Innovations In Clinical Neuroscience

CNS Summit 2016

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

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[ V O L U M E 1 4 , N U M B E R 1 – 2 , J A N U A R Y – F E B R U A R Y 2 0 1 7 , S U P P L E M E N T ] Innovations in CLINICAL NEUROSCIENCE S17 employed by TeleSage, Inc. as a clinical research specialist. P atients with psychiatric diagnoses indicate willingness to report suicidal ideation and behavior more honestly by self-report than in face-to-face interviews P resenters: Yamamoto R 1 , Durand E 1 , Khurana L 1 , Tuller J 2 , Yershova K 2 , Dallabrida S 1 Affiliations: 1 ERT Corp., New York, New York; 2 Columbia University/New York State Psychiatric Institute, New York, New York Objective: Detection of honest/ accurate patient experiences with suicidal ideation and behavior (SIB) is critical to patient safety and to determining drug efficacy and safety. Herein, psychiatric patients were asked about the situations in which they would be most likely to honestly report their SIB. Design: Patients (recruited via Clinical Connection) who reported at least one psychiatric diagnosis (depression, generalized anxiety disorder, bipolar disorder, alcohol/drug addiction, or schizophrenia) and previously answered questions at a clinic visit about having thoughts of suicide/acts of self-harm were asked in which situation they would be most likely to honestly report their SIB. Results: Ninety-two percent of the patients (n=63, ages 18–60, 68% female) indicated that they would be more likely to honestly report SIB using electronic self-report assessments versus 74 percent of these same patients who indicated they would be likely to be honest during an in-person interview at a clinic visit. In psychiatric patients who truly exhibit SIB, the relative risk (ratio of proportion of risk between groups) that clinicians will miss SIB during face- to-face interviews is 3.37 times higher than using electronic self-report assessments (p=0.0225, 95% confidence interval 1.1866–9.5730). The odds ratio (probability of missing SIB) that a patient would not be honest reporting SIB in-person is 4.2 times greater than the odds that a patient would not be honest reporting SIB electronically (p<0.02). Conclusion: These data suggest that psychiatric patients who have experience completing SIB assessments are more l ikely to respond honestly to future questions about SIB via electronic self- report assessments. Disclosures/funding: Drs. Yamamoto, Durand, and Dallabrida and Ms. Khurana a nd Tuller are employees of ERT Corp. Dr. Yershova is an employee of Columbia University/New York State Psychiatric Institute, New York, New York. Translation of the National Institutes of Health Stroke Scale (NIHSS) list of words: methodology and challenges Presenters: Vasarri S 1 , Veal L 1 , Anfray C 2 , Emery M 2 Affiliations: 1 Mapi Language Services, Lyon, France; 2 Mapi Research Trust, Lyon, France Objective: The NIHSS was developed to assess stroke severity across 11 categories. Dysarthria is evaluated with a list of six terms, each one exploring different lips and tongue movements: mama, tip-top, fifty-fifty, thanks, huckleberry, and baseball player. The objective of our study was to present the methodology used to translate these words into Canadian French, Bulgarian, Korean, and American Spanish, and the resulting outcomes. The aim was not to find conceptual equivalents but words testing the same difficulties in articulation and using similar phonological characteristics as the original terms. Design: In each country, a thorough translation was performed with a neurologist and a speech therapist. The suggested words were then validated by an expert panel. Results: Only one word—mama—was translated literally in all languages, the pronunciation being similar. The translation of tip-top used satisfactory phonological equivalents in all languages. Thanks was difficult to translate because the sound ("th" [ð]) does not exist in the target languages. Equivalent words allowing measuring the weakness of the tongue were used. Fifty-fifty was rendered completely differently in Korean, since the fricative sound (f) does not exist in this language. The Korean translation of huckleberry could not contain all the original sounds. As for baseball player, this terms was referred to as baseball in Canadian French and Bulgarian. Conclusion: Finding phonological e quivalents to terms used to assess dysarthria was challenging and needed the collaboration of speech therapists and neurologists in each target language. Korean was the most c hallenging lanaguage due mainly to the absence of equivalent sounds. Disclosures/funding: None reported. PLACEBO RESPONSE Factors associated with response rate in inpatient schizophrenic participants Presenters: Tireman E, Templeton K, Kakar R Affiliations: All authors are from Segal Institute for Clinical Research, Fort Lauderdale, Florida. Background: Identifying appropriate patients for inpatient clinical trials can be challenging due to a number of factors. Placebo response and early response are factors that hinder the outcomes of clinical trials and often lead to many failed trials or lack of separation data. Demographics, number of prior hospitalizations, and previous participation in clinical trials may all influence how patients respond to treatment and their success in completing a trial. Currently, there limited research assessing factors associated with early response patterns and placebo response in relation to level of change on primary efficacy outcome measures. Recent research has been evaluating the relationship between demographics (gender and body mass index [BMI]), lifetime hospitalizations, and placebo response. The ideal patient has been described as younger in age with limited number of lifetime hospitalizations or previous clinical trial experience. Current discussions among rating professionals suggest that older male subjects with a higher BMI, greater number of lifetime hospitalizations and/or exposure to clinical trial procedures will demonstrate a greater difference in Positive and Negative Syndrome Scale (PANSS) scores beginning earlier in the trial. These individuals are likelier to have a higher placebo response rate and often times

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