Does the use of an automated tool for self-reporting mood by patients with bipolar disorder bias the collected data?
ABSTRACT Automating data collection from patients can improve data quality, enhance compliance, and decrease costs in longitudinal studies. About half of all households in industrialized countries now have a home computer.
While we previously validated the ChronoRecord software for self-reporting mood on a home computer with patients who have bipolar disorder, this study further investigates whether this technology created a bias in the collected data.
During the validation study, 80 of 96 (83%) patients returned 8662 days of data (mean, 114.7 +/- 32.3 SD days). The patients' demographics were compared with those of similar longitudinal studies in which patients used paper-based data collection tools. In addition, because demographic characteristics may influence attitudes toward technology, observer-rated scores on the Hamilton Depression Rating Scale and Young Mania Rating Scale were used to group patients by severity of illness, and the self-reported mood ratings were analyzed for evidence of bias from the patients' gender, ethnicity, diagnosis, age, disability status, or years of education. Analysis was performed using the 2-way analysis of variance and general linear model.
The patients' demographic characteristics were very similar to those of patients with bipolar disorder who participated in comparable longitudinal studies using paper-based tools. After grouping the patients by severity of illness, none of the demographic variables had a significant effect on the patients' self-reported mood using the automated tool.
The use of a computer does not seem to bias sample data. As with studies using paper-based self-reporting, results from studies of patients using ChronoRecord software on a home computer to report mood can be generalized.
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ABSTRACT: Bipolar disorder remains a serious public health problem with a significant personal and economic burden. In line with the widespread recognition of the value of active patient involvement in their care, daily mood charting may increase the patient's understanding of their condition and improve adherence with complex medication regimes. Knowledge about the course and pattern of an individual's disorder may also allow earlier recognition of new episodes and help determine the optimal treatment strategy. Mood charting is also an essential tool for longitudinal studies of patient outcomes. Traditionally, patients have used paper-based tools for this daily self-assessment, but these forms are associated with problems of data quality, poor compliance, high costs for data entry, and only provide limited feedback for the patient and physician. As computer technology has gained acceptance by the public worldwide, new options are available to automate monitoring of patients with mood disorders. This article will review mood charting and describe our experience with the development, validation and use of ChronoRecord, an automated instrument for mood charting.Current Psychiatry Reviews 10/2006; 2(4):423-429. DOI:10.2174/157340006778699747
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ABSTRACT: Mobile phones may provide a useful and engaging platform for supporting therapeutic services working with adolescents. This paper examines the potential benefits of the mobile phone for self-charting moods in comparison to existing methods in current practice. The paper describes a mobile phone application designed by the authors which allows adolescents to record moods on their personal mobile phones. The authors propose that a personal mobile device is more suitable for adolescents than other devices. A pilot study with a non-clinical adolescent group in schools comparing a mobile and a paper diary is presented, along with discussion and analysis of the results. The main finding of the study was that compliance was significantly higher on mobile phones than paper, and the task was not found to be any more difficult to complete using mobile phones than with paper charts. A number of salient issues requiring further research are also identified.British Journal of Guidance and Counselling 05/2008; 36(2):113-129. DOI:10.1080/03069880801926400 · 0.75 Impact Factor
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ABSTRACT: Longitudinal mood instability is the essential feature of bipolar disorder, however most rating scales are cross sectional in nature, and focus on acute symptoms. By contrast, the NIMH Life Chart Methodology (LCM) characterizes in detail the severity, duration, and frequency of mood episodes. Adherence to daily rating, however, tends to be low. In this study an online version of the LCM, designed to enhance adherence, was compared to the standard paper version. Patients from a mood disorders specialty clinic were randomized to the standard LCM or an online, open-source adaptation. The online version used hypertext links embedded in a daily email as the primary rating interface. Participants rated for 90 days. The total number of days rated and the number of days with complete data were compared for the two groups. Forty-eight patients participated in the study. The online group rated approximately twice as many days compared to the standard group (44.3 versus 20.4, p=.029). The online group also entered complete data for a larger portion of days (55.2% versus 27.7%, p=.039). This was a small, short-term study. The implications for longer-term rating are unclear. Despite the advantages of documenting mood fluctuation on a daily basis, the LCM is not commonly used, in part because ensuring adequate adherence can be resource intensive. An easily accessible online adaptation that utilizes email checking behavior can make this tool available to a wider range of patients.Journal of Affective Disorders 11/2009; 124(1-2):85-9. DOI:10.1016/j.jad.2009.10.019 · 3.71 Impact Factor