远程精神病学在美国印第安退伍军人中的诊断可靠性。
Diagnostic reliability of telepsychiatry in American Indian veterans.
作者信息
Shore Jay H, Savin Daniel, Orton Heather, Beals Jan, Manson Spero M
机构信息
American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Nighthorse Campbell Native Health Building, Mail Stop F800, P.O. Box 6508, Aurora, CO 80045-0508, USA.
出版信息
Am J Psychiatry. 2007 Jan;164(1):115-8. doi: 10.1176/ajp.2007.164.1.115.
OBJECTIVE
This study examined the reliability of the Structured Clinical Interview for DSM-III-R (SCID) in the administration of psychiatric assessments by real-time videoconferencing compared to face-to-face assessment within a rural American Indian community.
METHOD
The SCID was administered to 53 male American Indian veterans who were randomly assigned over two separate occasions by different interviewers to face-to-face and real-time interactive videoconferencing within 2 weeks. Comparisons were made with prevalences, the McNemar test, and the kappa statistic.
RESULTS
With the exception of past-year substance dependence and abuse/dependence combined, there were no significant differences between face-to-face and videoconference administration. The majority of kappas calculated (76%) indicated a good or fair level of agreement. Externalizing disorders tended to elicit greater concordance than internalizing disorders.
CONCLUSIONS
Overall, SCID assessment by live interactive videoconferencing did not differ significantly from face-to-face assessment in this population. Videoconferencing is a viable vehicle for clinical and research purposes.
目的
本研究考察了与美国印第安农村社区内的面对面评估相比，通过实时视频会议进行精神科评估时《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）结构化临床访谈（SCID）的可靠性。
方法
对53名美国印第安男性退伍军人进行SCID访谈，由不同访谈者在两周内分两次将他们随机分配为面对面访谈组和实时交互式视频会议访谈组。采用患病率比较、McNemar检验和kappa统计量进行分析。
结果
除过去一年的物质依赖以及滥用/依赖合并情况外，面对面访谈和视频会议访谈之间没有显著差异。计算得出的大多数kappa值（76%）表明一致性水平良好或尚可。外化性障碍比内化性障碍往往能引发更高的一致性。
结论
总体而言，在该人群中，通过实时交互式视频会议进行的SCID评估与面对面评估没有显著差异。视频会议是用于临床和研究目的的一种可行方式。
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