在急诊室对两个症状检查器 (Ada和Symptoma) 的比较:随机,交叉,对对,双盲研究
Johannes Knitza1,2,3,4, Ragip Hasanaj5, Jonathan Beyer5
1Institute for Digital Medicine, University Hospital Giessen, Philipps University, Marburg, Germany.
Journal of medical Internet research
|August 20, 2024
概括
像Ada和Symptoma这样的症状检查器 (SC) 显示出不同的诊断准确性和可用性. 艾达的表现更好,但这两种工具都引发了对安全性和可信度的担忧,需要进一步的临床评估.
科学领域:
- 数字健康数字健康
- 医疗信息学医学信息学
- 临床决策支持 临床决策支持
背景情况:
- 紧急诊所 (ED) 面临着过度拥挤,非紧急病人的患者有助于解决这个问题.
- 症状检查器 (SC) 提供可访问的疾病信息和行动建议,可能缓解患者流动.
- 有限的直接患者使用证据存在于SCs,尽管它们的采用越来越多.
研究的目的:
- 为了比较两个领先的SCs的诊断准确性,安全性,可用性和接受性:Ada和Symptoma.
- 评估SC建议与最终诊断的一致性,并评估分拣建议的安全性.
- 收集用户对SC易用性和整体推可能性的反.
主要方法:
- 一个随机,双盲,交叉研究,涉及450名成年患者在ED.
- 患者使用了Ada和Symptoma,结果由盲目的专家评估者评估.
- 主要结果:诊断准确性;次要结果:安全性,可用性 (利克尔特尺度) 和接受性 (净促进者得分 - NPS).
主要成果:
- 艾达提供相同或可信的诊断比Symptoma更频繁 (58%对38%).
- 两个SC都未能在很大比例的病例中识别出可能危及生命的诊断 (Ada: 13%,症状: 14%).
- Ada被评为更容易使用 (88%对78%),但对分拣准确性有所担忧 (53%过分分拣);NPS分数对两者都是负的.
结论:
- 与Symptoma相比,Ada表现出更高的诊断准确性和可用性.
- 仍然存在关于SCs安全性的重大担忧,包括错过的关键诊断和不准确的分拣建议.
- 在广泛部署SC之前,严格的临床验证至关重要,以确保患者的安全并防止资源的滥用.
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