Department of Philosophy, Virginia Polytechnic Institute and State University, Blacksburg, VA 24060, USA.
University of Vermont Medical Center, Burlington, VT 05401, USA.
Sensors (Basel). 2024 May 18;24(10):3214. doi: 10.3390/s24103214.
In response to a burgeoning pediatric mental health epidemic, recent guidelines have instructed pediatricians to regularly screen their patients for mental health disorders with consistency and standardization. Yet, gold-standard screening surveys to evaluate mental health problems in children typically rely solely on reports given by caregivers, who tend to unintentionally under-report, and in some cases over-report, child symptomology. Digital phenotype screening tools (DPSTs), currently being developed in research settings, may help overcome reporting bias by providing objective measures of physiology and behavior to supplement child mental health screening. Prior to their implementation in pediatric practice, however, the ethical dimensions of DPSTs should be explored. Herein, we consider some promises and challenges of DPSTs under three broad categories: accuracy and bias, privacy, and accessibility and implementation. We find that DPSTs have demonstrated accuracy, may eliminate concerns regarding under- and over-reporting, and may be more accessible than gold-standard surveys. However, we also find that if DPSTs are not responsibly developed and deployed, they may be biased, raise privacy concerns, and be cost-prohibitive. To counteract these potential shortcomings, we identify ways to support the responsible and ethical development of DPSTs for clinical practice to improve mental health screening in children.
针对日益严重的儿科心理健康问题，最近的指南指示儿科医生定期使用一致性和标准化的方法对其患者进行心理健康障碍筛查。然而，评估儿童心理健康问题的黄金标准筛查调查通常仅依赖于护理人员的报告，而护理人员往往会无意识地低估，在某些情况下则会高估儿童的症状。目前正在研究环境中开发的数字表型筛查工具（DPST），可以通过提供生理和行为的客观测量来补充儿童心理健康筛查，从而有助于克服报告偏见。然而，在将 DPST 应用于儿科实践之前，应该探讨其伦理方面的问题。在此，我们从准确性和偏差、隐私以及可及性和实施三个广泛的类别来考虑 DPST 的一些承诺和挑战。我们发现 DPST 具有准确性，可能消除对少报和多报的担忧，并且可能比黄金标准调查更易获得。但是，我们还发现，如果 DPST 的开发和部署不负责，它们可能存在偏见，引发隐私问题，并且成本过高。为了应对这些潜在的缺点，我们确定了支持 DPST 在临床实践中负责任和合乎道德的开发的方法，以改善儿童心理健康筛查。
