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远程访谈评估重度抑郁症患者疾病严重程度的可行性:一项试点研究。

Feasibility of remote interviews in assessing disease severity in patients with major depressive disorder: A pilot study.

作者信息

Sumiyoshi Tomiki, Morio Yasunori, Kawashima Takahiro, Tachimori Hisateru, Hongo Seiji, Kishimoto Taishiro, Watanabe Koichiro, Otsubo Tempei, Oi Hideki, Nakagome Kazuyuki, Ishigooka Jun

机构信息

National Center of Neurology and Psychiatry, Tokyo, Japan.

Ichigaya Himorogi Clinic, Tokyo, Japan.

出版信息

Neuropsychopharmacol Rep. 2024 Mar;44(1):149-157. doi: 10.1002/npr2.12411. Epub 2024 Jan 24.

Abstract

AIM

Interview quality is an important factor in the success of clinical trials for major depressive disorder (MDD). There is a substantial need to establish a reliable, remote clinical assessment interview system that can replace traditional in-person interviews.

METHODS

We conducted a multicenter, randomized, unblinded, prospective, cross-sectional study to assess the reliability of remote interviews in patients with MDD (UMIN000041839). Eligible patients with MDD underwent remote and in-person sessions of the Montgomery-Åsberg Depression Rating Scale (MADRS) assessment performed by different raters within 28 days of providing consent. Patients were randomized to a group first assessed using in-person interviews and secondarily using remote interviews (in-person-first group) or a group first assessed by remote interviews and secondarily using in-person interviews (remote-first group). Nineteen trained people (15 clinical psychologists, 3 nurses, and 1 clinical laboratory technologist) performed interviews.

RESULTS

Of 59 patients (in-person-first group, n = 32; remote-first group, n = 27) who completed both remote and in-person interviews, 51% (n = 30) were women; the mean age was 41.6 years (range, 21-64 years). There was a strong association between remote and in-person MADRS scores (r = 0.891, kappa = 0.901). An overall intraclass correlation coefficient (ICC) of 0.886 (95% confidence interval, 0.877-0.952) indicated good consistency between MADRS scores in remote and in-person interviews. The ICC decreased as the severity of depression increased.

CONCLUSION

Our results suggest remote interviews are a feasible alternative option to in-person interviews in assessing symptom severity in MDD patients and could promote clinical trials in Japan.

摘要

目的

访谈质量是重度抑郁症(MDD)临床试验成功的重要因素。迫切需要建立一个可靠的远程临床评估访谈系统,以取代传统的面对面访谈。

方法

我们进行了一项多中心、随机、非盲、前瞻性横断面研究,以评估MDD患者远程访谈的可靠性(UMIN000041839)。符合条件的MDD患者在获得同意后的28天内,由不同的评估者进行蒙哥马利-阿斯伯格抑郁评定量表(MADRS)的远程和面对面评估。患者被随机分为先进行面对面访谈,后进行远程访谈的组(面对面优先组)或先进行远程访谈,后进行面对面访谈的组(远程优先组)。19名经过培训的人员(15名临床心理学家、3名护士和1名临床检验技师)进行访谈。

结果

在完成远程和面对面访谈的59名患者中(面对面优先组,n = 32;远程优先组,n = 27),51%(n = 30)为女性;平均年龄为41.6岁(范围21 - 64岁)。远程和面对面MADRS评分之间存在很强的相关性(r = 0.891,kappa = 0.901)。总体组内相关系数(ICC)为0.886(95%置信区间,0.877 - 0.952),表明远程和面对面访谈中MADRS评分之间具有良好的一致性。ICC随着抑郁严重程度的增加而降低。

结论

我们的结果表明,在评估MDD患者的症状严重程度时,远程访谈是面对面访谈的一种可行替代方案,并且可以促进日本的临床试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2c4/10932799/197a573c273f/NPR2-44-149-g004.jpg

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