Web-based lab to study the decision to use antidepressants for the elderly

描述(由申请人提供)：建议的项目开发了一个基于网络的软件应用程序和调查，其中包括患者-病例描述和问卷调查，以促进对患者种族的研究和老年人使用抗抑郁药物治疗的决定。结果将指导进一步的研究，并为干预措施的发展提供信息。这个基于网络的应用程序将成为一个在线医疗决策实验室，为多年的研究提供支持。这项调查对于随后的患者种族和抗抑郁治疗的研究是必不可少的。该项目为期两年，有四个具体目标。目标1是软件开发：我们设计了准确测量响应时间的软件，实现了阈值下启动，并实现了析因调查。该软件还执行管理网站和数据收集的标准任务。目标2是开发患者病例的因子表示：我们将患者病例设计为因子调查，旨在改变患者线索，从而使抑郁症的治疗概率跨越单位间隔。析因调查是后续研究必不可少的一部分。目标3是开发医生问卷：我们开发了一份问卷，其中包括关于医生人口统计、经验和态度的问题：此目标的目标是促进与使用AT的决定相关的医生信息的收集，但将整个在线调查保持在40分钟以内。目标4是测试总体可行性：我们测试调查的在线应用程序，以确保使用家庭执业医生样本的总体可行性。这是对所有组件的测试，包括抽样策略和基于Web的应用程序。这项测试的目标是超过50%的应答率，并确定预测招募和退出的医生特征：这是设计后续研究的基本信息。相关性：众所周知，抑郁症影响老年人，治疗因患者种族不同而不同，医生的决定部分解释了这种差异。目前尚不清楚原因--必须填补这一知识空白才能提供补救措施。要知道原因，我们必须在认知水平上了解患者种族如何影响医生的决策。拟议的项目启动了一项计划，通过开发必要的方法和设施来回答患者种族如何影响治疗老年抑郁症的决定的问题，将心理学的基本知识转化为临床相关的研究。众所周知，抑郁症影响老年人，治疗因患者种族而异，医生的决定部分解释了这种差异。目前尚不清楚原因--必须填补这一知识空白才能提供补救措施。要知道原因，我们必须在认知水平上了解患者种族如何影响医生的决策。拟议的项目启动了一项计划，通过开发必要的方法和设施来回答患者种族如何影响治疗老年抑郁症的决定的问题，将心理学的基本知识转化为临床相关的研究。

DESCRIPTION (provided by applicant): The proposed project develops a web-based software application and survey containing both patient-case descriptions and questionnaire to facilitate research of patient race and the decision to use antidepressant treatment among the elderly. Results will direct further study and inform the development of interventions. The web-based application will be an online healthcare decision lab, supporting research for many years. The survey is essential to the ensuing research on patient race and antidepressant treatment. The project spans two years and has four specific aims. AIM 1 is software development: we design software that accurately measures response times, implements subliminal priming, and implements factorial surveys. The software also performs the standard tasks of governing the website and data collection. AIM 2 is develop a factorial representation of patient cases: we design patient cases as a factorial survey intended to vary in patient cues such that the probability of the treatment for depression spans the unit interval. The factorial survey is essential to the ensuing research. AIM 3 is develop physician questionnaire: we develop a questionnaire comprising questions regarding physician demographics, experience, and attitudes: the goal of this aim is to facilitate collection of physician information related to the decision to use AT, but keep the overall online survey to less than 40 minutes. AIM 4 is test overall feasibility: we test the online application of the survey to assure overall feasibility using a sample of family practice physicians. This is a test of all components including the sampling strategy and the web-based application. The goals of this test are a greater than 50% response rate and identification of physician characteristics that predict recruitment and dropout: essential information to the design of the subsequent study. Relevance: It is known that depression impacts the elderly, treatment differs by patient race, and physician decisions partially explain the disparity. It is not known why-a knowledge gap that must be filled to provide remedy. To know why, we must understand how patient race influences the decision-making of physicians at a cognitive level. The proposed project initiates a program that translates basic knowledge from psychology into clinically relevant research by developing the requisite methods and facility to answer the question of how patient race influences the decision to treat the elderly for depression. It is known that depression impacts the elderly, treatment differs by patient race, and physician decisions partially explain the disparity. It is not known why-a knowledge gap that must be filled to provide remedy. To know why, we must understand how patient race influences the decision-making of physicians at a cognitive level. The proposed project initiates a program that translates basic knowledge from psychology into clinically relevant research by developing the requisite methods and facility to answer the question of how patient race influences the decision to treat the elderly for depression.