{"title":"统计完善以患者为中心的病例小故事,促进数字健康研究。","authors":"Marvin Kopka, Markus A Feufel","doi":"10.3389/fdgth.2024.1411924","DOIUrl":null,"url":null,"abstract":"<p><p>Digital health research often relies on case vignettes (descriptions of fictitious or real patients) to navigate ethical and practical challenges. Despite their utility, the quality and lack of standardization of these vignettes has often been criticized, especially in studies on symptom-assessment applications (SAAs) and self-triage decision-making. To address this, our paper introduces a method to refine an existing set of vignettes, drawing on principles from classical test theory. First, we removed any vignette with an item difficulty of zero and an item-total correlation below zero. Second, we stratified the remaining vignettes to reflect the natural base rates of symptoms that SAAs are typically approached with, selecting those vignettes with the highest item-total correlation in each quota. Although this two-step procedure reduced the size of the original vignette set by 40%, comparing self-triage performance on the reduced and the original vignette sets, we found a strong correlation (<i>r</i> = 0.747 to <i>r</i> = 0.997, <i>p</i> < .001). This indicates that using our refinement method helps identifying vignettes with high predictive power of an agent's self-triage performance while simultaneously increasing cost-efficiency of vignette-based evaluation studies. This might ultimately lead to higher research quality and more reliable results.</p>","PeriodicalId":73078,"journal":{"name":"Frontiers in digital health","volume":"6 ","pages":"1411924"},"PeriodicalIF":3.2000,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532084/pdf/","citationCount":"0","resultStr":"{\"title\":\"Statistical refinement of patient-centered case vignettes for digital health research.\",\"authors\":\"Marvin Kopka, Markus A Feufel\",\"doi\":\"10.3389/fdgth.2024.1411924\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Digital health research often relies on case vignettes (descriptions of fictitious or real patients) to navigate ethical and practical challenges. Despite their utility, the quality and lack of standardization of these vignettes has often been criticized, especially in studies on symptom-assessment applications (SAAs) and self-triage decision-making. To address this, our paper introduces a method to refine an existing set of vignettes, drawing on principles from classical test theory. First, we removed any vignette with an item difficulty of zero and an item-total correlation below zero. Second, we stratified the remaining vignettes to reflect the natural base rates of symptoms that SAAs are typically approached with, selecting those vignettes with the highest item-total correlation in each quota. Although this two-step procedure reduced the size of the original vignette set by 40%, comparing self-triage performance on the reduced and the original vignette sets, we found a strong correlation (<i>r</i> = 0.747 to <i>r</i> = 0.997, <i>p</i> < .001). This indicates that using our refinement method helps identifying vignettes with high predictive power of an agent's self-triage performance while simultaneously increasing cost-efficiency of vignette-based evaluation studies. This might ultimately lead to higher research quality and more reliable results.</p>\",\"PeriodicalId\":73078,\"journal\":{\"name\":\"Frontiers in digital health\",\"volume\":\"6 \",\"pages\":\"1411924\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-10-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532084/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in digital health\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3389/fdgth.2024.1411924\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in digital health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/fdgth.2024.1411924","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
数字健康研究通常依赖于病例小故事(对虚构或真实患者的描述)来应对伦理和实际挑战。尽管这些小案例很有用,但其质量和缺乏标准化的问题经常受到批评,尤其是在症状评估应用(SAA)和自我分诊决策研究中。为了解决这个问题,我们的论文借鉴了经典测试理论的原则,介绍了一种完善现有小故事集的方法。首先,我们删除了所有项目难度为零且项目-总相关性低于零的小测验。其次,我们对剩余的小题进行分层,以反映自闭症患者通常会出现的症状的自然基数,并在每个配额中选择项目-总相关性最高的小题。尽管这两步程序将原始小节集的规模缩小了 40%,但比较缩小后的小节集和原始小节集的自我分诊表现,我们发现两者之间存在着很强的相关性(r = 0.747 到 r = 0.997,p<0.05)。
Statistical refinement of patient-centered case vignettes for digital health research.
Digital health research often relies on case vignettes (descriptions of fictitious or real patients) to navigate ethical and practical challenges. Despite their utility, the quality and lack of standardization of these vignettes has often been criticized, especially in studies on symptom-assessment applications (SAAs) and self-triage decision-making. To address this, our paper introduces a method to refine an existing set of vignettes, drawing on principles from classical test theory. First, we removed any vignette with an item difficulty of zero and an item-total correlation below zero. Second, we stratified the remaining vignettes to reflect the natural base rates of symptoms that SAAs are typically approached with, selecting those vignettes with the highest item-total correlation in each quota. Although this two-step procedure reduced the size of the original vignette set by 40%, comparing self-triage performance on the reduced and the original vignette sets, we found a strong correlation (r = 0.747 to r = 0.997, p < .001). This indicates that using our refinement method helps identifying vignettes with high predictive power of an agent's self-triage performance while simultaneously increasing cost-efficiency of vignette-based evaluation studies. This might ultimately lead to higher research quality and more reliable results.