SBIR-STTR Award

This research will design and implement an interactive voice response (IVR) program to screen for early dementia and provide referral information to local and regional resources for further information, assessment, and potential treatment. By demonstrating adequate sensitivity and specificity of the computerized screening instrument, the scientific justification for differential patient referral will be provided. Elderly patients being evaluated by a clinician will be asked to call the IVR screening system during their clinical visit and respond to a full- structured, computer administered interview. Their responses will be compared to results faxed to a study coordinator by the evaluating clinician, permitting derivation of a scoring algorithm optomized for the greatest differential screening sensitivity and specificity. Public interest in and willingness to use this technology will be assessed by advertising the availability of the screening and referral modules through a toll-free telephone number. Caller volume and estimates of the number of individuals indicating contact with file IVR system at the referral sites will provide data for analysis. The long-term objective of this project is to facilitate initiation of dementia treatment earlier in the course of the disease, promoting preservation of functional independence and quality of life and delaying patient institutionalization. PROPOSED COMMERCIAL APPLICATION: Early identification and treatment referral of dementia patients will promote awareness and sales of antidementia pharmaceutical compounds. Manufacturers will thus be willing to support early detection and referral services. Treatment providers will also benefit from referrals and will be willing to subscribe to the service. Finally, social benefits of delaying costs associated with institutionalization would be a cost-effective investment of public funds for system support

This application proposes to develop two interactive voice response (IVR) products: Alzheimer's Early Recognition Telephone System (ALERTS) and Telephonic Remote Evaluation of Neuropsychological Deficits (TREND). Research results from a previous Phase I grant provide the conceptual and scientific foundations for these products. Two independent research projects are proposed. In collaboration with the Wisconsin Alzheimer's Institute, ALERTS content will be developed and statewide system implementation will be promoted and evaluated by a regionally disperse network of diagnostic clinics and local chapters of the Alzheimer's Association. Modules to be included in ALERTS will be: (1) educational information about dementia; (2) current treatments; (3) informant-based or individual direct screening; (4) caregiver support; and (5) local resource referral. If successful in promoting early detection and initiation of dementia treatment, ALERTS design will permit nationwide expansion and multilingual delivery. Continued support and system expansion would be beneficial to public health agencies, private patient advocacy groups, and the pharmaceutical industry. In collaboration with the NIA-funded Alzheimer's Disease Center at Stanford University, a 24-week longitudinal study of TREND will be conducted with 105 subjects (N=35 from elderly controls, mild cognitive impairment, mild dementia). TREND data will be compared to clinical assessments using both the cognitive and non-cognitive items of the Alzheimer's disease Assessment Scale (ADAS) to assess the reliability and validity of IVR automated monitoring of longitudinal changes in cognitive functioning. If successful, pharmaceutical companies could be provided the ability to collect reliable and valid data remotely with electronic storage of data for immediate availability during and after randomized clinical trials. TREND availability would permit frequent patient evaluation with fewer logistic difficulties than is currently possible. Such capabilities would promote more rapid submission of effective compounds to the Food and Drug Administration and reduce drug development cycles. Methodological proof-of-concept regarding IVR assessment of cognitive deficits would open new avenues for research into treatments of many disorders and diseases, such as schizophrenia, depression, Parkinson's disease, epilepsy, alcohol and other drug dependence, and stroke.

Thesaurus Terms:
Alzheimer's disease, cognition, computer assisted instruction, dementia, educational resource design /development, health care referral /consultation, health education, interactive multimedia, telecommunication brain disorder diagnosis, caregiver, computer assisted patient care, coping clinical research, human subject