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 2021. 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 28 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 = 0.32-1.00, 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.
CLINICALTRIAL
INTERNATIONAL REGISTERED REPORT
RR2-10.2196/25382