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Decisional Informatics for Psychosocial Rehabilitation

2017; Lippincott Williams & Wilkins; Volume: 205; Issue: 11 Linguagem: Inglês

10.1097/nmd.0000000000000747

1539-736X

Jimmy Choi, Paul H. Lysaker, Morris D. Bell, Lisa B. Dixon, Paul J. Margolies, Matthew Gold, Elizabeth Golden-Roose, Warren Thime, Lawrence Haber, Michael J. Dewberry, Michael C. Stevens, Godfrey D. Pearlson, Joanna M. Fiszdon,

Mental Health and Psychiatry

This study introduces a computerized clinical decision-support tool, the Fluid Outpatient Rehabilitation Treatment (FORT), that incorporates individual and ever-evolving patient needs to guide clinicians in developing and updating treatment decisions in real-time. In this proof-of-concept feasibility pilot, FORT was compared against traditional treatment planning using similar behavioral therapies in 52 adults with severe mental illness attending community-based day treatment. At posttreatment and follow-up, group differences and moderate-to-large effect sizes favoring FORT were detected in social function, work readiness, self-esteem, working memory, processing speed, and mental flexibility. Of participants who identified obtaining a General Education Diploma as their goal, 73% in FORT passed the examination compared with 18% in traditional treatment planning. FORT was also associated with higher agency cost-effectiveness and a better average benefit-cost ratio, even when considering diagnosis, baseline symptoms, and education. Although the comparison groups were not completely equivalent, the findings suggest computerized decision support systems that collaborate with human decision-makers to personalize psychiatric rehabilitation and address critical decisions may have a role in improving treatment effectiveness and efficiency.