Mount Sinai School of Medicine, New York, USA.
Alzheimer Dis Assoc Disord. 2010 Jul-Sep;24(3):256-63. doi: 10.1097/WAD.0b013e3181d7109f.
This report describes a pilot study to evaluate feasibility of new home-based assessment technologies applicable to clinical trials for prevention of cognitive loss and Alzheimer disease.
Community-dwelling nondemented individuals >or=75 years old were recruited and randomized to 1 of 3 assessment methodologies: (1) mail-in questionnaire/ live telephone interviews (MIP); (2) automated telephone with interactive voice recognition (IVR); and (3) internet-based computer Kiosk (KIO). Brief versions of cognitive and noncognitive outcomes were adapted to the different methodologies and administered at baseline and 1-month. An Efficiency measure, consisting of direct staff-to-participant time required to complete assessments, was also compared across arms.
Forty-eight out of 60 screened participants were randomized. The dropout rate across arms from randomization through 1-month was different: 33% for KIO, 25% for IVR, and 0% for MIP (Fisher Exact Test P=0.04). Nearly all participants who completed baseline also completed 1-month assessment (38 out of 39). The 1-way ANOVA across arms for total staff-to-participant direct contact time (ie, training, baseline, and 1-month) was significant: F (2,33)=4.588; P=0.017, with lowest overall direct time in minutes for IVR (Mn=44.4; SD=21.5), followed by MIP (Mn=74.9; SD=29.9), followed by KIO (Mn=129.4; SD=117.0).
In this sample of older individuals, a higher dropout rate occurred in those assigned to the high-technology assessment techniques; however, once participants had completed baseline in all 3 arms, they continued participation through 1 month. High-technology home-based assessment methods, which do not require live testers, began to emerge as more time-efficient over the brief time of this pilot, despite initial time-intensive participant training.
本报告描述了一项试点研究,旨在评估适用于预防认知能力下降和阿尔茨海默病的临床试验的新型家庭评估技术的可行性。
招募了居住在社区中的非痴呆个体≥75 岁,并将其随机分为 3 种评估方法之一:(1)邮寄问卷/现场电话访谈(MIP);(2)带交互式语音识别的自动电话(IVR);(3)基于互联网的计算机信息亭(KIO)。不同方法采用简短的认知和非认知结局,并在基线和 1 个月时进行评估。效率测量指标由完成评估所需的直接工作人员与参与者的时间组成,也在各臂之间进行了比较。
从 60 名筛选出的参与者中,有 48 名被随机分配。各臂从随机化到 1 个月的失访率不同:KIO 为 33%,IVR 为 25%,MIP 为 0%(Fisher 精确检验 P=0.04)。几乎所有完成基线评估的参与者也完成了 1 个月的评估(39 人中的 38 人)。各臂之间的总工作人员与参与者直接联系时间(即培训、基线和 1 个月)的单因素方差分析有显著性差异:F(2,33)=4.588;P=0.017,分钟数最少的是 IVR(Mn=44.4;SD=21.5),其次是 MIP(Mn=74.9;SD=29.9),再次是 KIO(Mn=129.4;SD=117.0)。
在本老年个体样本中,分配到高科技评估技术的个体的失访率更高;然而,一旦所有 3 个臂的参与者完成了基线评估,他们就会继续参与到 1 个月。尽管最初需要对参与者进行时间密集型培训,但在本试点的短暂时间内,无需现场测试员的高科技家庭评估方法开始变得更加高效。