Improving Patient Care Through Objective Monitoring of At-Home Repetitive Ritual Behaviors in Obsessive-Compulsive Disorder

通过客观监测强迫症患者的家庭重复仪式行为来改善患者护理

• 批准号: 10384150
• 负责人: Anu Asnaani
• 金额: $ 44.98万
• 依托单位: ADVANCED MEDICAL ELECTRONICS CORPORATION
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10384150
• 关键词: Acute; Address; Adult; Alcohols; Anxiety; Area; Behavior; Behavior Therapy; Behavior monitoring; Behavioral; Big Data; Caring; Clinical; Clinical Data; Clinical Research; Clinical Trials; Collaborations; Communities; Compulsive Behavior; Computer software; Data; Data Analyses; Data Reporting; Data Set; Detection; Development; Device Designs; Devices; Disease; Disease remission; Distress; Effectiveness; Electrocardiogram; Entrepreneurship; Event; FDA approved; Feedback; Frequencies; Fright; Funding; Future; Goals; Grant; Hair; Handwashing; Health Personnel; Healthcare; Home; Impairment; Individual; Interview; Language; Lead; Measures; Medical Device; Medical Electronics; Mental Health; Methodology; Modality; Monitor; Movement; Observational Study; Obsession; Obsessive-Compulsive Disorder; Participant; Patient Care; Patient Self-Report; Patients; Pattern; Pennsylvania; Performance; Phase; Positioning Attribute; Prevention; Protocols documentation; Provider; Psychologist; Publishing; Randomized; Records; Reporting; Research; Research Personnel; Ritual compulsion; Sampling; Services; Small Business Innovation Research Grant; Small Business Technology Transfer Research; Symptoms; System; Technology; Temperature; Testing; Textbooks; Thinking; Time; Treatment Efficacy; United States National Institutes of Health; Universities; Utah; Water; Wrist; base; clinically relevant; cloud storage; commercialization; compulsion; cost effective; dashboard; data portal; design; effective therapy; experience; feasibility testing; improved; improved outcome; innovation; mHealth; novel; prototype; real time monitoring; repetitive behavior; response; skills; smartphone Application; software systems; technological innovation; tool; treatment optimization; user-friendly; web interface; wireless

Project Summary Obsessive-compulsive disorder (OCD) is characterized by intrusive, distressing thoughts (obsessions) in response to which an individual feels compelled to perform a repetitive behavior (compulsions), which are performed in order to reduce the acute distress experienced by the patient but which perpetuate OCD symptoms. Effective treatment requires accurate reporting of compulsive behaviors, and a key challenge is that patients often underreport their behaviors to their providers because the short-term anxiety relief brought about by engaging in the compulsion is preferable to the long-term challenge of resisting the compulsions in order to treat the condition, thereby impairing the efficacy of these treatments. Available objective monitoring tools, such as electrocardiogram (ECG) monitors, can detect periods of increased anxiety, while wrist-worn devices can monitor behaviors such as hair pulling, but they have limited accuracy for detecting hand-washing compulsions which are common in OCD and are thus not indicated for use in these patients. The overall goals of this Phase 1 STTR are to address this key gap by developing and testing the feasibility of a technological innovation involving a novel wearable smart-ring recording modality that is unintrusive and provides a more objective measure of compulsive behavior to both patients and their therapists in order to appreciably improve the effectiveness of OCD treatment. This ring device offers several innovations: It is a smart ring (1) that can detect cleaning agents like water or alcohol (2) as well as repetitive behaviors (3) in order to objectively monitor obsessive hand-washing or other ritualistic events (4). This information would be sent to a dashboard (5) with a real-time log for a therapist to objectively measure the number of behaviors the ring detects and monitor wear- time compliance (6). Specific aims of this proposal are to: 1) Optimize acceptability, feasibility and utility of the ring device and its associated smartphone app/web interface through iterative 1:1 feedback from the range of users of this technology (patients/providers); 2) Develop a prototype activity recording smart ring and associated software system based on Aim 1 findings. The smart ring will be a miniature system that records movement, temperature, and wetness. It will record while worn and wirelessly download data, pairing with a smartphone app which will sync with a cloud storage modality; 3) Conduct a multi-phased acceptability, feasibility and experimental assessment protocol first with healthy adults and then with patients with OCD, followed by in-depth feedback interviews with clinicians. Advanced Medical Electronics has extensive experience in biomedical development, and academic partners (Asnaani, Gooneratne) have expertise in OCD, experimental methodology, mHealth, biomedical entrepreneurship, along with a prior track record of successful collaboration on previous STTR funded studies and proposals. If successful, this project will provide patients and health care providers with an unintrusive and more accurate tool for real-time monitoring of typical compulsive behaviors in order to appreciably improve the efficacy of front-line treatments for OCD.

项目摘要 强迫症（OCD）的特点是 个人感到被迫执行重复行为（强迫）的响应， 为了减少患者经历的急性困扰而进行，但会使强迫症永存 症状。有效的治疗需要准确报告强迫行为，关键的挑战是 病人经常向提供者报告其行为，因为短期焦虑缓解带来了 通过参与强迫，比抵抗强迫症的长期挑战更可取 治疗疾病，从而损害这些治疗的功效。可用的客观监控工具， 例如心电图（ECG）监测器，可以检测到焦虑增加的时期，而腕部设备则可以检测 可以监视拉毛等行为，但它们的准确性有限，无法检测手洗手 强迫症在强迫症中很常见，因此未指示这些患者使用。总体目标 该阶段1的sttr是通过开发和测试技术的可行性来解决此关键差距 创新涉及一种新颖的可穿戴智能环录音方式，该模式没有引人注目，并且提供了更多 为了显着改善，对患者及其治疗师的强迫行为的客观度量 强迫症治疗的有效性。该环设备提供了几种创新：这是一个智能环（1）可以 检测水或酒精（2）等清洁剂以及重复行为（3），以便客观地监视 痴迷的手洗或其他仪式事件（4）。此信息将被发送到仪表板（5） 治疗师的实时日志，以客观地测量环检测和监视磨损的行为数量 时间合规性（6）。该提案的具体目的是：1）优化可接受性，可行性和效用 通过迭代1：1的反馈范围的反馈 该技术的用户（患者/提供者）； 2）开发一个原型活动记录智能环和 基于AIM 1发现的关联软件系统。智能环将是一个小型系统，记录 运动，温度和湿度。它将在磨损和无线下载数据时录制，并与 智能手机应用将与云存储模式同步； 3）具有多个可接受性， 可行性和实验评估方案首先与健康的成年人，然后是强迫症患者 随后是对临床医生的深入反馈采访。高级医疗电子设备广泛 在生物医学发展方面的经验，学术伙伴（Asnaani，Gooneratne）在强迫症中具有专业知识， 实验方法，MHealth，生物医学企业家精神，以及先前成功的记录 先前的STTR资助研究和建议的合作。如果成功，该项目将为患者提供 以及具有不受欢迎和更准确的工具，用于实时监控典型的医疗保健提供者 强迫行为是为了显着提高OCD前线治疗的功效。