Feasibility and validation of a web-based platform for the self-administered patient collection of demographics, health status, anxiety, depression, and cognition in community dwelling elderly

Abstract

The coronavirus disease pandemic has brought a new urgency for the development and deployment of web-based applications which complement, and offer alternatives to, traditional one-on-one consultations and pencil-and-paper (PaP) based assessments that currently dominate clinical research. We have recently developed a web-based application that can be used for the self-administered collection of patient demographics, self-rated health, depression and anxiety, and cognition as part of a single platform. In this study we report the findings from a study with 155 cognitively healthy older adults who received established PaP versions, as well as our novel computerized measures of self-rated health, depression and anxiety, and cognition. Moderate to high correlations were observed between PaP and web- based measures of self-rated health (r = 0.77), depression and anxiety (r = 0.72), and preclinical Alzheimer’s disease cognitive composite (PACC) (r = .61). Test-retest correlations were variable with high correlations for a measure of processing speed and a measure of delayed episodic memory. Taken together, these data support the feasibility and validity of utilization of this novel web-based platform as a new alternative for collecting patient demographics and the assessment of self-rated health, depression and anxiety, and cognition in the elderly.

Implementing patient-reported outcomes in routine clinical care for diverse and underrepresented patients in the United States

“…Remaining specialties included rheumatology [ 52 – 55 ] (n = 4, 14.3%), psychology/psychiatry [ 56 – 58 ] (n = 3, 10.7%), and one study each (3.6%) for neurology [ 37 ], geriatrics [ 59 ], trauma [ 60 ], home health care [ 61 ], and orthopedic hand surgery [ 62 ].…”

“…Self-administered web-based collection system for elderly patients required little assistance from staff [ 56 ]…”

“…Primary care was the most common specialty represented (n = 10, 35.7%) [11,36,[38][39][40][41][42][43][44][45], followed by oncology (n = 4, 21.4%) [46][47][48][49][50][51], of which two studies were specific to breast oncology [46,47] and two studies were specific to urologic/radiation oncology [49,50]. Remaining specialties included rheumatology [52][53][54][55] (n = 4, 14.3%), psychology/psychiatry [56][57][58] (n = 3, 10.7%), and one study each (3.6%) for neurology [37], geriatrics [59], trauma [60], home health care [61], and orthopedic hand surgery [62].…”

“…Older patients less likely than younger patients (mean 57) to be able to complete a touch-screen enabled computer-assisted self-interview [38] Older patients less likely than patients aged 18-64 to complete PROMs [11] Late responses to web-based PRO platform associated with older age [62] Among elderly patients using smartphone-based PROs, there was a discrepancy between perceived vs. actual survey completion adherence [57] Needs: Self-administered web-based collection system for elderly patients required little assistance from staff [56] Older, majority Black, low-income hemodialysis patients found iPad-based PROs easy to use, but desired a tutorial video [59] Preferences: Older patients in home health care settings found tablet-based PRO collection easy to use with a preference for using finger over stylus [61] Other: Smartphone-based PROs successful among elderly patients [57] Sexual and gender minority populations Concerns: n/a Needs: n/a Preferences: ePRO collection was appreciated by a > 50% LGBTQ clinic population [40] Other: ePRO collection made participants of a > 50% LGBTQ clinic population feel that they more direct participants in their care [40] Notably, the least studied implementation outcomes in studies to date were penetration and sustainability. While it is still helpful to understand elements of PRO implementation such as acceptability and feasibility in the shortterm, it is evident that less is known regarding longer-term and institution-wide outcomes of these interventions.…”

Novel approaches to measuring neurocognitive functions in Alzheimer's disease clinical trials

“…Speeded matching, a computerized analogue to the WAIS-R digit symbol coding, measures processing speed. A validation study [17 ▪ ] indicated that cPACC scores were moderately associated with the original PACC ( r = 0.61). Participants who scored above and below a 25 on the MMSE had significantly different scores across all measures, implying some sensitivity to cognitive changes.…”