Evaluating Computer Self-assessments In Patients With Severe Mental Illness

[Guest allanopie]

1006 — Evaluating Computer Self-Assessments In Patients With Severe Mental Illness

Author List:

Chinman MJ (VISN 22 MIRECC and RAND)

Young AS (VISN 22 MIRECC and UCLA)

Mintz J (VISN 22 MIRECC and UCLA)

Shih S (VISN 22 MIRECC)

Hassell J (VISN 22 MIRECC)

Objectives:

Usual care for severe mental illness (SMI) is often poor, yielding suboptimal outcomes. Improving care for this chronic illness has been difficult because routine data collection is rare and existing medical records contain little information regarding clinical needs in patients, such as symptoms or side-effects. Efficient collection of, and access to, this information is needed for evaluating and improving healthcare quality. Audio computer-assisted self-interviewing (ACASI) can facilitate data collection by presenting patients important clinical questions visually and aurally, typically in clinic waiting rooms. Collected information can then be used by providers to improve clinical decision-making and by researchers and policy makers to evaluate and improve care. Given that ACASI surveys have helped improve outcomes for a number of disorders, this study will shed light on their accuracy and reliability in people with SMI, a difficult to treat chronic illness.

Methods:

In a large VAMC, ninety patients with schizophrenia or bipolar disorder (N=45 each) completed duplicate standardized symptom surveys 20 minutes apart, randomized by administration order. One was an in-person interview; the second an ACASI survey self-administered through an Internet browser using a touchscreen developed to meet the cognitive needs of people with SMI. We evaluated attitudes, understanding of the ACASI survey, reliability, concurrent validity, and a possible administration mode bias with scales from the BSI and revised BASIS-32 (Daily Living, Impulsivity, Interpersonal Competence, Depression and Anxiety, Psychosis, Substance Abuse). We evaluated reliability with Pearson correlations and bias with Mode (ACASI vs. face-to-face) x Order (ACASI first vs. ACASI second) repeated measures ANOVAs.

Results:

Across modes of administration, all ACASI and face-to-face interview scales were similar (at p<.05) and highly correlated (r=.81-.99). Patients completed the ACASI survey faster (13.6 vs.14.8 minutes, p<.05), and a large majority rated it as easier, more enjoyable, more preferable if monthly completion of a survey were required, more private, and 97% to 99% perfectly answered questions about how to use it.

Implications:

ACASI-based data collection is reliable among people with bipolar disorder and schizophrenia.

Impacts:

ACASI systems could be a valuable component of systems to improve care in people with SMI.

http://www.hsrd.research.va.gov/about/nati....cfm?RecordID=4

[Guest Berta]

Allan- I have not read this yet -but dont tell anybody- but this triggered a thought -almost a fear- I have from time to time-

that some 90 day wonder who works for the gov will start trying to say that computer literate 100% vets are somehow employable by virtue of their computer skills on the net-

They have never come up with this idea yet but we could defeat dea that anyhow-

for most 100% vets I know- if they are PC literate on the net -it sure obviously does not account for them to be able to go beyond the net and be able to use spreadsheets, office programs, lotus, etc, all that other stuff---that substantial employment would require.

Another thing too- for most vets - the PC is their only way of reaching people who understand them-like hadit -veteran to veteran-often

the only social life they really have----or can put any trust into---

Dont know why I even mentioned this-

I am still ticked that the VAOIG original PTSD hoopla report last year mentioned web sites like this one as providing help to claimants-ike that is a bad thing?

heck -if the VA did their job- there would be no need for these web sites-and the VA can learn from them anyhow.

I think your link is not about this at all----

just a thought I had- I am always wondering what tactics the VA will come up with next to somehow try to keep comp from deserving men and women who have served.

The PTSD Commission hoopla was an unnecessary and stress -causing crock but I think- since the Commission got so many complaint letters- they have assessed that the real problems are at the VAROs.

[Guest allanopie]

Hello Berta,

I think I understand your concern.

Mentally ill Vets, will always be easy targets for bean counters like Buyers. Maybe thats why we have no legal protection?

Simply because I have male plumbing, that hardly qualifies me to hold a job as a fireman. But I can see how "Buyers" could interpret it that way.

[Pete53]

Berta:

I would hazzard a guess that most who work at VA have poor computer skills?