Verification of a clinical decision support system for the diagnosis of headache disorders based on patient–computer interactions: a multi-center study

作者：Xun Han, Dongjun Wan, Shuhua Zhang, Ziming Yin, Siyang Huang, Fengbo Xie, Junhong Guo, Hongli Qu, Yuanrong Yao, Huifang Xu, Dongfang Li, Sufen Chen, Faming Wang, Hebo Wang, Chun-Fu Chen, He Qiu, Ming Dong, Qi Wan, Yanmei Xu, Min Chen, Fanhong Yan, Xiaolin Wang, Rongfei Wang, Mingjie Zhang, Ye Ran, Zhihua Jia, Yinglu Liu, Xiaoyan Chen, Lei Hou, Dengfa Zhao, Zhao Dong, Shengyuan Yu · 发表于：The Journal of Headache and Pain · 年份：2023 · DOI：10.1186/s10194-023-01586-1 · 被引用次数：15 · 研究领域：Electronic Health Records Systems、Migraine and Headache Studies、Machine Learning in Healthcare

BACKGROUND: Although headache disorders are common, the current diagnostic approach is unsatisfactory. Previously, we designed a guideline-based clinical decision support system (CDSS 1.0) for diagnosing headache disorders. However, the system requires doctors to enter electronic information, which may limit widespread use. METHODS: In this study, we developed the updated CDSS 2.0, which handles clinical information acquisition via human-computer conversations conducted on personal mobile devices in an outpatient setting. We tested CDSS 2.0 at headache clinics in 16 hospitals in 14 provinces of China. RESULTS: Of the 653 patients recruited, 18.68% (122/652) were suspected by specialists to have secondary headaches. According to "red-flag" responses, all these participants were warned of potential secondary risks by CDSS 2.0. For the remaining 531 patients, we compared the diagnostic accuracy of assessments made using only electronic data firstly. In Comparison A, the system correctly recognized 115/129 (89.15%) cases of migraine without aura (MO), 32/32 (100%) cases of migraine with aura (MA), 10/10 (100%) cases of chronic migraine (CM), 77/95 (81.05%) cases of probable migraine (PM), 11/11 (100%) cases of infrequent episodic tension-type headache (iETTH), 36/45 (80.00%) cases of frequent episodic tension-type headache (fETTH), 23/25 (92.00%) cases of chronic tension-type headache (CTTH), 53/60 (88.33%) cases of probable tension-type headache (PTTH), 8/9 (88.89%) cases of clu...