Background
Web-based depression screenings are commonly used, often providing automated feedback to users. However, there are concerns about potential negative effects, and clear evidence is lacking.
Objective
The goal of this study was to investigate if automated feedback after screening could lead to:
- Misdiagnosis
- Mistreatment
- Worsening depression
- Negative emotional responses
- Increased suicidal thoughts
Methods
This analysis was part of a larger study called the DISCOVER trial, which involved individuals who screened positive for depression but had not yet been diagnosed. Participants were divided into three groups:
- No feedback
- Nontailored feedback
- Tailored feedback
We compared the outcomes of these groups over time.
Results
Among 948 participants, we found:
- Misdiagnosis rates were low and similar across all groups (3.5% to 4.9%).
- Mistreatment rates were also consistent (7.2% to 8.3%).
- Worsening depression was minimal (2% to 6.8%).
- Emotional responses did not significantly change (0.7% to 2.9%).
- However, there was a notable increase in suicidal thoughts in the nontailored feedback group at one month (12.3% vs 6.4% in no feedback).
Conclusions
The study suggests that automated feedback after web-based depression screening does not lead to significant negative outcomes like misdiagnosis or worsening depression. However, nontailored feedback may increase suicidal thoughts, highlighting the need for cautious implementation.
Next Steps for Healthcare Providers
Measurable Outcomes
Define clear goals for monitoring potential harms of feedback in clinical settings.
Select Appropriate AI Tools
Choose AI solutions that meet the specific needs of your clinical practice.
Implement Gradually
Start with a pilot project to track outcomes and gather data on the real-world impact of feedback systems.
Contact Us for AI Solutions
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