The proposed project develops a web-based software application and survey containing both patient-case descriptions and questionnaire to facilitate research of patient race and the decision to use antidepressant treatment among the elderly. Results will direct further study and inform the development of interventions. The web-based application will be an online healthcare decision lab, supporting research for many years. The survey is essential to the ensuing research on patient race and antidepressant treatment. The project spans two years and has four specific aims.
AIM 1 is software development: we design software that accurately measures response times, implements subliminal priming, and implements factorial surveys. The software also performs the standard tasks of governing the website and data collection.
AIM 2 is develop a factorial representation of patient cases: we design patient cases as a factorial survey intended to vary in patient cues such that the probability of the treatment for depression spans the unit interval. The factorial survey is essential to the ensuing research.
AIM 3 is develop physician questionnaire: we develop a questionnaire comprising questions regarding physician demographics, experience, and attitudes: the goal of this aim is to facilitate collection of physician information related to the decision to use AT, but keep the overall online survey to less than 40 minutes.
AIM 4 is test overall feasibility: we test the online application of the survey to assure overall feasibility using a sample of family practice physicians. This is a test of all components including the sampling strategy and the web-based application. The goals of this test are a greater than 50% response rate and identification of physician characteristics that predict recruitment and dropout: essential information to the design of the subsequent study. Relevance: It is known that depression impacts the elderly, treatment differs by patient race, and physician decisions partially explain the disparity. It is not known why-a knowledge gap that must be filled to provide remedy. To know why, we must understand how patient race influences the decision-making of physicians at a cognitive level. The proposed project initiates a program that translates basic knowledge from psychology into clinically relevant research by developing the requisite methods and facility to answer the question of how patient race influences the decision to treat the elderly for depression. It is known that depression impacts the elderly, treatment differs by patient race, and physician decisions partially explain the disparity. It is not known why-a knowledge gap that must be filled to provide remedy. To know why, we must understand how patient race influences the decision-making of physicians at a cognitive level. The proposed project initiates a program that translates basic knowledge from psychology into clinically relevant research by developing the requisite methods and facility to answer the question of how patient race influences the decision to treat the elderly for depression. ? ? ?
