Accepted for/Published in: JMIR Mental Health
Date Submitted: Aug 17, 2021
Open Peer Review Period: Sep 7, 2021 - Nov 7, 2021
Date Accepted: Nov 11, 2021
(closed for review but you can still tweet)
A Systematic Review of the Current State and Validity of Digital Assessment Tools for Psychiatry
ABSTRACT
Background:
Given the role digital technologies are likely to play in the future of mental healthcare, there is a need for a comprehensive appraisal of the current state and validity (i.e., screening/diagnostic accuracy) of digital mental health assessments.
Objective:
To explore the current state and validity of question-and-answer-based digital tools for diagnosing and screening psychiatric conditions in adults.
Methods:
This systematic review was based on the Population, Intervention, Comparison, and Outcome (PICO) framework and was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, Embase, Cochrane Library, ASSIA, Web of Science Core Collection, CINAHL, and PsycINFO were systematically searched for articles published between 2005 and 2020. A descriptive evaluation of the study characteristics and digital solutions and a quantitative appraisal of the screening/diagnostic accuracy of the included tools was conducted. Risk of bias and applicability were assessed using the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) guidelines.
Results:
A total of 25 studies met the inclusion criteria, with the most frequently evaluated conditions encompassing generalized anxiety disorder (GAD), major depressive disorder (MDD), and any depressive disorder. The majority of the studies employed digitized versions of existing pen-and-paper questionnaires, with findings revealing poor to excellent screening/diagnostic accuracy (sensitivity = 0.36-1.00, specificity = 0.37-1.00, AUC = 0.57-0.98) and a high risk of bias for most of the included studies.
Conclusions:
The current state of the field of digital mental health tools is in its early stages and high-quality evidence is lacking.
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© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.