MYnd Analytics Directed Therapy in Depression
2017년 11월 1일 업데이트: Cota Inc.
Randomized Trial Evaluating the Effectiveness of MYnd Analytics Directed Therapy in Depression
The MYnd Analytics PEER Online strategy utilizes EEG diagnostics to direct patients with psychiatric illnesses to the best medication treatments.
This trial will evaluate patients with a diagnosis of depression who will either receive (1) PEER Online directed therapy or (2) conventional treatment without EEG guidance and will compare 6 month clinical and economic outcomes between these groups.
연구 개요
상태
알려지지 않은
정황
상세 설명
Mynd Analytics has developed the Psychiatric Electroencephalography Evaluation Registry (PEER) Online® clinical decision support database that uses a combination of software, analytics, and clinical outcomes to provide objective, adjunctive medication response information to physicians treating patients with non-psychotic behavioral disorders. PEER Online uses a statistical analysis of EEG outputs and other patient information to generate a report that indicates the statistical likelihood of the patient's responsiveness to classes of central nervous system (CNS) medications (i.e. antidepressants), groups (i.e. SSRI) and individual agents (i.e. fluoxetine). A discriminant analysis compares neurophysiologic abnormalities of the patient to patterns of abnormalities of known responders to CNS drugs in the company's outcomes database of symptomatic patients. This provides a probability estimate of the similarity of the patient's profile with the profile of groups of individuals constituting the normative and clinical (symptomatic) database, which provides the treating physician guidance to which treatments the patient will most likely respond to, and those treatments to which the patient is least likely to respond.
Procedurally, PEER Online utilizes standard 21-lead digital electroencephalographic equipment measuring the patient in a resting (but awake) state. The recording generally takes 30-60 minutes. Patients are classified based upon the 1,142 variables calculated in the recording (FDA-approved neurometric system) and categorized based on the outcome history in treating patients with similar neurophysiologic outputs. From these outputs and the correlation to the outcome database, reports may indicate single or multiple medications based on the nature of the physiologic abnormality discovered. The entire procedure is rapid, non-invasive, devoid of radiation or high strength magnetic fields, and results in a report, the PEER Outcome Report that is provided to clinicians in a format similar to antibiotic sensitivity testing.
Study Design (summary)
- The patient population will consist of individuals with depression who in the opinion of their physician require medication management. A score of 10 or more on the PHQ-9 instrument will be required for enrollment. Non-psychotic co-morbid illnesses will be permitted. Patients must not currently be receiving psychotropic medications (including stimulants, benzodiazepines, or THC). Patients previously on these medications but off treatment for >30 days are permitted.
- The physician will declare whether they wish to treat the depression or refer to a participating psychiatrist. Individual physicians (prior to enrolling any patients) will be assigned to either agree to utilize MYnd Analytic directed care or to be part of the control cohort. This will minimize any physician learning effect.
- The patient will sign informed consent to participate.
- All patients will undergo a study related EEG and MYnd Analytics will develop a PEER Online report. The report will be released to the treating physicians in the directed care group but will not be released to the control physicians.
- All patients will complete a disease specific assessment tool (QIDS-SR16) at every office visit (at a minimum assessments at baseline, 3 months into treatment, and 6 months into treatment). Patients choosing to withdraw from the study or from treatment will also be offered the assessment at participation endpoint. COTA will score each patient based on the standardized tools as either improved, stable, or worsened. The primary endpoint for this study is QIDS-SR16 percent mean change from baseline, with response being defined as a reduction of >50% from baseline. Physicians may know the results of these tests and may alter therapy per their usual practice.
- Medication management will be at the final discretion of the treating physician. Physicians assigned to the MYnd Analytics directed care cohort will be encouraged, but not required, to follow the PEER Online report. Any change in therapy will be documented by the physician with reason (lack of efficacy, toxicity, patient preference).
