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控制维尼特研究中的输入变量 评估基于Web的症状检查器:对当前实践的评估和对孤立准确度指标的建议
András Meczner1,2, Nathan Cohen1, Aleem Qureshi1
1Healthily, London, United Kingdom.
JMIR formative research
|May 31, 2024
概括
对症状检查器 (SC) 进行标签测试的标准化改善了测试器的一致性,但仍然存在显著的变异性. 孤立的性能指标提供了比单独的复合精度更可靠的评估.
科学领域:
- 数字健康数字健康
- 医疗信息学 医疗信息学
- 医疗人工智能 医疗人工智能
背景情况:
- 基于网络的症状检查器 (SC) 在没有标准化质量保证的情况下快速增长.
- 标签研究对于SC评估是常见的,但准确性是一个由测试器可变性影响的复合度量.
- 现有的方法缺乏广泛接受的标准来评估SC的性能.
研究的目的:
- 评估测试器变异性对SC结果准确性的影响,使用临床图片.
- 探索测量SC性能的孤立方面的可行性.
- 提高SC绩效评估的可靠性和通用性.
主要方法:
- 评估了Healthily的SC,在三个测试组 (免费,部分免费,受限制的指令) 中使用了114个标记.
- 计算 κ 统计数据,以达成对结果条件和分拣的共识.
- 测量原油和调整准确度与黄金标准相比,调整准确度通过审查过程来改进.
- 评估了症状理解的可行性,使用三个SC的51个主要投诉的变化.
主要成果:
- 随着标准化的增加,测试人员之间的协议得到了改善 (免费:0.49-0.51;部分免费:0.66-0.66;受限制:0.71-0.72).
- 限制组准确率平均为50.6% (SD5.35%),调整后准确率为56.1%.
- 对症状理解的评估是可行的,得分从52.9%到68%不等.
结论:
- 标准化维涅特测试显著提高了测试者之间的共识,但并没有消除测试者依赖的变化.
- 维涅特研究中的复合精度测量受到测试器变异性和小样本大小的限制.
- 测量孤立的SC性能方面,如症状理解,提供更可靠的评估.
- 对于未来的SC绩效评估,建议使用调整后的精度度量和单独的指标.
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