Hollis Chris, Sampson Stephanie, Simons Lucy, Davies E Bethan, Churchill Rachel, Betton Victoria, Butler Debbie, Chapman Kathy, Easton Katherine, Gronlund Toto Anne, Kabir Thomas, Rawsthorne Mat, Rye Elizabeth, Tomlin André
Institute of Mental Health, University of Nottingham, Nottingham, UK.
Centre for Reviews and Dissemination and Cochrane Common Mental Disorders Group, University of York, York, UK.
Lancet Psychiatry. 2018 Oct;5(10):845-854. doi: 10.1016/S2215-0366(18)30296-7. Epub 2018 Aug 28.
Digital technology, including the internet, smartphones, and wearables, provides the possibility to bridge the mental health treatment gap by offering flexible and tailored approaches to mental health care that are more accessible and potentially less stigmatising than those currently available. However, the evidence base for digital mental health interventions, including demonstration of clinical effectiveness and cost-effectiveness in real-world settings, remains inadequate. The James Lind Alliance Priority Setting Partnership for digital technology in mental health care was established to identify research priorities that reflect the perspectives and unmet needs of people with lived experience of mental health problems and use of mental health services, their carers, and health-care practitioners. 644 participants contributed 1369 separate questions, which were reduced by qualitative thematic analysis into six overarching themes. Following removal of out-of-scope questions and a comprehensive search of existing evidence, 134 questions were verified as uncertainties suitable for research. These questions were then ranked online and in workshops by 628 participants to produce a shortlist of 26. The top ten research priorities, which were identified by consensus at a stakeholder workshop, should inform research policy and funding in this field. Identified priorities primarily relate to the safety and efficacy of digital technology interventions in comparison with face-to-face interventions, evidence of population reach, mechanisms of therapeutic change, and the ways in which the effectiveness of digital interventions in combination with human support might be optimised.
数字技术，包括互联网、智能手机和可穿戴设备，通过提供灵活且量身定制的精神卫生保健方法，为弥合精神卫生治疗差距提供了可能性，这些方法比现有方法更容易获得，而且可能减少污名化。然而，数字心理健康干预措施的证据基础，包括在现实环境中的临床有效性和成本效益证明，仍然不足。詹姆斯·林德联盟精神卫生保健数字技术优先事项设定伙伴关系的成立，旨在确定反映有精神健康问题经历和使用精神卫生服务的人、他们的护理人员以及医疗从业者的观点和未满足需求的研究优先事项。644名参与者提出了1369个单独的问题，通过定性主题分析将这些问题归纳为六个总体主题。在剔除范围外问题并全面检索现有证据后，134个问题被确认为适合研究的不确定性问题。然后，628名参与者通过在线和研讨会对这些问题进行排序，以产生一份26个问题的入围名单。在一次利益相关者研讨会上通过协商一致确定的十大研究优先事项，应为该领域的研究政策和资金提供参考。确定的优先事项主要涉及数字技术干预措施与面对面干预措施相比的安全性和有效性、人群覆盖范围的证据、治疗改变的机制，以及如何优化数字干预措施与人力支持相结合的有效性。
