PDF(Pubmed)
Abstract：
In contrast to the validated scales for face-to-face assessment of negative symptoms, no widely accepted tools currently exist for remote monitoring of negative symptoms. Remote assessment of negative symptoms can be broadly divided into 3 categories: (1) remote administration of an existing negative-symptom scale by a clinician, in real time, using videoconference technology to communicate with the patient; (2) direct inference of negative symptoms through detection and analysis of the patient\'s voice, appearance, or activity by way of the patient\'s smartphone or other device; and (3) ecological momentary assessment, in which the patient self-reports their condition upon receipt of periodic prompts from a smartphone or other device during their daily routine. These modalities vary in cost, technological complexity, and applicability to the different negative-symptom domains. Each modality has unique strengths, weaknesses, and issues with validation. As a result, an optimal solution may be more likely to employ several techniques than to use a single tool. For remote assessment of negative symptoms to be adopted as primary or secondary endpoints in regulated clinical trials, appropriate psychometric standards will need to be met. Standards for substituting 1 set of measures for another, as well as what constitutes a \"gold\" reference standard, will need to be precisely defined and a process for defining them developed. Despite over 4 decades of progress toward this goal, significant work remains to be done before clinical trials addressing negative symptoms can utilize remotely assessed secondary or primary outcome measures.
摘要：
与经过验证的阴性症状面对面评估量表相反，目前没有广泛接受的工具用于远程监测阴性症状.对阴性症状的远程评估大致可分为3类：（1）由临床医生对现有阴性症状量表进行远程管理，实时,使用视频会议技术与患者进行沟通；（2）通过检测和分析患者的声音，直接推断阴性症状，外观,或通过患者的智能手机或其他设备进行活动；和(3)生态瞬时评估，患者在日常生活中收到来自智能手机或其他设备的定期提示时自我报告他们的状况。这些模式的成本各不相同，技术复杂性,以及对不同阴性症状领域的适用性。每种模式都有独特的优势，弱点,和验证问题。因此,与使用单一工具相比，最佳解决方案可能更有可能采用多种技术。为了远程评估阴性症状，将其作为受监管临床试验的主要或次要终点，需要满足适当的心理测量标准。用一套措施代替另一套措施的标准，以及构成“黄金”参考标准的内容，将需要精确定义，并开发定义它们的过程。尽管在实现这一目标方面取得了超过40年的进展，在针对阴性症状的临床试验可以利用远程评估的次要或主要结局指标之前,仍有大量工作要做.
