seven general practitioners (GPs): breadth of coverage and condition-suggestion and urgency advice accuracy measured against the vignettes’ gold-standard. (1) Proportion of conditions ‘covered’ by an app, that is, not excluded because the user was too young/old or pregnant, or not modelled; (2) proportion of vignettes with the correct primary diagnosis among the top 3 conditions suggested; (3) proportion of ‘safe’ urgency advice (ie, at gold standard level, more conservative, or no more than one level less conservative). Condition-suggestion coverage was highly variable, with some apps not offering a suggestion for many users: in alphabetical order, Ada: 99.0%; Babylon: 51.5%; Buoy: 88.5%; K Health: 74.5%; Mediktor: 80.5%; Symptomate: 61.5%; Your.MD: 64.5%; WebMD: 93.0%. Top-3 suggestion accuracy was GPs (average): 82.1%±5.2%; Ada: 70.5%; Babylon: 32.0%; Buoy: 43.0%; K Health: 36.0%; Mediktor: 36.0%; Symptomate: 27.5%; WebMD: 35.5%; Your.MD: 23.5%. Some apps excluded certain user demographics or conditions and their performance was generally greater with the exclusion of corresponding vignettes. For safe urgency advice, tested GPs had an average of 97.0%±2.5%. For the vignettes with advice provided, only three apps had safety performance within 1 SD of the GPs—Ada: 97.0%; Babylon: 95.1%; Symptomate: 97.8%. One app had a safety performance within 2 SDs of GPs—Your.MD: 92.6%. Three apps had a safety performance outside 2 SDs of GPs—Buoy: 80.0% (p<0.001); K Health: 81.3% (p<0.001); Mediktor: 87.3% (p=1.3×10-3). The utility of digital symptom assessment apps relies on coverage, accuracy and safety. While no digital tool outperformed GPs, some came close, and the nature of iterative improvements to software offers scalable improvements to care.
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影响因子：
--
作者：
Van Riel, Noor;Auwerx, Koen;Schoenmakers, Birgitte
通讯作者：
Schoenmakers, Birgitte
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
DOI：
10.1016/j.ijchp.2014.12.001
发表时间：
2015-05-01
影响因子：
8.8
作者：
Evans, Spencer C.;Roberts, Michael C.;Reed, Geoffrey M.
通讯作者：
Reed, Geoffrey M.
影响因子：
3.7
作者：
Shan, Guogen;Gerstenberger, Shawn
通讯作者：
Gerstenberger, Shawn
影响因子：
158.5
作者：
BERNER, ES;WEBSTER, GD;TAUNTON, D
通讯作者：
TAUNTON, D