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复合性诊断系统的编制及其信度、效度测试

Composite Diagnostic System and artificial neural network

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【作者】 邹义壮沈渔邨舒良王玉凤冯锋王健刘学俊

【Author】 ZOU Yizhuang; SHEN Yucun; SHU Liang; etal.( Beijing Huilongguan Hospital, Beijing 100096)

【机构】 北京回龙观医院!100096北京医科大学精神卫生研究所

【摘要】 目的研制适合国内临床使用的精神疾病计算机辅助诊断系统。方法在复合性国际诊断交谈表(CIDI)基础上,将绝大部分项目由他评变为自评,简化了检查过程,在诊断中使用了人工神经网络技术,建立了复合性诊断系统(CDS)。在精神分裂症、神经症各70例和70名正常人中对该系统进行跨效度检验。结果4名检查者使用CDS的地评一致性为94.39%;被检查者的自评重测一致性为92.44%。CDS跨效度检验与临床诊断的符合率的Kappa值为0.96-0.99;对疑难病例诊断的符合率的Kappa值为0.89。CDS、CIDI-国际疾病分类第10版(ICD-10)和CIDI-美国精神疾病诊断与统计手册第3版修订本(DSM-Ⅲ-R)的诊断结果与临床诊断比较,符合率的Kappa值分别为0.96,0.76和0.72。结论CDS具有满意的信度和效度,使用和操作远较CIDI方便,培训简单、可以使用光学符号阅读机输入答卷,有希望成为精神科临床广泛使用的辅助诊断工具。

【Abstract】 Objective To develop a computerized psychiatric assistant diagnostic system— theComposite Diagnostic System (CDS) which was revised from the Composite International Diagnostic Interview(CIDI), for its efficient application in China. Methods Most of the items were changed into self-rating fromothers-rating and the artificial neural network was used to assist diagnosis in the CDS. The research samglesincluded 70 schizophrenics, 70 neurosis and 70 normal people. Results The reliability between 4 raters was94.39% and the test-retest reliability was 92.44%. The overall correct Kappa between the CDS and the clinicaldiagnosis was 0.96~0.99 and with the 18 difficult-diagnostic patients, the Kappa was 0.89. The CDS and CIDIand the ICD-10 were parallel compared with clinical diagnosis, the overall Kappa were 0.96, 0.76 and 0.72,respectively. Conclusions The CDS is of higher diagnostic validity and more convenient than the CIDI inadministration, and it could be widely used by clinicians in China.

【关键词】 精神病学诊断计算机辅助
【Key words】 Psychiatry Diagnosiscompute-assistant
  • 【文献出处】 中华精神科杂志 ,CHINESE JOURNAL OF PSYCHIATRY , 编辑部邮箱 ,1999年02期
  • 【分类号】R749
  • 【被引频次】2
  • 【下载频次】117
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