Feasibility of Dual Use Module for Major Depression

重度抑郁症双用模块的可行性

• 批准号: 7215101
• 负责人: G. Richard Smith
• 金额: $ 7.58万
• 依托单位: PHYSICIANS ASSESSMENT SERVICES & SYSTEMS
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-15 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7215101
• 关键词: Internet; automated data processing; clinical research; computer human interaction; computer program /software; computer system design /evaluation; health care professional practice; health care quality; health services research tag; human subject; major depression; mental health services; psychiatrist; questionnaires

DESCRIPTION (provided by applicant): Each year, only 10-20% of 18.5 million Americans with depression receive appropriate, effective care. Psychiatric Assessment Systems (PAS) seeks to address poor quality of care for this common, debilitating disorder by developing a tool to help psychiatrists more effectively treat patients with depression. Psychiatrists have little incentive now to use clinical assessment tools, but emerging demands to show improved practice are creating a market for reliable practice assessment tools. PAS plans to capitalize on this trend with a product to meet the needs of potentially thousands of psychiatrists AND be a mechanism to improve quality of care without added effort or cost. PAS will partner with the PI and his research team, who have >10 years' experience in R&D of outcomes assessment instruments, to develop their Depression Outcomes Module (DOM) and its web-based system into an accountability tool, using DOM technology to monitor essential quality improvement data (patient characteristics, processes of care, outcomes of care). The key issue for Phase I feasibility is how PAS can change this outcomes assessment tool with proven reliability and validity into an accountability tool to meet psychiatrists' needs for re-licensing, re-privileging, and re-certification (specific aim-to determine feasibility of adapting an existing provider-focused assessment tool into a tool to effectively assess abilities to meet new practice requirements). PAS plans to determine needed modifications (research to identify broad/specific content needs [face and limited content validity]), develop/test a paper-based prototype (refine by limited field testing), and develop a web-based version of the paper-based prototype and supporting data acquisition processes (web-based technical decisions). After modifying DOM into a web-based accountability form in Phase 1, PAS plans to develop data processing and reporting components and test the overall system for scientific validity, reliability, and feasibility in Phase II to produce a web-based application with proven reliability and validity in monitoring and data collection. This technologically innovative product (a dual-use, user-friendly method to monitor factors needed to improve care and a mechanism to verify improved practice) will have commercial viability as a web-based subscription service. The product will have significant public health and NIMH importance because of its potential to improve treatment for the world's 2nd leading cause of disability (public health) and transform recovery from mental disorders (NIMH). Widespread implementation of a scientifically sound method to analyze accuracy of diagnoses, guideline concordance of care, and relative success of approaches to clinical treatment of major depression would also be an important step toward a quality-centered healthcare industry.

描述（由申请人提供）：每年，1850万美国抑郁症患者中只有10-20%接受适当，有效的护理。精神病学评估系统（PAS）旨在通过开发一种工具来帮助精神科医生更有效地治疗抑郁症患者，从而解决这种常见的、使人衰弱的疾病的护理质量差的问题。精神科医生现在几乎没有动力使用临床评估工具，但新兴的需求，以显示改进的做法是创造一个市场，可靠的实践评估工具。PAS计划利用这一趋势，开发一种产品，以满足潜在的数千名精神科医生的需求，并成为一种在不增加努力或成本的情况下提高护理质量的机制。PAS将与PI及其研究团队合作，他们在结果评估工具的研发方面拥有超过10年的经验，将他们的抑郁症结果模块（DOM）及其基于网络的系统开发成一个问责制工具，使用DOM技术来监测基本的质量改进数据（患者特征，护理过程，护理结果）。第一阶段可行性的关键问题是PAS如何将这种具有可靠性和有效性的结果评估工具转变为一种问责工具，以满足精神科医生对重新许可、重新认证和重新认证的需求（具体目的是确定将现有的以提供者为中心的评估工具转变为有效评估能力以满足新的实践要求的工具的可行性）。考绩制度计划确定所需的修改（研究以确定广泛/具体的内容需求[表面和有限的内容有效性]），开发/测试基于纸张的原型（通过有限的实地测试进行完善），并开发基于纸张的原型的网络版本和支持数据采集流程（基于网络的技术决策）。在第一阶段将DOM修改为基于网络的问责表后，PAS计划开发数据处理和报告组件，并在第二阶段测试整个系统的科学有效性、可靠性和可行性，以制作一个基于网络的应用程序，证明在监测和数据收集方面的可靠性和有效性。这一技术创新产品（一种双重用途、方便用户的方法，用于监测改善护理所需的因素，以及一种机制，用于核实改进后的做法）作为一种网上订阅服务，将具有商业可行性。该产品将具有重大的公共卫生和NIMH的重要性，因为它有可能改善对世界第二大残疾原因（公共卫生）的治疗，并改变精神障碍（NIMH）的康复。广泛实施一种科学合理的方法来分析诊断的准确性，护理的指导一致性以及临床治疗抑郁症的相对成功方法也将是迈向以质量为中心的医疗保健行业的重要一步。