News
Computerised screening helps identify dangerous behaviours among
adolescents
24 June 2008
A computerised screening system may be the key to the early
identification of high-risk behaviours among adolescents. Adolescents
who participated in a computerised screening, with direct data entry by
the adolescents and real-time results, were more likely to be identified
as having behavioural problems than adolescents whose screening results
were delayed. The study is published in the June 2008 issue of the
journal Pediatrics
Injury risk, depressive symptoms and drug and alcohol use are the
leading causes of adolescent morbidity and mortality; yet paediatricians
often lack the time to screen for these behavioural concerns.
The study, conducted by researchers at the Center for Innovation in
Pediatric Practices in The Research Institute at Nationwide Children’s
Hospital in the US, compared the results of 878 primary care patients,
aged 11 to 20 years, who participated in a computerised behavioural
screening system called 'Health eTouch'.
Developed by researchers at Nationwide Children’s Hospital, Health
eTouch is a web application, presented to patients on secure wireless
web tablets with 10-inch touchscreen displays. Questions vary based on
the user’s age and reported behaviours, and are drawn from existing
publicly available validated measures.
Study participants took part in Health eTouch screening in the
waiting rooms of the urban clinics they attended. These clinics were
randomly assigned to have paediatricians either receive screening
results just prior to face-to-face encounters with patients ('immediate
results' condition) or two to three business days later ('delayed
results') condition.
Direct data entry by youths in waiting rooms and automated scoring
and printing programs minimize staff time necessary for screening,
scoring, reporting and filing results. Also, past research has shown
adults and adolescents are more willing to disclose sensitive
information to a computer than to a clinician.
When provided with the screening results, paediatricians were able to
view a summary of patient responses to screening questions, as well as a
list of flagged responses thought to be indicative of high-risk
behaviours and an overall positive or negative rating for various
behavioural concerns tested during the screening process.
After participating in Health eTouch, 59% of respondents screened
positive for at least one of the following behavioural concerns: injury
risk behaviours, significant depressive symptoms or substance use. Of
those youths who screened positive and whose results were provided to
paediatricians just prior to their consultation, 68% were identified as
having a problem by their paediatrician, while only 52% of youths whose
results were delayed were identified as having a problem by their
paediatrician.
“Routine behavioural screening, although critical in identifying and
addressing high-risk behaviours, often does not occur or is limited due
to the time constraints and competing demands facing primary care
physicians,” said Kelly Kelleher, MD, a principal investigator for the
Center for Innovation in Pediatric Practices in The Research Institute
at Nationwide Children’s Hospital and a faculty member at The Ohio State
University College of Medicine.
“Our research has found that recent advances in information
technology, such as the Health eTouch system, and the immediate
reporting of computerised screening results may help overcome barriers
to behavioural screening.”
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