Development and Validation of Puberty Interpreter, a Mobile Clinical Decision-Support Tool for Pubertal Disorders

Area of Science:

• Pediatric Endocrinology
• Clinical Decision Support Systems
• Mobile Health

Background:

• Pubertal disorders require accurate diagnosis and management for optimal patient outcomes.
• Existing clinical decision support tools for pediatric endocrinology are limited.
• Point-of-care tools can enhance diagnostic accuracy and efficiency.

Purpose of the Study:

• To develop and validate the Puberty Interpreter, a mobile application-based clinical decision support tool.
• To assess the accuracy of the Puberty Interpreter in diagnosing and managing pubertal disorders.
• To compare the tool's performance against pediatricians and trainees.

Main Methods:

• The Puberty Interpreter was developed as a mobile application.
• Recommendations from the app were compared to a gold standard (pediatrician, senior trainee, junior trainee) in 306 children.
• Concordance rates for diagnosis and management were calculated.

Main Results:

• The Puberty Interpreter achieved 99.0% concordance for diagnosis and management, significantly higher than pediatricians (77.8%) and trainees (49.8%-53.9%).
• The app demonstrated a substantially lower relative risk of error compared to human clinicians.
• Implementing the Puberty Interpreter could reduce diagnostic discordance by over 96% and yield significant economic benefits.

Conclusions:

• The Puberty Interpreter provides accurate clinical guidance for pubertal disorders.
• The tool effectively reduces over- and under-investigation compared to current clinical practice.
• Further multi-center prospective evaluation and implementation are recommended.