Computerized Assessment by Remote Examiner System (CARES)

远程检查系统计算机化评估（CARES）

• 批准号: 7613525
• 负责人: JAMES P O'HALLORAN
• 金额: $ 16.01万
• 依托单位: NEUROCOMP SYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-02-01 至 2010-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7613525
• 关键词: Area; Behavior; Behavioral; Client; Clinic; Clinical; Clinical Trials; Clinical assessments; Cognitive; Complex; Computers; Controlled Clinical Trials; Data Collection; Dementia; Development; Devices; Digit structure; Distal; Electronics; Ensure; Evaluation; Generations; Home environment; Human; Individual; Instruction; Interview; Left; Letters; Location; Measures; Medication Management; Monitor; Neurocognitive; Office Nursing; Online Systems; Paper; Patients; Performance; Phase; Phase I Clinical Trials; Physicians' Offices; Population; Primary Care Physician; Procedures; Qualifying; Reporting; Research; Resolution; Rural; Services; Shipping; Ships; Site; Speed; System; Technology; Telemedicine; Testing; Time; Training; Travel; User-Computer Interface; Wireless Technology; base; behavior measurement; computerized; cost; evaluation/testing; field study; graphical user interface; health care delivery; instrument; meetings; metropolitan; neurocognitive test; novel strategies; prototype; public health relevance; response; rural area; systems research; usability

DESCRIPTION (provided by applicant): Telemedicine is a paradigm defined by the delivery of healthcare services to distal locations by electronic connectivity. In recent years, telemedicine has expanded to include a wide range of remotely delivered services, including vital signs monitoring, medication management, "telepsychiatry" and others. The increasing utilization of such services is driven by cost and, for distal areas, demand for otherwise unavailable services. The present proposal aims to develop a computerized cognitive and behavioral-psychiatric assessment system capable of remote, audio-video-based administration of a wide range of commonly applied cognitive test instruments and behavioral-psychiatric measures, in a similar manner as if the examiner were sitting next to the subject. The proposed Computerized Assessment by Remote Examiner System (CARES) will enable qualified examiners to perform thorough cognitive and behavioral evaluations of patients at remote locations that may be otherwise prohibited by various cost factors. Remote locations would include primary care physician's offices, nursing facilities, treatment clinics, and non-ambulatory patient's homes in both rural and metropolitan regions. The CARES will implement a fundamentally new approach in which a remote examiner views a full-screen, secondary display that provides GUIs with on-screen controls for comprehensive administration and scoring. The examiner will be able to control the pacing of the test session, repeat and supplement computerized instructions (to ensure understanding of the task demands), immediately score verbal report or overt behavior in real time and pause or terminate a test. Significantly, the CARES is an extension of a previously validated, dual-display, computerized assessment system in which the subject is physically accompanied by a human examiner. High-speed, very low latency, wireless Third/Fourth Generation (3G/4G) connectivity will permit the subject and examiner to freely interact throughout a session via a high-resolution audio-video interface, as is critical for tests requiring interactive scoring of verbal report or behavioral performance. Thus, the CARES will be suitable for application in impaired populations that may require ongoing monitoring and supplemental instruction. The CARES test set will consist of computerized versions of established instruments, commonly applied in clinical settings, research and clinical trials (e.g., AVLT, Trails A/B, Verbal Fluency, Letter-Number, Symbol-Digit, Clock Drawing). Accordingly, the CARES schema contrasts sharply with available, web-based assessments that are not only unaccompanied by an examiner, but suffer from rigid administration procedures, as well as multiple technical shortcomings, that significantly limit the range of test instruments that can be reliably administered to impaired populations. In Phase I, the main objectives are to evaluate the viability of the human-computer interface and evaluate the feasibility of remote administration of cognitive assessments in normal and impaired subjects. The CARES will be the first system of its kind and will find immediate application in healthcare delivery networks, research settings, and controlled clinical trials. PUBLIC HEALTH RELEVANCE: The CARES constitutes a fundamentally new approach for administration of cognitive assessments in which a remote examiner can administer a wide range of cognitive and clinical assessments without having to be physically present at a given site. This is particularly relevant for rural areas. This technology will decrease the cost of specialized assessments and find immediate application in healthcare delivery systems, research settings and controlled clinical trials.

描述（由申请人提供）：远程医疗是通过电子连通性向远端位置提供医疗服务来定义的范式。近年来，远程医疗已扩展到包括各种远程交付的服务，包括生命体征监测，药物管理，“远程精神病学”等。这种服务的利用日益增加是由成本驱动的，对于远端领域，要求其他无法提供的服务。本提案旨在开发一种计算机化的认知和行为精神病学评估系统，能够以相似的方式以相似的方式对远程，音频视频的管理进行基于远程的音频评估系统，并以类似的方式进行了类似的方式。远程考官系统（CARES）提出的计算机评估将使合格的审查员能够对远程位置的患者进行彻底的认知和行为评估，而各种成本因素可能会禁止这些评估。偏远地区将包括初级保健医师的办公室，护理设施，治疗诊所以及农村和大都市地区的非注重患者家。照料将实施一种根本新的方法，其中远程检查员认为全屏，次要显示，为GUI提供了屏幕上的控制控制，以进行全面的管理和评分。审查员将能够控制测试会话的起搏，重复和补充计算机指令（以确保对任务需求的理解），立即实时评分口头报告或公开行为，并暂停或终止测试。值得注意的是，护理是先前验证的，双显示的，计算机化评估系统的扩展，在该系统中，受试者在人体上伴有人类检查员。高速，非常低的延迟，无线第三/第四代（3G/4G）连接将使受试者和检查者可以通过高分辨率的音频视频界面自由互动，这对于需要口头报告或行为表现的交互评分的测试至关重要。因此，护理将适用于可能需要进行持续监测和补充指导的人群中的应用。 CARES测试集将由已建立的仪器的计算机版本组成，该仪器通常应用于临床环境，研究和临床试验（例如Avlt，Trails A/B，言语流利度，字母数字，符号数字，符号数字，时钟图）。因此，CARES模式与可用的基于Web的评估形成鲜明对比，这些评估不仅是由审查员陪伴的，而且遭受了严格的管理程序以及多个技术缺陷的影响，这些缺点大大限制了可以可靠地管理对受损人群的测试工具的范围。在第一阶段，主要目标是评估人类计算机界面的生存能力，并评估正常受试者和受损受试者认知评估的可行性。护理将是同类系统的第一个系统，并将在医疗保健提供网络，研究环境和对照临床试验中立即应用。公共卫生相关性：这些关心构成了一种从根本上进行认知评估的新方法，在该方法中，远程检查员可以管理广泛的认知和临床评估，而无需在给定的站点上进行物理存在。这与农村地区尤其重要。该技术将降低专业评估的成本，并在医疗保健提供系统，研究环境和对照临床试验中立即应用。