The key innovation for this revised application for a SBIR project is she integration of a detailed instrument for clinically-based standardized psychiatric assessment of psychopathology with synchronized digital audio and video recording. The Schedules for Clinical Assessment m Neuropsychiatry (SCAN) provides a widely recognized and used international standard, and over the past two years has been carefully revised and refined. Publication of version 2.1 is expected shortly. The advantage that using a detailed instrument such as SCAN offers is that the SCAN items, upon which the standardization of assessment using the SCAN rests, can also provide a means of indexing the digital recording. This link between SCAN items and the digital recording is expected to provide significant benefits through more efficient retrieval and use of recorded material. Rather than having to rewind and fast-forward tapes, the software will allow selection of a SCAN item and immediately playing the digital recording from the point where the SCAN item was first selected during the course of the interview. A person reviewing the interview will also be able to add additional index markers with labels, for example to note an important statement by the patient or an informative clinical vignette. These functions are useful for both research and clinical applications. In Phase I, a number of difficulties prevented completion of the Phase I Aims. Nevertheless, work has continued on the software, and subsequent to the first submission of the Phase II proposal, an entirely new version of computer software (""""""""CliniMetrica"""""""") combining the SCAN and indexed digital audio recording has been produced. In this revised Phase II application, implementation of digital video recording is proposed. After iterative implementation and pilot testing, a formal study of the clinical and research feasibility, efficiency, and reliability will be carried out at a collaborating SCAN Center at the West Virginia University, using a sample of male and female patients with admission diagnoses in the areas of bipolar disorder, depression, schizophrenia, substance abuse. Establishing the efficiency and reliability of CliniMetrica through the research protocol at Sharpe Hospital will provide substantial business validation for the product. With the imminent publication of SCAN version 2.1, researchers worldwide will have substantial interest in the CliniMetrica product. In Phase III, the product will be further extended and refined to serve as a key component in a mental health software system for mental health clinicians, a much larger market than the research market. In general, successful computerization of clinical assessment has potential to improve the quality of mental health services by fostering standardization of training and education as well as routine clinical assessment, thus helping create clinical databases which can be used for scientific management and optimization of assessment. In doing so, the commercial value will be enhanced, as will public mental health goals.
Commercial potential is present in several areas related to psychiatric diagnosis: training, education, reliability research, medical records, and managed care. The software program once developed will be readily adapted to other assessments, e.g., neuropsychological testing, or other interviews.
