Branched Outcomes Instrument for Mental Health Service

DESCRIPTION (provided by applicant): In its Roadmap Initiatives, NIH has highlighted the need for improvement in dynamic assessments in health care and for the use of new technology in the collection of patient-reported outcomes (PRO). The goal of this project is to further validate a new mental health outcomes-tracking instrument for depression, anxiety, social functioning, and occupational functioning. At the end of Phase II, we will produce a suite of marketable products for collecting and managing mental health PRO data. Components will include the underlying software platform for collecting and managing data, an Internet-administered computerized adaptive test (CAT) version of the instrument, an automated telephone CAT version of the instrument, and a computerized fixed-length version of the instrument. The major innovations of this work will be the application of item response theory (IRT) in the validation of the instrument and the use of new technologies for survey administration, (n Phase I, we successfully developed item pools, validated item banks, and established the unidimensionality of the four domains. In Phase II, we will conduct 3 validation studies using clinical and community samples. In Study 1, we will further validate the item banks using cognitive interviewing (36 subjects). In Study 2, we will further assess item-test functioning using IRT (800 subjects). We will also compare scores on the new instrument with DSM-IV diagnoses and (b) treatment modalities (private sector outpatient, partial hospital program, and public sector outpatients) to establish the ability of the instrument to differentiate between groups. In Study 3, we will assess the test-retest reliability of 3 automated versions of the instrument, the inter-technology reliability, and patient satisfaction (375 subjects). The instrument and associated outcomes tracking system resulting from this research will help speed research and facilitate quality assurance programs and government-mandated monitoring of mental health treatment effectiveness.