SBIR-STTR Award

The Diagnostic Interview Schedule for Children (DISC) has served as a gold-standard assessment for diagnosing DSM disorders in children and has been cited in over 805 peer reviewed publications. In 2015, the DSM-IV-TR was updated to DSM-5. While a gold standard instrument, the DISC-5 is also cumbersome: it is a 400-page document with over 4,000 text pieces and a complex branching pattern. An electronic version, the cDISC was once available for the DISC-IV, but the software is no longer functional. It was written on a software platform that can no longer be updated. Our objective is to develop a browser-based software program that will enable computer-assisted administration and scoring of the DISC-5, for use in both research studies and clinical practice. There will be two complementary versions: the NetDISC-5-Parent (P) for administration to parents on behalf of children and youths aged 6-17 and the NetDISC-5-Child (C) for administration to youths aged 10-17. Both instruments will be for administration by lay staff with minimal clinical experience. The software will provide complete scoring, generate user-friendly, individual-clinician reports, and all data will be easily exportable to SAS and SPSS. The NetDISC will run on our existing PORTAL 2.0 platform that was written in C# in a .net environment. The PORTAL platform already runs the NetSCID and Screening Assessment for Guiding Evaluation Self-Report (SAGE-SR) products, as well as the statewide outcomes-tracking systems in Tennessee and Louisiana. The NetDISC will enable users to: select any combination of DISC modules, choose current and/or lifetime sections, and turn on or off optional branching. It will have the ability to programmatically upload translated prompts. A progress bar will show administrators where they are in the survey. It will be possible to skip items, back up to earlier items, change responses, and go forward with new branching. The NetDISC will have hierarchical permission structure limiting access based on “need to know.” It will be possible to download data directly into a comma-delineated file format, SAS, and SPSS. It will send pretty, intuitive, individual clinical reports with a green, yellow, red alert system. It will have HIPAA compliant encrypted data storage with geo- redundant back up in at least two states, and the ability to transfer data to EHRs via HL7 and HFIR data transfer protocols. Reports will have a drill-down mode for optimal display of information. TeleSage will work closely with Prudence Fisher PhD, the author of the DISC-5, to convert the DISC-5 faithfully into the electronic NetDISC-5. We have planned out a rigorous testing and control system to assure accuracy and fidelity. The NetDISC will fit very well with our existing products: the adult NetSCID Research Version, Clinician Version, and Personality Disorders Version; the SAGE-SR, Clinician Modified, and Clinician Interview Versions; and our self-report Early Psychosis Screener. All our behavioral health diagnostic products would be marketed together for both research and clinical settings.

Public Health Relevance Statement:
Project Narrative The current research project plans to develop and test a cloud-based version of the Diagnostic Interview Schedule for Children-5 (DISC-5). Completion of this project will decrease training time, eliminate scoring and branching errors, increase the speed at which the DISC-5 can be translated to other languages, and create integrative diagnostic reports for the parent and youth versions of the DISC-5. Each of these improvements will ultimately assist clinicians and researchers in identifying childhood mental disorders.

Project Terms:
No Project Terms available.

Since 1982, through four versions, the Diagnostic Interview Schedule for Children (DISC) has served as a gold-standard assessment for diagnosing behavioral, DSM disorders in children aged 6 to 17. As a computer- assisted lay interview (LI) and more recently in a self-report (SR) format, the DISC-IV has been reliable, comparatively inexpensive to administer, and was cited in over 805 peer-reviewed publications. The DISC has been revised for the DSM-5 and now covers 37 diagnoses in 56 paired modules (28 for Youth, and 28 for Parents/guardians). As a highly structured, branched interview, the DISC is too complex to administer on paper. The computerized C-DISC-IV been obsolete for 4 years. To make the DISC available again with cutting-edge technological features, we need to build on our Phase 1 work. This will enable widespread DISC- 5 use in (1) routine primary care pediatrics, (2) routine behavioral healthcare, (3) juvenile justice, (4) K-12 school health programs, (5) general research, and (6) epidemiology research. There is growing evidence that identifying and treating psychopathology early -- during childhood -- may prevent or greatly lessen the severity of life-long mental illness and increase emotional and social wellbeing during adult life, lower health care costs, increase function, and, for children in juvenile justice, decrease the likelihood of future incarceration. Our successful Phase I project responded to a Centers for Disease Control (CDC) RFP for an electronic administration and reporting system for the core DISC-5 modules. TeleSage successfully fulfilled and surpassed its Phase I specific aims and criteria for success. We converted 28 core modules of the DISC-5 (14 youth and 14 parent) into two products, the core NetDISC-5-LI-Y and the NetDISC-LI-5-P. These have been thoroughly tested and are now being used by researchers. The CDC is interested in a Phase II project to complete development of the NetDISC-5 products to represent the full range of DSM-5 diagnoses, as well as to take advantage of the new functionality of cloud and browser-based computing, such as the real-time, high- quality text-to-speech functionality that we will use to develop computerized self-report versions of the DISC. The NetDISC-5 features will greatly increase the DISC’s potential impact in research and clinical practice. In this proposed two-year Phase II project, TeleSage will continue to work closely with Dr. Prudence Fisher, author of the DISC-5. In Quarter 1, the remaining 28 modules of the DISC-5 (14 Youth modules andamp;14 Parent modules) will be converted and programmed to complete the NetDISC-5-LI Y andamp; P. In Quarter 2, all 56 modules of the NetDISC-5-LI-Y andamp; P will be converted to make the self-report (SR) youth and parent instruments. During the middle 6 Quarters, the software will be tested via 800 paired LI and SR assessments. In Quarter 8, we will analyze data on reliability, as well as youth, parent, and clinician satisfaction. We will also release all four complete commercial products: NetDISC-5-Y-LI, NetDISC-5-P-LI, NetDISC-5-Y-SR, and NetDISC-5-P-SR.Project Narrative The gold standard Diagnostic Interview Schedule for Children (DISC)-IV was a highly structured diagnostic PC- based interview that was available in lay interview (LI) and audio enhanced self-report (SR) formats in both youth (Y) and parent (P) versions. This project proposes to create four cutting-edge, HIPAA compliant, cloud- based DISC-5 products. The NetDISC-5-LI-P, NetDISC-5-LI-Y, NetDISC-5-SR-P, and NetDISC-5-SR-Y) will be designed to promote accurate behavioral health diagnosis in(1) routine primary care pediatrics, (2) routine behavioral healthcare, (3) juvenile justice, (4) K-12 student health services, ( 5) Child Welfare services: (6) general research, and (7) epidemiology research settings.