연구 유형
중재적
등록 (예상)
600
단계
- 4단계
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 장소
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New Jersey
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Brick Township, New Jersey, 미국, 08723
- 모병
- Hackensack Meridian Health Network
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연락하다:
- Richard Reisher, DO
- 전화번호: 732-477-5600
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Brick Township, New Jersey, 미국, 08724
- 모병
- Hackensack Meridian Health Network
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연락하다:
- Jay Vida, DO
- 전화번호: 732-892-4548
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Hackensack, New Jersey, 미국, 07601
- 모병
- Hackensack Meridian Health Network
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연락하다:
- Arthur Chaney, MD
- 전화번호: 201-881-0721
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Holmdel, New Jersey, 미국, 07733
- 모병
- Hackensack Meridian Health Network
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연락하다:
- Anthony DeTulio, MD
- 전화번호: 732-264-8484
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Jackson, New Jersey, 미국, 08527
- 모병
- Hackensack Meridian Health Network
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연락하다:
- Scott Druckman, DO
- 전화번호: 732-987-5780
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Lodi, New Jersey, 미국, 07644
- 모병
- Hackensack Meridian Health Network
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연락하다:
- Aurora Andreescu, MD
- 전화번호: 973-473-3896
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Neptune City, New Jersey, 미국, 07753
- 모병
- Hackensack Meridian Health Network
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연락하다:
- Richard Abramowitz, MD
- 전화번호: 732-897-3990
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Oakhurst, New Jersey, 미국, 07755
- 모병
- Hackensack Meridian Health Network
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연락하다:
- John Ciciarelli, MD
- 전화번호: 732-663-0900
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Old Bridge, New Jersey, 미국, 08857
- 모병
- Hackensack Meridian Health Network
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연락하다:
- James Demos, MD
- 전화번호: 732-753-9890
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Paramus, New Jersey, 미국, 07652
- 모병
- Hackensack Meridian Health Network
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연락하다:
- Morey Menacker, DO
- 전화번호: 201-986-1881
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Point Pleasant, New Jersey, 미국, 08742
- 모병
- Hackensack Meridian Health Network
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연락하다:
- Richard Murachanian, MD
- 전화번호: 732-899-2353
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Saddle Brook, New Jersey, 미국, 07653
- 모병
- Hackensack Meridian Health Network
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연락하다:
- Mathew Silverman, DO
- 전화번호: 201-845-4048
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Tinton Falls, New Jersey, 미국, 07724
- 모병
- Hackensack Meridian Health Network
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연락하다:
- Robert Carracino, MD
- 전화번호: 732-450-0961
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Toms River, New Jersey, 미국, 08753
- 모병
- Hackensack Meridian Health Network
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연락하다:
- Brenard Wayman, MD
- 전화번호: 732-349-8866
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참여기준
연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.
자격 기준
공부할 수 있는 나이
18년 이상 (성인, 고령자)
건강한 자원 봉사자를 받아들입니다
아니
연구 대상 성별
모두
설명
Inclusion Criteria:
- Patients with a clinical diagnosis of depression who in the judgement of their physician require medication management may be eligible for enrollment. A score of 10 or more on the PHQ-9 instrument will be required for enrollment.
- Some practices utilize the PHQ-2 and PHQ-9 are part of routine screening for depression. If the tests are performed routinely, they do not need to be repeated for study eligibility, and may be performed prior to informed consent for this study. If, however, the PHQ-9 is not routinely performed, informed consent must be performed prior to administration. Patients with a score below 10 will be considered screen failures and will not be enrolled or offered the MYnd testing.
- Patients with non-psychotic comorbid conditions may be included.
- Patients must be either medication treatment naïve for behavioral illnesses or have no active medication treatments for at least 1 month prior to enrollment. Prohibited medications at the time of enrollment will include stimulants, benzodiazepines and THC. Prior therapy with these agents is permitted with a washout of >30 days.
- Patients must have private medical insurance coverage through Horizon Blue Cross Blue Shield. This is limited to insured commercial members, including HMO, and excluding, for the avoidance of doubt, members of self-insured customers or Medicare or Medicaid programs.
Exclusion Criteria:
- Diagnosis of a psychotic disorder.
- History of, or current, open head brain trauma. Candidates with any metal, shrapnel or other similar objects in the head that could affect the QEEG
- History of: craniotomy, cerebral metastases, cerebrovascular accident; current diagnosis of seizure disorder, schizophrenia, schizo-affective disorder, dementia, mental retardation, or major depression with psychotic features; or use of depot neuroleptics in last 12 months.
- Uncontrolled thyroid disorders.
