Chen H Y, Luo H C, Phillips M R
Shashi Psychiatric Hospital, Hubei, People's Republic of China.
Acta Psychiatr Scand. 1992 Jan;85(1):11-4. doi: 10.1111/j.1600-0447.1992.tb01434.x.
Current diagnostic methods in psychiatry use sequential logical decision rules that generate a single diagnosis. Insufficient attention has been paid to parallel methods that can simultaneously determine the relative probability of many diagnoses. This study installed 45 items from various symptom scales on a portable computer and applied a euclidean distance formula to generate immediate diagnoses based on responses to the items. The reliability and validity of the method were assessed using Chinese psychiatric inpatients. Interrater reliability was excellent (kappa = 0.91) and 3-week test-retest reliability was fair (k = 0.50). The concordance of this method with clinicians' diagnoses and with diagnoses based on standardized Chinese diagnostic criteria was excellent (k = 0.73 and 0.76). Concordance with DSM-III-R diagnoses and ICD-10 diagnoses was fair (kappa = 0.55 and 0.65). The clinical utility of such parallel methods of psychiatric diagnosis deserves further evaluation.
目前精神病学的诊断方法采用顺序逻辑决策规则来得出单一诊断。对于能够同时确定多种诊断相对概率的并行方法,关注不足。本研究在一台便携式计算机上安装了来自各种症状量表的45个项目,并应用欧几里得距离公式,根据对这些项目的回答生成即时诊断。使用中国精神科住院患者评估该方法的信度和效度。评定者间信度极佳(kappa = 0.91),3周重测信度尚可(k = 0.50)。该方法与临床医生诊断以及基于标准化中国诊断标准的诊断的一致性极佳(k = 0.73和0.76)。与DSM - III - R诊断和ICD - 10诊断的一致性尚可(kappa = 0.55和0.65)。这种精神病诊断并行方法的临床实用性值得进一步评估。