BACKGROUND Diagnostics are increasingly shifting to patients' home environment, facilitated by new digital technologies. Digital diagnostics (diagnostic services enabled by digital technologies) can be a tool to better respond to the challenges faced by primary care systems while aligning with patients' and healthcare professionals' needs. However, it needs to be clarified how to determine the success of these interventions. OBJECTIVES We aim to provide practical guidance to facilitate the adequate development and implementation of digital diagnostics. STRATEGY Here, we propose the quadruple aim (better patient experiences, health outcomes and professional satisfaction at lower costs) as a framework to determine the contribution of digital diagnostics in primary care. Using this framework, we critically analyse the advantages and challenges of digital diagnostics in primary care using scientific literature and relevant casuistry. RESULTS Two use cases address the development process and implementation in the Netherlands: a patient portal for reporting laboratory results and digital diagnostics as part of hybrid care, respectively. The third use case addresses digital diagnostics for sexually transmitted diseases from an international perspective. CONCLUSIONS We conclude that although evidence is gathering, the often-expected value of digital diagnostics needs adequate scientific evidence. We propose striving for evidence-based 'responsible digital diagnostics' (sustainable, ethically acceptable, and socially desirable digital diagnostics). Finally, we provide a set of conditions necessary to achieve it. The analysis and actionable guidance provided can improve the chance of success of digital diagnostics interventions and overall, the positive impact of this rapidly developing field.

中文翻译：

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初级保健中直接面向患者的数字诊断：负责任的数字诊断的机遇、挑战和必要条件。

背景技术在新的数字技术的推动下，诊断越来越多地转移到患者的家庭环境中。数字诊断（由数字技术支持的诊断服务）可以成为更好地应对初级保健系统面临的挑战的工具，同时满足患者和医疗保健专业人员的需求。然而，需要澄清如何确定这些干预措施的成功。目标 我们的目标是提供实用指导，以促进数字诊断的充分开发和实施。策略在这里，我们提出四重目标（以更低的成本提供更好的患者体验、健康结果和专业满意度）作为确定数字诊断在初级保健中的贡献的框架。利用这个框架，我们利用科学文献和相关的疑难分析批判性地分析数字诊断在初级保健中的优势和挑战。结果 两个用例涉及荷兰的开发过程和实施：分别是用于报告实验室结果的患者门户和作为混合护理一部分的数字诊断。第三个用例从国际角度解决性传播疾病的数字诊断问题。结论 我们的结论是，尽管证据正在收集，但数字诊断的通常预期价值需要足够的科学证据。我们建议努力实现基于证据的“负责任的数字诊断”（可持续的、道德上可接受的、社会期望的数字诊断）。最后，我们提供了实现这一目标所需的一系列条件。提供的分析和可行的指导可以提高数字诊断干预措施的成功机会，并总体上提高这一快速发展领域的积极影响。