Automated Interactive Text Messaging to Assess Adolescent Depression

描述（由申请人提供）：新的交互式通信技术在现代社会中不断发展。儿童和青少年往往是最早采用新技术的人群之一。通过短消息服务（SMS）进行通信“文本消息”就是一个例子。本应用程序建议开发计算机自动化方法，使用动态分支SMS“文本”消息来交互式评估儿童和青少年的临床状态。抑郁症的评估将被用作拟议研究的模板。研究的目的是(1)评估计算机自动交互短信系统的技术可行性，(2)评估抑郁儿童和青少年对该技术的接受程度，以及(3)收集专门为青少年使用并通过短信发送的抑郁症状快速量表（QIDS-A-SMS）的信度和效度数据。交互式SMS技术发展的长期目标是提供临床有效、可广泛获得、国际可及、易于使用和用户可接受的工具，以获得儿童患者群体中各种情况下患者报告的结果。如果成功，本申请提出的研究将支持在儿科抗抑郁药物临床试验中使用QIDS-A-SMS作为有效的治疗结果测量。从美国国立卫生研究院资助的“儿童重度抑郁症：氟西汀序贯治疗和预防复发CBT”（MH039188； Graham Emslie博士，PI）中招募25名8-17岁的确诊为重度抑郁症的门诊患者。在基线和氟西汀治疗6周结束时的办公室访问期间，研究参与者将使用手机通过对一系列动态分支的计算机自动SMS消息的“文本回复”完成交互式QIDS-A-SMS评估。将收集有关评估体验的用户反馈。德克萨斯大学西南医学院的独立评估人员也将使用儿童抑郁评定量表-修订版（CDRS-R）来评估抑郁症的严重程度，并与QIDS-A-SMS数据进行比较。将分析系统性能的技术指标，如完成评估的时间和错误频率、用户接受反馈以及QIDS-A-SMS的心理测量可靠性和有效性。

DESCRIPTION (provided by applicant): New interactive communication technologies continue to expand in modern society. Children and adolescents are frequently among the earliest adopters of new technologies. Communication via Short Message Service (SMS) "text messaging" is one example. This application proposes to develop computer-automated methods for interactively assessing clinical states in children and adolescents using dynamically branching SMS "text" messaging. Assessment of depression will be used as a template for the proposed research. Study aims are to (1) evaluate the technical feasibility of a computer-automated interactive SMS messaging system, (2) assess acceptance of the technology among depressed children and adolescents, and (3) collect reliability and validity data on a version of the Quick Inventory of Depressive Symptomatology specifically designed for use by adolescents and delivered by SMS (QIDS-A-SMS). Long-term objectives for the development of an interactive SMS technology are to provide clinically valid, widely available, internationally accessible, easily used, and user- acceptable tools for obtaining patient reported outcomes across a wide range of conditions in pediatric patient populations. If successful, the research proposed by this application will support use of the QIDS-A-SMS as a valid treatment outcome measure in pediatric antidepressant clinical trials. Twenty-five outpatients, 8-17 years old, diagnosed with major depression will be recruited from the NIH-sponsored "Pediatric MDD: Sequential Treatment with Fluoxetine and Relapse Prevention CBT" (MH039188; Dr. Graham Emslie, PI). During office visits at baseline and at the end of 6 weeks of treatment with fluoxetine, study participants will use cell phones to complete interactive QIDS-A-SMS assessments via "text replies" to a series of dynamically branching, computer-automated SMS messages. User feedback regarding the assessment experience will be collected. Independent evaluators at the University of Texas - Southwestern Medical School will also assess depression severity using the Child Depression Rating Scale-Revised (CDRS-R) for comparison with the QIDS-A-SMS data. Technical measures of system performance such at time to complete the assessments and error frequencies, user acceptance feedback, and psychometric reliability and validity of the QIDS-A-SMS will be analyzed. PUBLIC HEALTH RELEVANCE: Modern technologies, such as "text messaging" via cellular telephone, are attractive to adolescents and may provide new opportunities to provide behavioral and mental health interventions. The technology may also be helpful for assessing the impact of such interventions in pediatric populations. Major depression is a disabling condition that often begins between the ages of 15-19 years, disrupting development, impairing functioning, and increasing risk for substance abuse, suicide, and adulthood depression. Recent concerns about an increased risk of suicide in adolescents being treated with antidepressants have focused public attention on the need for closer monitoring of adolescent signs and symptoms of depression.