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接向远端地点提供医疗保健服务所定义的范例。近年来，远程医疗已扩展到包括各种远程提供的服务，包括生命体征监测、药物管理、“远程精神病学”等。此类服务的利用率不断提高是由成本驱动的，对于远端区域来说，是对其他不可用服务的需求推动的。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，能够对各种常用的认知测试仪器和行为精神病学测量进行远程、基于音频视频的管理，就像检查者在进行评估一样。坐在对象旁边。拟议的远程检查系统计算机化评估（CARES）将使合格的检查人员能够对偏远地区的患者进行彻底的认知和行为评估，否则这些评估可能会因各种成本因素而被禁止。偏远地点包括农村和大都市地区的初级保健医生办公室、护理机构、治疗诊所以及非流动患者的家中。 CARES 将实施一种全新的方法，远程检查者可以查看全屏辅助显示器，该显示器提供 GUI 和屏幕控件，以进行全面的管理和评分。考官将能够控制测试的节奏、重复和补充计算机指令（以确保理解任务要求）、立即对口头报告或公开行为进行实时评分以及暂停或终止测试。值得注意的是，CARES 是先前经过验证的双显示器计算机化评估系统的延伸，在该系统中，受试者由一名真人检查员陪同。高速、极低延迟、无线第三代/第四代 (3G/4G) 连接将允许受试者和考官在整个会话过程中通过高分辨率音频-视频接口自由交互，这对于需要交互式评分的测试至关重要。口头报告或行为表现。因此，CARES 将适用于可能需要持续监测和补充指导的受损人群。 CARES 测试集将由现有仪器的计算机化版本组成，通常应用于临床环境、研究和临床试验（例如 AVLT、Trails A/B、语言流畅性、字母数字、符号数字、时钟绘图）。因此，CARES 模式与现有的基于网络的评估形成鲜明对比，后者不仅没有审查员的陪同，而且还存在严格的管理程序以及多种技术缺陷，极大地限制了可以可靠管理的测试仪器的范围给受损人群。第一阶段的主要目标是评估人机界面的可行性，并评估对正常和受损受试者进行认知评估远程管理的可行性。 CARES 将是同类系统中的第一个，并将立即应用于医疗保健服务网络、研究环境和对照临床试验。公共卫生相关性：CARES 构成了一种全新的认知评估管理方法，远程检查者无需亲自到指定地点即可进行广泛的认知和临床评估。这对于农村地区尤其重要。该技术将降低专业评估的成本，并立即应用于医疗保健服务系统、研究环境和对照临床试验。