JMIR Publications Inc.通过避免重复的患者报告来卡塔尔世界杯8强波胆分析最大化移动健康监测的价值:自动化健康评估服务中抑郁相关症状和坚持问题的预测%A Piette,John D %A Sussman,Jeremy B %A Pfeiffer,Paul N %A Silveira,Maria J %A Singh,Satinder %A Lavieri,Mariel S %+ VA临床管理研究中心和全科医学部，密歇根大学，邮政信箱130170，密歇根州安娜堡，48130 -0170，美国，1 734 936 4787，jpiette@umich.edu %K手机%K远程医疗%K抑郁症%K自我护理%D 2013 %7 05.07.2013 %9原创论文%J J医学互联网Res %G英文%X背景:交互式语音响应(IVR)呼叫增强卫生系统识别健康风险因素的能力，从而实现有针对性的临床随访。然而，重复的评估可能会增加患者的退出，意味着失去了收集更多临床有用数据的机会。目的:我们确定了之前的IVR评估在抑郁症诊断患者中预测后续反应的程度，可能避免了重复收集相同信息的需要。我们还评估了频繁(即每周)的IVR评估尝试是否比两周或每月收集的信息更能预测患者的后续报告。方法:使用来自208名抑郁症诊断患者的1050个IVR评估数据，我们检验了四种IVR报告结果的可预测性:中度/重度抑郁症状(PHQ-9评分≥10)、一般/较差的总体健康状况、较差的抗抑郁依从性和因心理健康不良而卧床天数。我们使用训练和测试样本的logistic模型来预测患者的IVR反应，基于他们最近的五次每周、两周和每月的评估尝试。基于受试者操作特征(ROC)曲线和曲线下面积(AUC)的统计比较评估更频繁评估的边际效益。结果:基于先前的评估反应，患者关于抑郁症状和感知健康状态的报告具有高度可预测性。 For models predicting moderate/severe depression, the AUC was 0.91 (95% CI 0.89-0.93) when assuming weekly assessment attempts and only slightly less when assuming biweekly assessments (AUC: 0.89; CI 0.87-0.91) or monthly attempts (AUC: 0.89; CI 0.86-0.91). The AUC for models predicting reports of fair/poor health status was similar when weekly assessments were compared with those occurring biweekly (P value for the difference=.11) or monthly (P=.81). Reports of medication adherence problems and days in bed were somewhat less predictable but also showed small differences between assessments attempted weekly, biweekly, and monthly. Conclusions: The technical feasibility of gathering high frequency health data via IVR may in some instances exceed the clinical benefit of doing so. Predictive analytics could make data gathering more efficient with negligible loss in effectiveness. In particular, weekly or biweekly depressive symptom reports may provide little marginal information regarding how the person is doing relative to collecting that information monthly. The next generation of automated health assessment services should use data mining techniques to avoid redundant assessments and should gather data at the frequency that maximizes the value of the information collected. %M 23832021 %R 10.2196/jmir.2582 %U //www.mybigtv.com/2013/7/e118/ %U https://doi.org/10.2196/jmir.2582 %U http://www.ncbi.nlm.nih.gov/pubmed/23832021