COMPUTERIZED DIAGNOSIS IN ACUTE PSYCHIATRY - VALIDITY OF CIDI-AUTO AGAINST ROUTINE CLINICAL-DIAGNOSIS

The validity of the self-administered CIDI-Auto for detecting ICD-IO d iagnoses was assessed in a study of 126 patients admitted to an acute psychiatry unit. A comparison was made between the level of agreement of the CIDI-Auto with a psychiatrist and that between two psychiatrist s. The CIDI-Auto generated an average of 2.3 diagnoses per subject, an d the psychiatrists 1.3. Agreement measured by overall agreement and b y Kappas between the CIDI-Auto and the psychiatrist's principal diagno sis was poor, whereas agreement between psychiatrists was good. At the level of general diagnostic class (e.g. substance use disorder, schiz ophrenic disorder, mood disorder), agreement between CIDI-Auto and psy chiatrist on principal diagnosis was poor, Kappa = 0.23, while agreeme nt between psychiatrists was good, Kappa = 0.69. The findings indicate that the self-administered CIDI-Auto has poor validity measured again st clinical diagnosis for hospitalised patients of acute psychiatric s ervices. Poor validity of computer-based diagnosis limits the diagnost ic utility of these methods in clinical situations. II also creates un certainty of diagnostic findings in survey use. (C) 1997 Elsevier Scie nce Ltd.