Web-based Training & Reliability for Psychiatric Raters

点击翻译按钮获取中文摘要

DESCRIPTION (Provided by Applicant): The important task of training raters and establishing and maintaining reliability for the duration of a psychiatric clinical trial is a major problem that is often ignored. This problem is particularly vexing for trials involving many raters at multiple sites. Furthermore, factors effecting rater expectancy (bias) with standard psychiatric rating instruments has never been fully explored. This Phase II project is intended to develop an interactive video system for training research raters to use rating instruments with shared rating conventions and assess interrater reliability across sites and over time. Programs are to be written that will enable this video system to be used as (1) an interactive "tutorial" system that can be used to train raters on the use of the rating instrument, and (2) a "reliability testing" system, that uses an integrated database to record ratings and compute interrater reliability within an identified group of raters or with preset ratings, i.e., a "gold standard". The plan involves developing a complete library of 30 variations of the Hamilton Depression Rating Scale (HDRS) using four different actors of both genders and diverse ethnicity. The Phase II study will assess variability and rater bias as an interaction of demographic and professional characteristics of the raters and "patients" with 200 novice raters. Phase I created a prototype for assessing interrater reliability for the HDRS. Using scripts from actual patient interviews, a male and a female actor each portrayed three separate HDRS interviews reflecting depressive symptoms of various severity. In preparation for Phase II, the functionality of the system was found to be excellent. Feasibility was established by 1) having experienced raters assess videos of the HDRS interviews of both actors and actual patients and establish the validity of the actors' portrayals, 2) calculating interrater reliability scores for a group of experienced raters (0.97) and a group of novice raters (0.96) using the system prototype, and 3) convening focus groups to assess the positive and negative attributes of the system with both experienced and novice raters. Future product development will utilize the software and statistical methodology with other rating instruments, including those used to assess schizophrenia, anxiety disorders, and dementia.