AIIMS app to help doctors diagnose neuro disorders
An app developed by doctors from All India Institute of Medical Sciences (AIIMS) will help primary care physicians in diagnosing four neuro-development disorders in children.
The free PedNeuroAiims Diagnostics app guides doctors through a set of questions and observations to diagnose whether a child has attention deficit hyperactivity disorder (ADHD), neuro-motor impairments (NMI), autism spectrum disorder, or epilepsy.
“There is often a delay in the diagnosis and treatment of neuro-development disorders in children because they are either not screened or get underdiagnosed or misdiagnosed. These tools can aid doctors in timely and appropriate diagnosis,” said Dr Sheffali Gulati, head of child neurology division of the department of paediatrics, AIIMS.
The app, available on the iOS App Store and Android Play Store, asks for information about a child’s name, age and gender before moving to a questionnaire. The answers are scored and a diagnosis is given at the end.
“Some of the questions for all four disorders also ask the doctors to make some observations. And in case the observations differ from what the parents are saying, then the app also tells which one to give weightage to,” Dr Gulati said.
The app can diagnose autism in children between the ages one and 14, with the help of questions on whether the child talks about his/ her achievements and emotions without being asked about it, whether they like to play alone or in a group, or whether they make eye contact while talking.
“Early intervention is essential for autism so that the child can start learning better, can improve at social communication etc. If a child does not respond to sounds by the age of one-year-old or speak a single word by the age of 14 to 16 months, they should be taken to a doctor,” said Dr Gulati.Around 0.9% of all the children between ages 1 and 18 years are estimated to have autism.
The app is based on the latest standard reference used by doctors for diagnosing mental illnesses.
Sensitivity tests tell how accurately a test can identify those with the disease and specificity shows its ability to accurately tell who do not have it.
A study, published in March the journal PLOS One, showed that the tool for diagnosing autism has a sensitivity of 98.4% and specificity of 91.7%.
The diagnostic tool for ADHD , which can be used for children between the ages of 6 and 18 years, has a sensitivity of 87.7% and specificity of 97.2%. The tool asks whether a child follows instructions or has difficulty in doing routine chores among others for diagnosis. Around 1.33% of children are thought to have ADHD.
The AIIMS tool can diagnose epilepsy in children between the 1 month and 18 years, as opposed to existing tools that can diagnose only children between 2 and 9 years.
A study shows that the sensitivity and specificity of the tool is 91.5% and 88.6% respectively.
The sensitivity and specificity of the tool for NMI was shown to be 90.5% and 95.5% and can diagnose anyone between the age of 1 month and 18 years. It asks whether they have difficulty in sitting, standing or walking or have abrupt, jerky movements.
“Apps can never replace the experience and the expertise of a trained doctor, but in a resource -poor setting it is a good tool to guide physicians so that a disorder is not missed. But, diagnosis is just the start, getting to a proper treatment centre is still a challenge for many,” said Dr SK Chandan from neurology department of Safdarjung hospital.