Web-based Training & Reliability for Psychiatric Raters

描述(由申请人提供)：在精神病学临床试验期间培训评分员以及建立和保持可靠性的重要任务是一个经常被忽视的主要问题。对于涉及多个地点的多名评分员的试验来说，这个问题尤其令人恼火。此外，使用标准精神病学评分工具影响评分者预期(偏见)的因素从未得到充分探讨。该第二阶段项目旨在开发一个互动视频系统，用于培训研究评分员使用具有共同评分惯例的评分工具，并评估跨地点和随着时间的推移评审员之间的可靠性。编写的程序将使这一视频系统能够被用作(1)可用于培训评分员如何使用评级仪器的交互式“教程”系统，以及(2)“可靠性测试”系统，该系统使用一个综合数据库来记录评分员的评分并计算评价员之间的可靠性，在确定的评分员组内或使用预设的评分，即“黄金标准”。该计划包括开发一个完整的汉密尔顿抑郁评定量表(HDRS)30种变体的库，使用四个不同的演员，不同性别和不同种族。第二阶段的研究将评估变异性和评分者的偏向，将其作为评分者和有200名新手评分者的患者的人口统计和专业特征的交互作用。第一阶段创建了用于评估人类发展报告评价员间可靠性的原型。使用实际患者采访的剧本，一名男性和一名女性演员各自描绘了三次不同的HDRS采访，反映了不同严重程度的抑郁症状。在第二阶段的筹备工作中，该系统的功能被认为是极好的。可行性是通过以下方式建立的：1)有经验的评分员对演员和实际患者的HDRS访谈视频进行评估，并确定演员描述的有效性；2)使用系统原型计算一组有经验的评分员(0.97)和一组新手评分员(0.96)的评审员间可靠性分数；以及3)召集焦点小组评估该系统的正面和负面属性。未来的产品开发将利用该软件和统计方法以及其他评级工具，包括用于评估精神分裂症、焦虑症和痴呆症的工具。

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.