Computerized ambulatory monitoring in psychiatry: a multi‐site collaborative study of acceptability, compliance, and reactivity

Abstract

Computerized ambulatory monitoring overcomes a number of methodological and conceptual challenges to studying mental disorders, however concerns persist regarding the feasibility of this approach with severe psychiatric samples and the potential of intensive monitoring to influence data quality. This multi-site investigation evaluates these issues in four independent samples. Patients with schizophrenia (n = 56), substance dependence (n = 85), anxiety disorders (n = 45), and a non-clinical sample (n = 280) were contacted to participate in investigations using computerized ambulatory monitoring. Micro-computers were used to administer electronic interviews several times per day for a one-week period. Ninety-five percent of contacted individuals agreed to participate in the study, and minimum compliance was achieved by 96% of these participants. Seventy-eight percent of all programmed assessments were completed overall, and only 1% of micro-computers were not returned to investigators. There was no evidence that missing data or response time increased over the duration of the study, suggesting that fatigue effects were negligible. The majority of variables investigated did not change in frequency as a function of study duration, however some evidence was found that socially sensitive behaviors changed in a manner consistent with reactivity.

Feasibility and validity of computerized ambulatory monitoring in stroke patients

“…These findings are similar to compliance rates observed in nonclinical samples. 17 Importantly, the frequency of missing data in this sample was not associated with time in study. The participants required less time to complete electronic interviews as the study progressed, and, with the exception of changes in sad mood, the intensity of daily life variables did not vary as a function of time.…”

“…18 An additional consideration is that the assessment schedule was limited to 5 assessments per day over a 1-week period. Although this schedule is among the most frequently applied, 17 different assessment rhythms may be appropriate as a function of the nature of participating samples. It is also possible that some patients received assistance in responding despite being instructed to complete the daily assessments independently.…”

Predicting the Occurrence, Conviction, Distress, and Disruption of Different Delusional Experiences in the Daily Life of People with Schizophrenia

“…The assessment times were fixed for each participant but randomized across participants. Investigation of fatigue effects and reactivity to the ambulatory methodology using this specific protocol revealed no correlation of time in the study with missing data or with the frequency or intensity of variables, 24 and no participant indicated that they changed their usual activities due to PDA use. The signals occurred within each of the following time periods: 9:00 AM to 12:00 noon; 12:00 noon to 3:00 PM; 3:00 PM to 6:00 PM; and 6:00 PM to 9:00 PM.…”

“…21 Computerized ESM uses handheld computers such as personal digital assistants (PDAs), which provide signaling, responding, and data storage through a single device. Studies have recently shown that computerized ESM is a feasible and valid approach to data collection in both hospitalized 22 and community-dwelling 23,24 people with schizophrenia. A major advantage of computerized ESM is that all self-reports are time stamped, enabling researchers to accurately map the sequence of events over a given period of data collection and examine prospective relationships between variables over time within individuals.…”

A risk factor analysis of accumulated postoperative pain and swelling sensation after dental implant surgery using a cellular phone-based real-time assessment

“…Moreover, EMA also enables data collection at each person's natural environment. Thus, it can reduce bias caused by ambiguous memory, and consequently, it increases the validity level of the assessment [6].…”