This SBIR Phase II application proposes to extend an existing multi-tier Internet client-server assessment and diagnostic system (""""""""CliniMetrica(R)-Diagnostica"""""""") by improving the current and implementing new diagnostic logic functions. CliniMetrica(R)-Diagnostica (CM-Dx) currently provides systematic psychiatric assessment using the World Health Organization (WHO) Schedules for Clinical Assessment in Neuropsychiatry (SCAN, version 2.1). The diagnostic logic engine provides raters with the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnoses based upon their ratings of an interview subject, and adaptive guidance to further assessment items that need to be rated in order to rule in or rule out any given diagnosis. In addition, CM-Dx automatically indexes digital audio and video recording of assessment interviews, developed with prior SBIR support from NIMH, and includes functions to support remote psychometrics for the training and monitoring of interviewers. The CM-Dx system has application for both biomedical research (e.g., clinical trials) and for more routine clinical practice. While the Phase I diagnostic functionality filled a major gap, a number of improvements and additions can be made to provide greater value. Improved performance and interfaces would make the assessment and diagnostic functions easier to use. These functions will guide clinical raters through their interview and provide them with the current and longitudinal diagnostic status of their subjects. Phase II will also involve a larger study of the use of the functions in clinical settings. The Phase II Specific Aims are: (1) To improve the usability of the diagnostic functions and add additional preferences; (2) To improve the performance of the digital audio and video functions; (3) To allow users to customize diagnostic rules; (4) To provide support for repeated assessments; and (5) To establish the reliability, validity, and efficiency of the integrated system in clinical settings.
