Jungmann Stefanie Maria, Klan Timo, Kuhn Sebastian, Jungmann Florian
Department of Psychology, Johannes Gutenberg-University Mainz, Mainz, Germany.
University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.
JMIR Form Res. 2019 Oct 29;3(4):e13863. doi: 10.2196/13863.
Health apps for the screening and diagnosis of mental disorders have emerged in recent years on various levels (eg, patients, practitioners, and public health system). However, the diagnostic quality of these apps has not been (sufficiently) tested so far.
The objective of this pilot study was to investigate the diagnostic quality of a health app for a broad spectrum of mental disorders and its dependency on expert knowledge.
Two psychotherapists, two psychology students, and two laypersons each read 20 case vignettes with a broad spectrum of mental disorders. They used a health app (Ada-Your Health Guide) to get a diagnosis by entering the symptoms. Interrater reliabilities were computed between the diagnoses of the case vignettes and the results of the app for each user group.
Overall, there was a moderate diagnostic agreement (kappa=0.64) between the results of the app and the case vignettes for mental disorders in adulthood and a low diagnostic agreement (kappa=0.40) for mental disorders in childhood and adolescence. When psychotherapists applied the app, there was a good diagnostic agreement (kappa=0.78) regarding mental disorders in adulthood. The diagnostic agreement was moderate (kappa=0.55/0.60) for students and laypersons. For mental disorders in childhood and adolescence, a moderate diagnostic quality was found when psychotherapists (kappa=0.53) and students (kappa=0.41) used the app, whereas the quality was low for laypersons (kappa=0.29). On average, the app required 34 questions to be answered and 7 min to complete.
The health app investigated here can represent an efficient diagnostic screening or help function for mental disorders in adulthood and has the potential to support especially diagnosticians in their work in various ways. The results of this pilot study provide a first indication that the diagnostic accuracy is user dependent and improvements in the app are needed especially for mental disorders in childhood and adolescence.
近年来，用于精神障碍筛查和诊断的健康应用程序在各个层面（如患者、从业者和公共卫生系统）纷纷涌现。然而，这些应用程序的诊断质量迄今尚未得到（充分）测试。
本试点研究的目的是调查一款针对广泛精神障碍的健康应用程序的诊断质量及其对专业知识的依赖性。
两名心理治疗师、两名心理学专业学生和两名外行人分别阅读了20个包含广泛精神障碍的病例 vignettes。他们使用一款健康应用程序（Ada - 你的健康指南），通过输入症状来获得诊断结果。计算每个用户组对病例 vignettes 的诊断与应用程序结果之间的评分者间信度。
总体而言，该应用程序的结果与成年期精神障碍病例 vignettes 之间存在中等程度的诊断一致性（kappa = 0.64），而儿童和青少年期精神障碍的诊断一致性较低（kappa = 0.40）。当心理治疗师使用该应用程序时，成年期精神障碍的诊断一致性良好（kappa = 0.78）。学生和外行人的诊断一致性为中等（kappa = 0.55/0.60）。对于儿童和青少年期的精神障碍，心理治疗师（kappa = 0.53）和学生（kappa = 0.41）使用该应用程序时诊断质量中等，而外行人的诊断质量较低（kappa = 0.29）。平均而言，该应用程序需要回答34个问题，耗时7分钟完成。
此处研究的健康应用程序可为成年期精神障碍提供有效的诊断筛查或辅助功能，并有可能以各种方式特别支持诊断人员的工作。本试点研究结果初步表明，诊断准确性取决于用户，尤其对于儿童和青少年期精神障碍，该应用程序需要改进。
