Bryant Emma, Miskovic-Wheatley Jane, Touyz Stephen, Crosby Ross D, Koreshe Eyza, Cao Li, Maguire Sarah
School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
InsideOut Institute for Eating Disorders, The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia.
J Eat Disord. 2020 Nov 12;8(1):60. doi: 10.1186/s40337-020-00339-8.
Only one in four people with eating disorders seeks treatment, and of those who do seek treatment, 20% go on to experience a chronic course. Early intervention has been associated with better prognosis, with those seeking specialised intervention in the early stages of their illness more than twice as likely to achieve remission. Current screening measures typically require expert administration and are rarely validated across a spectrum of DSM-5 eating disorder presentations or for online use. In light of COVID-19 and increasing reliance on telehealth technologies in the intervention and delivery of mental health services, online assessments suitable for self-referral are likely to be the first step to seeking care. InsideOut Institute has developed a 6-item online screening tool for the purposes of identifying eating disorder risk and symptomatology, aimed specifically at increasing help-seeking behaviour in subsyndromal and early presentations.
This study investigates the reliability and validity of the InsideOut Institute Screener (IOI-S), using a cross-sectional survey research design. Participants aged 14 and over will complete an extensive baseline survey battery for evaluation. 50% of participants will be randomly selected for one follow-up re-test of the IOI-S only, 2 weeks post initial testing. The IOI-S will be analysed for statistical reliability on two parameters: internal consistency and test re-test reliability, and for statistical validity on four parameters: concurrent validity, sensitivity and specificity, convergent and discriminant validity.
The rapid and ongoing shift to digital intervention has highlighted gaps and opportunities in our pathways to care. Adequate screening for eating disorders is a major gap. This study aims to validate an online screening tool for use in telehealth early intervention, designed for users seeking information for a suspected eating disorder. The screener meets those at risk 'where they are' (i.e. online) and may improve timely referrals to relevant services. This is of particular salience as face-to-face healthcare and traditional frontline interventions are disrupted, and we are challenged to re-design our practices to deliver diagnostic and treatment services in highly adaptive digital contexts.
只有四分之一的饮食失调患者寻求治疗，而在那些寻求治疗的患者中，20%会经历慢性病程。早期干预与更好的预后相关，那些在疾病早期寻求专业干预的患者实现缓解的可能性是其他人的两倍多。目前的筛查措施通常需要专家进行管理，并且很少在一系列DSM-5饮食失调表现中得到验证，也未针对在线使用进行验证。鉴于新冠疫情以及心理健康服务干预和提供过程中对远程医疗技术的依赖增加，适合自我推荐的在线评估可能是寻求护理的第一步。内心研究所开发了一种6项在线筛查工具，用于识别饮食失调风险和症状，特别旨在增加亚综合征和早期表现患者的求助行为。
本研究采用横断面调查研究设计，调查内心研究所筛查工具（IOI-S）的可靠性和有效性。14岁及以上的参与者将完成一系列广泛的基线调查以进行评估。50%的参与者将被随机选择仅在初次测试后2周对IOI-S进行一次随访重新测试。将从两个参数分析IOI-S的统计可靠性：内部一致性和重测可靠性，并从四个参数分析统计有效性：同时效度、敏感性和特异性、聚合效度和区分效度。
向数字干预的快速且持续的转变凸显了我们护理途径中的差距和机遇。对饮食失调进行充分筛查是一个重大差距。本研究旨在验证一种用于远程医疗早期干预的在线筛查工具，该工具专为怀疑患有饮食失调症并寻求信息的用户设计。该筛查工具在“患者所在之处”（即在线）接触到有风险的人群，并可能改善及时转介到相关服务的情况。鉴于面对面医疗保健和传统一线干预受到干扰，并且我们面临着重新设计我们的实践以在高度适应性数字环境中提供诊断和治疗服务的挑战，这一点尤为重要。