- Known pregnancy and/or lactation, or intent to become pregnant during this study.
- Chronic or acute pain requiring prescription pain medication(s) (narcotic or synthetic narcotic)
- Participation in any other therapeutic drug study within 60 days preceding inclusion.
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 하나의
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: MYnd Analytics PEER Online directed therapy
Patients in this arm will receive anti-depressants as recommended by the PEER Online algorithm as described below.
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PEER Online is similar to a standard QEEG in that it uses QEEG output variables, but differs from a standard QEEG in that it references the QEEG to a normative and then symptomatic database.
By comparing a given patient's QEEG to a database of QEEGs of subjects who have tried and responded to a specific medication, PEER Online can provide useful information regarding the response of neuro-physiologically similar patients to a wide number of medications.
PEER Online may thus have the advantage of providing physicians with useful information as to medication outcomes before a medication regime is started.
It has also been used to help select the medication that best matches the QEEG brainwave pattern, regardless of "symptom clusters," currently used for diagnostic nomenclature.
Patients will receive anti-depressant therapy guide by the results of the PEER Online algorithm.
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가짜 비교기: Conventional therapy
Patients in this arm will receive anti-depressants as chosen by the physician without guidance by the PEER Online algorithm.
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Anti-depressant therapy chosen based on physician best judgement.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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50% Reduction From Baseline in Self-rated Severity of Depressive Symptoms as Measured by Quick Inventory of Depressive Symptomatology Self-Rated 16-item Scale (QIDS-SR-16)
기간: 6 months
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QIDS-SR-16 is a 16-question self-report inventory that includes the 9 Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) criteria symptom domains: sad mood, concentration, self-outlook, suicidal ideation, involvement, energy/fatigability, sleep disturbance (4 items: initial, middle, late insomnia, and hypersomnia), appetite/weight increased or decrease (4 items), and psychomotor agitation/retardation (2 items).
The QIDS-SR-16 total scores range from 0 (least severe) to 27 (most severe).
This study will examine the percentage of patients with improvement in depression as assessed by the QIDS-SR-16 at the 6 month treatment visit [repeated measures from all visits - for patients who received the intervention ie.
MD followed PEER recommended therapy].
Response will be defined as a >50% reduction in QIDS-SR-16 score from baseline.
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6 months
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Clinical improvement based on physician access to MyND Analytic PEER Online report.
기간: 6 months
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Percentage of patients improving on the standardized assessments stratified by whether the physician had access to the MyND Analytic PEER Online report.
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6 months
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Persistence of PEER recommended therapy.
기간: 3 months
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Percentage of patients remaining on PEER Online concordant therapy vs discordant therapy at the 3 month visit.
Sub-analysis will include whether the patient was on the original therapy or whether changes were made due to lack of efficacy or toxicity.
Switches in medications from a PEER recommended therapy to another recommended therapy based on a physician assessment of lack of efficacy will be counted as a failure, however a switch for toxicity will not be counted as failure.
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3 months
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기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Total cost of care.
기간: 6 months
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Total cost of care (all cause) for patients on PEER Online concordant therapy vs discordant therapy.
Sub-analysis will focus on total cost of care based on whether the physician had access to the PEER report.
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6 months
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Exploring use of Cota Nodal Address (CNA)
기간: 6 months
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CNA is a unique prognostic classification schema.
All patients will undergo classification at time of diagnosis and exploratory analysis for patterns of responsiveness will be undertaken.
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6 months
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공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
스폰서
수사관
- 수석 연구원: Ramon Solhkhah, MD, Hackensack Meridian Health
간행물 및 유용한 링크
연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.
유용한 링크
연구 기록 날짜
이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.
연구 주요 날짜
연구 시작 (실제)
2017년 10월 1일
기본 완료 (예상)
2020년 10월 1일
연구 완료 (예상)
2020년 10월 1일
연구 등록 날짜
최초 제출
2017년 10월 27일
QC 기준을 충족하는 최초 제출
2017년 10월 27일
처음 게시됨 (실제)
2017년 11월 1일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2017년 11월 6일
QC 기준을 충족하는 마지막 업데이트 제출
2017년 11월 1일
마지막으로 확인됨
2017년 11월 1일
추가 정보
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .