Biomedical subjects

James C Mundt

Publications and source records attributed to James C Mundt.

11 recordsLinked to original sources

PubMed2006

An interactive voice response program to reduce drinking relapse: a feasibility study.

Substance-abusing patients often relapse soon after undergoing treatment, thus requiring intensive aftercare or re-treatment. More efficient monitoring and follow-up of patients could contribute to better treatment outcomes. This study evaluated the feasibility of a computer-automated interactive voice response (IVR) system to reduce relapse following discharge from residential treatment. Sixty participants completing a residential treatment program and meeting DSM-IV criteria for alcohol dependence were randomized to three groups: (1) daily IVR reporting with personal follow-up on noncompliant callers; (2) daily IVR reporting without follow-up; or (3) no IVR reporting (control group). At 30, 90, and 180 days after discharge, participants were interviewed to obtain timeline follow-back drinking data and completed the Work and Social Adjustment Scale, Obsessive-Compulsive Drinking Scale, SF-36, and Drinker Inventory of Consequences. This pilot study suggests that using automated IVR technology to monitor clients after discharge is feasible and warrants further research and development. IVR systems also provide the potential for delivering individualized feedback.

Adult↗

PubMed2006

Dial "T" for testing: Technological flexibility in neuropsychological assessment.

Computer-automated neuropsychological testing can be conducted over the telephone via interactive voice response (IVR) technology by adapting cognitive measures traditionally administered by a clinician or in paper-and-pencil formats. By utilizing automated telephone interviews in neuropsychological research, time and money can be saved, and patients can be assessed remotely. This paper reviews the use of IVR to assess neuropsychological functioning in six studies that examined alcohol impairment of mental and physical functioning, cognitive and psychomotor recovery after surgery, and impairment resulting from central nervous system disease. Future directions for expanding application of cognitive performance assessment via IVR are discussed.

Alcoholic Beverages↗

PubMed2006

An examination of 26,168 Hamilton Depression Rating Scale scores administered via interactive voice response across 17 randomized clinical trials.

This article presents descriptive and psychometric data from 26,168 Hamilton Depression Rating Scale (HAM-D) scores administered via Interactive Voice Response (IVR) in 17 randomized clinical trials sponsored by 6 pharmaceutical companies. To provide evidence for construct validity, the IVR HAM-D scores before and after randomization are compared, and the change in the IVR HAM-D scores over time after randomization are examined. In addition, the evidence for the reliability of the IVR-administered HAM-D is presented. An examination of the distribution of first-time IVR HAM-Ds before randomization may provide useful information to researchers planning to use the IVR HAM-D as a screening tool for entry or to verify baseline severity in randomized clinical trials.

Depressive Disorder↗

PubMed2005

An evaluation of the quick inventory of depressive symptomatology and the hamilton rating scale for depression: a sequenced treatment alternatives to relieve depression trial report.

BACKGROUND: Nine DSM-IV-TR criterion symptom domains are evaluated to diagnose major depressive disorder (MDD). The Quick Inventory of Depressive Symptomatology (QIDS) provides an efficient assessment of these domains and is available as a clinician rating (QIDS-C16), a self-report (QIDS-SR16), and in an automated, interactive voice response (IVR) (QIDS-IVR16) telephone system. This report compares the performance of these three versions of the QIDS and the 17-item Hamilton Rating Scale for Depression (HRSD17). METHODS: Data were acquired at baseline and exit from the first treatment step (citalopram) in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. Outpatients with nonpsychotic MDD who completed all four ratings within +/-2 days were identified from the first 1500 STAR*D subjects. Both item response theory and classical test theory analyses were conducted. RESULTS: The three methods for obtaining QIDS data produced consistent findings regarding relationships between the nine symptom domains and overall depression, demonstrating interchangeability among the three methods. The HRSD17, while generally satisfactory, rarely utilized the full range of item scores, and evidence suggested multidimensional measurement properties. CONCLUSIONS: In nonpsychotic MDD outpatients without overt cognitive impairment, clinician assessment of depression severity using either the QIDS-C16 or HRSD17 may be successfully replaced by either the self-report or IVR version of the QIDS.

Adult↗

PubMed2005

Validation of an IVRS version of the MADRS.

Interest in self-reported measures of depression in clinical trials has grown in recent years. This study compared the reliability and validity of the clinician-administered Montgomery-Asberg Depression Rating Scale (MADRS) to a computer-administered version administered over the telephone using Interactive Voice Response (IVR) technology. Sixty subjects were administered both the clinician- and computer-administered versions of the MADRS in a counter-balanced order. A subsample of 20 patients was reassessed 24h later by both methods. Mean score differences between IVR and clinician were not statistically significant (<1 point) and a high correlation was found between forms (r=.815, p<.001). Reliability measures (Cronbach's Alpha and 24-h test-retest) were comparable. Clinicians rated the severity of subjects' sadness and pessimistic thoughts lower than subjects self-report. The data obtained in this pilot study provide support for the equivalence between the clinician and IVR versions of the MADRS.

Adult↗

PubMed2005

Remote capture of human voice acoustical data by telephone: a methods study.

In this pilot study we sought to determine the reliability and validity of collecting speech and voice acoustical data via telephone transmission for possible future use in large clinical trials. Simultaneous recordings of each participant's speech and voice were made at the point of participation, the local recording (LR), and over a telephone line using a dedicated in-line computerized interactive voice recording system, the remote recording (RR). All voice recordings were made from our laboratory telephone located in Groton, Connecticut to the RR system located in Madison, Wisconsin. All data points were compared on a measure-by-measure basis between the LR and RR recordings. The results suggest that both measures of frequency excursion and of speech motor timing are reliably captured over the telephone. Results are discussed in terms of specific acoustic measures that may be useful and accurately measured via telephone transmission, for examining disease severity and pharmacological intervention for use in a large-scale clinical trial.

Adult↗

PubMed2005

The value of computer-administered self-report data in central nervous system clinical trials.

Over the past decade, significant research has been conducted into the development of computer-delivered interviews and scoring methods to assess disease severity in a number of central nervous system indications. In particular, equivalence has been demonstrated between gold standard assessments (such as the Hamilton depression and Hamilton anxiety rating scales) delivered either by computer or by clinicians, in a number of clinical studies. Such computer-based approaches have a number of advantages including the elimination of inter-rater variance and prevention of inclusion bias when inclusion criteria are based upon baseline ratings. In addition, some studies have demonstrated that computer-administered ratings can be more sensitive to the detection of treatment-related changes than clinician ratings. Much of this evidence has led to recent US Food and Drug Administration acceptance of certain computer-administered assessments as primary endpoints in depression clinical trials.

Central Nervous System Diseases↗

PubMed2002

The Work and Social Adjustment Scale: a simple measure of impairment in functioning.

BACKGROUND: Patients' perspectives concerning impaired functioning provide important information. AIMS; To evaluate the reliability and validity of the Work and Social Adjustment Scale (WSAS). METHOD: Data from two studies were analysed. Reliability analyses included internal scale consistency, test-retest and parallel forms. Convergent and criterion validities were examined with respect to disorder severity. RESULTS: Cronbach's alpha measure of internal scale consistency ranged from 0.70 to 0.94. Test-retest correlation was 0.73. Interactive voice response administrations of the WSAS gave correlations of 0.81 and 0.86 with clinician interviews. Correlations of WSAS with severity of depression and obsessive-compulsive disorder symptoms were 0.76 and 0.61, respectively. The scores were sensitive to patient differences in disorder severity and treatment-related change. CONCLUSIONS: The WSAS is a simple, reliable and valid measure of impaired functioning. It is a sensitive and useful outcome measure offering the potential for readily interpretable comparisons across studies and disorders.

Depressive Disorder↗

PubMed2002

Automating standard alcohol use assessment instruments via interactive voice response technology.

BACKGROUND: Interactive voice response (IVR) technology integrates touch-tone telephones with computer-automated data processing. IVR offers a convenient, efficient method for remote collection of self-report data. METHODS: Twenty-six subjects recruited from an outpatient alcohol treatment center completed IVR and paper/pencil versions of a demographic and drinking history questionnaire, Stages of Change Readiness and Treatment Eagerness Scale, Drinker Inventory of Consequences, Obsessive-Compulsive Drinking Scale, Alcohol Dependence Scale, and two numerical rating scales of craving and desire to drink during the prior week. Administration of the instruments in both formats was repeated 1 week later. The order of administration method was counterbalanced between subjects and reversed across data collection sessions. Scale and subscale scores from both methods were correlated within sessions. Test-retest correlations were also calculated for each method. A criterion of alpha = 0.01 was used to control type I statistical error. RESULTS: Intermethod correlations within each session were significant for all of the instruments administered. Test-retest correlations for both methods were also significant, except for the numerical ratings. Scores on the Alcohol Dependence Scale obtained via IVR were significantly lower than those collected by paper/pencil. Other differences between the data collection methods or across the sessions were inconsistent. The average IVR call length was 34 min and 23 sec. Paper/pencil forms required an average of 18 min and 38 sec to complete and an additional 10 min and 17 sec for data entry. CONCLUSIONS: IVR technology provides a convenient alternative to collecting self-report measures of treatment outcomes. Both paper/pencil and IVR assessments provide highly convergent data and demonstrate good test-retest reliability. Alcohol Dependence Scale score differences between methods highlight special considerations for IVR adaptation of existing paper/pencil instruments. Benefits of IVR include procedural standardization, automatic data scoring, direct electronic storage, and remote accessibility from multiple locations.

Adult↗

PubMed2002

Factors contributing to failed trials of new agents: can technology prevent some problems?

For psychiatry to contribute to the development of the next generation of antidepressant pharmacotherapies, effective use of clinical trial methods is as critical as innovation in neurochemical research. Results from clinical trials on the efficacy of a new drug can be obscured by methodological problems. Accurate diagnosis and precise measurement of the clinical symptoms during conduct of the clinical trials are crucial to obtaining interpretable outcomes. As tools that reliably diagnose disorders and assess symptoms become available, computer administration of rating instruments may improve the accuracy of clinical trial results. This article describes methodological factors that can confound study outcomes and discusses the potential for interactive voice response (IVR) technology to address some of these problems.

Antidepressive Agents↗

PubMedDate not supplied

A novel interactive voice response (IVR) system for dementia screening, education, and referral: one-year summary.

This article summarizes the data collected from an interactive voice response (IVR) system for dementia screening, education, and referral during its first year of use. After its development and pilot testing, the system was made available to the public via a toll-free number and advertised in targeted, rural areas in the state of Wisconsin. After 1 year of availability, the data gathered by the system suggests that the majority of the callers remained in the system long enough to, at minimum, listen to educational information. The system received calls from both those concerned about themselves and those concerned about another person. The screening portions of the system received significant use, and most individuals receiving positive screens continued to explore the interactive voice response system, suggesting they sought additional information. Overall, the 1-year results support the need for accessible and anonymous resources for individuals concerned about dementia.

Aged↗