Background: Given the role digital technologies are likely to play in the future of mental health care, there is a need for a comprehensive appraisal of the current state and validity (ie, screening or diagnostic accuracy) of digital mental health assessments. Objective: The aim of this review is 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 framework and was carried out in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 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 or diagnostic accuracy of the included tools were conducted. Risk of bias and applicability were assessed using the revised tool for the Quality Assessment of Diagnostic Accuracy Studies 2. Results: A total of 28 studies met the inclusion criteria, with the most frequently evaluated conditions encompassing generalized anxiety disorder, major depressive disorder, and any depressive disorder. Most of the studies used digitized versions of existing pen-and-paper questionnaires, with findings revealing poor to excellent screening or diagnostic accuracy (sensitivity=0.32-1.00, specificity=0.37-1.00, area under the receiver operating characteristic curve=0.57-0.98) and a high risk of bias for most of the included studies. Conclusions: The field of digital mental health tools is in its early stages, and high-quality evidence is lacking.

中文翻译：

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精神病学数字评估工具的现状和有效性：系统评价

背景：鉴于数字技术可能在未来的精神卫生保健中发挥作用，有必要对数字精神卫生评估的当前状态和有效性（即筛查或诊断准确性）进行全面评估。目的：本综述的目的是探讨用于诊断和筛查成人精神疾病的基于问答的数字工具的现状和有效性。方法：该系统评价基于人口、干预、比较和结果框架，并根据 PRISMA（系统评价和元分析的首选报告项目）指南进行。系统检索了 MEDLINE、Embase、Cochrane Library、ASSIA、Web of Science 核心合集、CINAHL 和 PsycINFO 以查找 2005 年至 2021 年间发表的文章。对研究特征和数字解决方案的描述性评估以及对筛查或诊断准确性的定量评估进行了包含的工具。使用修订后的诊断准确性研究质量评估工具 2 评估偏倚风险和适用性。结果：共有 28 项研究符合纳入标准，最常评估的疾病包括广泛性焦虑症、重度抑郁症和任何抑郁症。大多数研究使用现有纸笔问卷的数字化版本，结果显示筛查或诊断准确性差至极好（敏感性=0.32-1.00，特异性=0.37-1.00，受试者工作特征曲线下面积=0.57-0.98 ) 并且大多数纳入研究的偏倚风险很高。结论：数字心理健康工具领域处于早期阶段，缺乏高质量的证据。