CAMCI: Advancing the Use of Computerized Screening in Healthcare

描述（由申请人提供）：老年人群的认知功能障碍，从简单的健忘到阿尔茨海默病的诊断，都会影响一个人的生活质量和日常活动的能力。至关重要的是，尽早发现下降，以便评估原因是否可以治疗，并在适用的情况下采取适当的治疗。大多数老年患者依靠他们的初级保健医生来满足他们的大部分医疗保健需求，但是医生缺乏可用的敏感工具，并且医生缺乏时间来使用可用的工具。在诊断认知功能障碍方面的犹豫使问题更加复杂，导致对导致痴呆症的认知能力下降的严重检测不足，并且未能在认知丧失的早期阶段提供治疗干预，以潜在地减缓疾病的进展。显然需要一种易于使用和简短的评估工具，旨在针对早期认知能力下降，并且需要将该工具介绍给最经常照顾老年人的提供者：初级保健医生（pcp）。心理学软件工具公司（PST）开发了这样一种工具，轻度认知障碍计算机评估（CAMCI），这是一种计算机筛选工具，用于检测认知能力下降的早期迹象，已被证明在识别轻度认知丧失患者方面比PCP办公室最常用的工具（即MMSE）更有效。凭借PST在计算机化测试和老年人群工作方面的丰富经验，以及PST推进研究和评估领域的公司使命，CAMCI将为pcp和临床医生提供一种选择，在痴呆症诊断之前提供治疗干预。最近增加的CPT代码允许保险报销由计算机进行的神经心理测试，包括医生或临床心理学家的解释和报告时间。为pcp和临床医生引入这种新的收入来源，加上简短和自我给药的特点，使CAMCI成为改善阿尔茨海默病前进行性疾病早期干预的有吸引力的选择。在这一有前途的工具的商业化过程中，目前存在诸如开发替代形式、语言翻译和有效培训材料等障碍，这些障碍将推迟或阻止CAMCI的广泛采用。在当前的项目中，我们建议解决这些采用障碍，最终目标是为医生提供一种有用和有效的工具来检测认知功能障碍，医生是大多数老年人医疗保健的提供者。

DESCRIPTION (provided by applicant): Cognitive dysfunction in the elderly population, ranging from simple forgetfulness to a diagnosis of Alzheimer's disease, can impact one's quality of life and ability to function in daily activities. It is crucial that decline be detected as early as possible in order to evaluate whether the cause is treatable, and to employ appropriate treatment, if applicable. The majority of elderly patients rely on their primary care physician for the bulk of their healthcare needs, but there is a lack of sensitive tools available to the physician, and there is a lack of physician's time to use the tools that are available. A hesitancy to diagnose cognitive dysfunction compounds the problem, resulting in a severe under-detection of cognitive decline leading to dementia, and a failure to provide therapeutic intervention at the earliest stages of loss to potentially slow the progression of disease. There is a clear need for an easy-to-use and brief assessment tool designed to target early cognitive decline, and a need to introduce the tool to providers who most frequently care for the elderly population: Primary Care Physicians (PCPs). Psychology Software Tools, Inc. (PST) has developed such a tool, the Computer Assessment of Mild Cognitive Impairment (CAMCI), a computerized screening tool for the detection of early signs of cognitive decline, which has been shown to be more effective in the identification of patients with subtle cognitive loss than the tool most frequently used within the PCP office (i.e., MMSE). With PST's considerable experience in computerized testing and working with elderly populations, and in accordance with PST's company mission to advance the fields of research and assessment, CAMCI would provide an option for PCPs and clinicians to provide therapeutic intervention prior to a diagnosis of dementia. Recent additions to CPT codes permit insurance reimbursement for neuropsychological testing by a computer, including time for the physician's or clinical psychologist's interpretation and reporting. The introduction of this new revenue stream for PCPs and clinicians, coupled with the characteristics of being brief and self-administered make the CAMCI an attractive option for improving early intervention in the progressive condition preceding Alzheimer's disease. Hurdles such as the development of alternate forms, language translations, and effective training materials now exist in the commercialization of this promising tool that would delay or prevent the widespread adoption of the CAMCI. In the current project, we propose to address these barriers to adoption with the ultimate goal of providing a useful and effective tool in the detection of cognitive dysfunction to physicians, the providers of the majority of healthcare to the elderly population. PUBLIC HEALTH RELEVANCE: Alzheimer's disease (AD) is a significant health problem in the United States, resulting in a cost as much as $100 billion a year. We will provide a solution to Primary Care Physician's that does not impede on their time or budget so that they may identify of mild cognitive impairment (MCI) in the earliest stages so that treatment can be started to delay the transition from MCI to AD. This has the potential to delay the devastating effects of the disease, and also lessen the financial burden on the health care system in the United States.