Verification of a clinical decision support system for the diagnosis of headache disorders based on patient–computer interactions: a multi-center study
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Published:2023-05-23
Issue:1
Volume:24
Page:
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ISSN:1129-2377
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Container-title:The Journal of Headache and Pain
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language:en
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Short-container-title:J Headache Pain
Author:
Han Xun, Wan Dongjun, Zhang Shuhua, Yin Ziming, Huang Siyang, Xie Fengbo, Guo Junhong, Qu Hongli, Yao Yuanrong, Xu Huifang, Li Dongfang, Chen Sufen, Wang Faming, Wang Hebo, Chen Chunfu, He Qiu, Dong Ming, Wan Qi, Xu Yanmei, Chen Min, Yan Fanhong, Wang Xiaolin, Wang Rongfei, Zhang Mingjie, Ran Ye, Jia Zhihua, Liu Yinglu, Chen Xiaoyan, Hou Lei, Zhao Dengfa, Dong ZhaoORCID, Yu ShengyuanORCID
Abstract
Abstract
Background
Although headache disorders are common, the current diagnostic approach is unsatisfactory. Previously, we designed a guideline-based clinical decision support system (CDSS 1.0) for diagnosing headache disorders. However, the system requires doctors to enter electronic information, which may limit widespread use.
Methods
In this study, we developed the updated CDSS 2.0, which handles clinical information acquisition via human–computer conversations conducted on personal mobile devices in an outpatient setting. We tested CDSS 2.0 at headache clinics in 16 hospitals in 14 provinces of China.
Results
Of the 653 patients recruited, 18.68% (122/652) were suspected by specialists to have secondary headaches. According to “red-flag” responses, all these participants were warned of potential secondary risks by CDSS 2.0. For the remaining 531 patients, we compared the diagnostic accuracy of assessments made using only electronic data firstly. In Comparison A, the system correctly recognized 115/129 (89.15%) cases of migraine without aura (MO), 32/32 (100%) cases of migraine with aura (MA), 10/10 (100%) cases of chronic migraine (CM), 77/95 (81.05%) cases of probable migraine (PM), 11/11 (100%) cases of infrequent episodic tension-type headache (iETTH), 36/45 (80.00%) cases of frequent episodic tension-type headache (fETTH), 23/25 (92.00%) cases of chronic tension-type headache (CTTH), 53/60 (88.33%) cases of probable tension-type headache (PTTH), 8/9 (88.89%) cases of cluster headache (CH), 5/5 (100%) cases of new daily persistent headache (NDPH), and 28/29 (96.55%) cases of medication overuse headache (MOH). In Comparison B, after combining outpatient medical records, the correct recognition rates of MO (76.03%), MA (96.15%), CM (90%), PM (75.29%), iETTH (88.89%), fETTH (72.73%), CTTH (95.65%), PTTH (79.66%), CH (77.78%), NDPH (80%), and MOH (84.85%) were still satisfactory. A patient satisfaction survey indicated that the conversational questionnaire was very well accepted, with high levels of satisfaction reported by 852 patients.
Conclusions
The CDSS 2.0 achieved high diagnostic accuracy for most primary and some secondary headaches. Human–computer conversation data were well integrated into the diagnostic process, and the system was well accepted by patients. The follow-up process and doctor–client interactions will be future areas of research for the development of CDSS for headaches.
Publisher
Springer Science and Business Media LLC
Subject
Anesthesiology and Pain Medicine,Neurology (clinical),General Medicine
Reference24 articles.
1. Collaborators GBDH (2018) Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 17(11):954–976 2. Yu S, Liu R, Zhao G, Yang X, Qiao X, Feng J, Fang Y, Cao X, He M, Steiner T (2012) The prevalence and burden of primary headaches in China: a population-based door-to-door survey. Headache 52(4):582–591 3. Yao C, Wang Y, Wang L, Liu Y, Liu J, Qi J, Lin Y, Yin P, Zhou M (2019) Burden of headache disorders in China, 1990–2017: findings from the Global Burden of Disease Study 2017. J Headache Pain 20(1):102 4. Liu R, Yu S, He M, Zhao G, Yang X, Qiao X, Feng J, Fang Y, Cao X, Steiner TJ (2013) Health-care utilization for primary headache disorders in China: a population-based door-to-door survey. J Headache Pain 14(1):47 5. Takeshima T, Wan Q, Zhang Y, Komori M, Stretton S, Rajan N, Treuer T, Ueda K (2019) Prevalence, burden, and clinical management of migraine in China, Japan, and South Korea: a comprehensive review of the literature. J Headache Pain 20(1):111
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