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Abstract
BackgroundHealth apps for the screening and diagnosis of mental disorders have emerged in recent years on various levels (eg, patients, practitioners, and public health system). However, the diagnostic quality of these apps has not been (sufficiently) tested so far.ObjectiveThe objective of this pilot study was to investigate the diagnostic quality of a health app for a broad spectrum of mental disorders and its dependency on expert knowledge.MethodsTwo psychotherapists, two psychology students, and two laypersons each read 20 case vignettes with a broad spectrum of mental disorders. They used a health app (Ada—Your Health Guide) to get a diagnosis by entering the symptoms. Interrater reliabilities were computed between the diagnoses of the case vignettes and the results of the app for each user group.ResultsOverall, there was a moderate diagnostic agreement (kappa=0.64) between the results of the app and the case vignettes for mental disorders in adulthood and a low diagnostic agreement (kappa=0.40) for mental disorders in childhood and adolescence. When psychotherapists applied the app, there was a good diagnostic agreement (kappa=0.78) regarding mental disorders in adulthood. The diagnostic agreement was moderate (kappa=0.55/0.60) for students and laypersons. For mental disorders in childhood and adolescence, a moderate diagnostic quality was found when psychotherapists (kappa=0.53) and students (kappa=0.41) used the app, whereas the quality was low for laypersons (kappa=0.29). On average, the app required 34 questions to be answered and 7 min to complete.ConclusionsThe health app investigated here can represent an efficient diagnostic screening or help function for mental disorders in adulthood and has the potential to support especially diagnosticians in their work in various ways. The results of this pilot study provide a first indication that the diagnostic accuracy is user dependent and improvements in the app are needed especially for mental disorders in childhood and adolescence.
Highlights
Digital media have become enormously important in the health sector
For mental disorders in adulthood, we found for the 72 case records (6 users×12 mental disorders), a percentage agreement of 68% and an interrater reliability according to Cohen kappa 0.64 between the textbook diagnosis and the result produced by the app
As the app is used at the consumer level, and our pilot study indicated that diagnostic quality was lower among users from the general population and students, an important research perspective is to examine in which areas the weaknesses and deficits lie with nonprofessionals and how these can be addressed in further development
Summary
Background Digital media have become enormously important in the health sector. Up to 80% of the internet users inform themselves on the Web about health [1], and about 60% of patients search for their symptoms on the internet before or after a visit to the doctor [2]. Health apps play an important role in physical diseases and in mental health conditions and disorders [4,5,6]. Access to professional diagnosis and treatment is often difficult and delayed (eg, long waits and concerns about psychotherapy). Health apps for the screening and diagnosis of mental disorders have emerged in recent years on various levels (eg, patients, practitioners, and public health system). The diagnostic quality of these apps has not been (sufficiently) tested so far
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