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，可能影响一个人的生活质量和日常活动的能力。至关重要的是，要尽早发现下降，以评估原因是否是可治疗的，并采取适当的治疗，如果适用。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，但是医生缺乏敏感的工具，并且医生没有时间使用可用的工具。诊断认知功能障碍的犹豫使问题更加复杂，导致对导致痴呆的认知下降的严重检测不足，以及未能在丧失的最早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，并需要将该工具介绍给最经常照顾老年人口的提供者：初级保健医生（PCP）。Psychology Software Tools，Inc. (PST)已经开发了这样一种工具，轻度认知障碍的计算机评估（CAMCI），这是一种用于检测认知下降的早期迹象的计算机化筛查工具，已经证明，与PCP办公室内最常用的工具（即，MMSE）。由于PST在计算机化测试和与老年人合作方面具有相当丰富的经验，并根据PST公司推进研究和评估领域的使命，CAMCI将为PCP和临床医生提供一种选择，在诊断痴呆症之前提供治疗干预。最近增加的CPT代码允许通过计算机进行神经心理学测试的保险报销，包括医生或临床心理学家的解释和报告的时间。为PCP和临床医生引入这种新的收入来源，加上简短和自我管理的特点，使CAMCI成为改善阿尔茨海默病前进展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，存在着诸如开发替代形式、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，我们建议解决这些障碍，最终目标是为医生提供一个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。 公共卫生相关性：阿尔茨海默病（AD）是美国的一个重大健康问题，每年造成高达1000亿美元的成本。我们将为初级保健医生提供一种解决方案，该方案不会妨碍他们的时间或预算，以便他们可以在最早阶段识别轻度认知障碍（MCI），从而可以开始治疗以延迟从MCI向AD的过渡。这有可能推迟疾病的破坏性影响，并减轻美国医疗保健系统的财政负担。

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.