虚拟顾问（VICKY）收集家族健康史的可接受性和可行性。
Acceptability and feasibility of a virtual counselor (VICKY) to collect family health histories.
作者信息
Wang Catharine, Bickmore Timothy, Bowen Deborah J, Norkunas Tricia, Campion MaryAnn, Cabral Howard, Winter Michael, Paasche-Orlow Michael
机构信息
Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA.
Northeastern University College of Computer and Information Science, Boston, Massachusetts, USA.
出版信息
Genet Med. 2015 Oct;17(10):822-30. doi: 10.1038/gim.2014.198. Epub 2015 Jan 15.
PURPOSE
To overcome literacy-related barriers in the collection of electronic family health histories, we developed an animated Virtual Counselor for Knowing your Family History, or VICKY. This study examined the acceptability and accuracy of using VICKY to collect family histories from underserved patients as compared with My Family Health Portrait (MFHP).
METHODS
Participants were recruited from a patient registry at a safety net hospital and randomized to use either VICKY or MFHP. Accuracy was determined by comparing tool-collected histories with those obtained by a genetic counselor.
RESULTS
A total of 70 participants completed this study. Participants rated VICKY as easy to use (91%) and easy to follow (92%), would recommend VICKY to others (83%), and were highly satisfied (77%). VICKY identified 86% of first-degree relatives and 42% of second-degree relatives; combined accuracy was 55%. As compared with MFHP, VICKY identified a greater number of health conditions overall (49% with VICKY vs. 31% with MFHP; incidence rate ratio (IRR): 1.59; 95% confidence interval (95% CI): 1.13-2.25; P = 0.008), in particular, hypertension (47 vs. 15%; IRR: 3.18; 95% CI: 1.66-6.10; P = 0.001) and type 2 diabetes (54 vs. 22%; IRR: 2.47; 95% CI: 1.33-4.60; P = 0.004).
CONCLUSION
These results demonstrate that technological support for documenting family history risks can be highly accepted, feasible, and effective.
目的
为克服电子家族健康史收集过程中与读写能力相关的障碍，我们开发了一款名为“了解你的家族病史动画虚拟顾问”（VICKY）的产品。本研究旨在检验与“我的家族健康画像”（MFHP）相比，使用VICKY从医疗服务不足的患者中收集家族病史的可接受性和准确性。
方法
从一家安全网医院的患者登记处招募参与者，并随机分配他们使用VICKY或MFHP。通过将工具收集的病史与遗传咨询师获取的病史进行比较来确定准确性。
结果
共有70名参与者完成了本研究。参与者对VICKY的评价是易于使用（91%）、易于理解（92%），愿意向他人推荐VICKY（83%），并且满意度很高（77%）。VICKY识别出86%的一级亲属和42%的二级亲属；综合准确率为55%。与MFHP相比，VICKY总体上识别出更多的健康状况（VICKY为49%，MFHP为31%；发病率比（IRR）：1.59；95%置信区间（95%CI）：1.13 - 2.25；P = 0.008），特别是高血压（47%对15%；IRR：3.18；95%CI：1.66 - 6.10；P = 0.001）和2型糖尿病（54%对22%；IRR：2.47；95%CI：1.33 - 4.60；P = 0.004）。
结论
这些结果表明，用于记录家族病史风险的技术支持可以被高度接受、可行且有效。
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