Online Outcome Measures for Depression: One More Reason to Toss Your Pencil and Paper?

How regularly do you use outcome measures to assess how well your patients with depression are doing? Research suggests many psychiatrists avoid such measures, believing that they are aren’t trained to use them; that they take too much time; or that they aren’t clinically helpful.¹

Would you be more inclined to use an outcome measure if your patient could complete it online in less than 3 minutes, if it could be scored under 15 seconds, and if the results were emailed directly to you? If results presented by researchers from Brown Medical School at a poster session at the ongoing APA in New Orleans are any indication, your answer might be yes.

Mark Zimmerman, MD and Janine Galione, BA tested the effectiveness of a Web-based version of the Clinically Useful Depression Outcome Scale (CUDOS-W). Their research poster demonstrated reliability, validity, and patient acceptance of the CUDOS-W in 46 outpatients undergoing treatment for depression. The scale covers DSM-IV symptoms of major depressive disorder and has been tested in a paper-and-pencil version as well. The poster highlighted the advantages of using a Web-based assessment over paper-and-pencil versions-including patient convenience, fewer missing data, reduction in cost, automatic scoring, automatic database generation, and aggregation of data across patients.

The researchers found that internal consistency, item-scale correlations (such as depressed mood, decreased interest in usual activities, decreased/increased appetite), and correlations with external validators (such as the Motgomery-Asberg Depression Rating Scale and the Clinical Global Index of Depression Severity) were as high with the CUDOS-W as with the paper-and-pencil version. Patients preferred to complete the CUDOS-W because it was “less burdensome, less time consuming, more secure, and more accurate and valid.”

To complete the CUDOS-W, patients are given a Web site address and are required to register on the site, indicating the date and time of their next appointment. Patients receive an automatic reminder 48 hours prior to their appointment, which also directs them to complete the CUDOS-W. After the form is complete, it is emailed to the physician. Zimmerman hopes that using scale will make regular appointments more productive because it will free up time for other aspects of care.¹

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Reference

1. Smith M. APA: Psychiatrists Shrink from Outcome Measures in Depression. MedPageToday.com. Available: http://www.medpagetoday.com/MeetingCoverage/APA/9398. Accessed: May 24, 2010.