One of the most critical areas of progress for biotechnology is in diagnostics these days, and new diagnostic medical technology has captured a lot of attention because it's being used to streamline the diagnostic processes for the seemingly least likely health conditions. Now, new research adds autism to that list, and that opens the door to all sorts of diagnostic MedTech for neurological conditions. In India, where there is a very significant psychiatrist shortage, MedTech that enhances diagnoses for mental illness is incredibly valuable.
India's psychiatrist shortage means that mental illness often goes undiagnosed in rural areas, and patients, therefore, are less likely to get the right treatment for their conditions. A so-called "virtual psychiatrist," however, may actually change all of that. Indian researchers developed it specifically to fill this void, and they've found it more than sufficient for use by non-psychiatrists as an excellent means of achieving accurate self-diagnosis. They call it a clinical decision support system.
The CDSS is used not only for the diagnosis of psychiatric disorders but also for treatment to some degree. The research team that engineered it hail from the Postgraduate Institute of Medical Education and Research in its psychiatry department, based in Chandigarh. They've already field tested it in Jammu and Kashmir, as well as in Uttarakhand and Himachal Pradesh. They analyzed the reliability and accuracy of the CDSS's application from remote sites when they observed its use on the parts of non-psychiatrists who were only briefly given a rundown on how it works.
CDSS is knowledge-based, logical diagnostic MedTech. It has already proven its reliability to be "acceptable" if not "good," classifications experts have attributed to it to signify that it isn't perfect but that it accomplishes a great deal from which the national community and, perhaps the international community, can benefit. They compared the diagnoses done by non-psychiatrists with those done by specialists. "Our findings show that diagnostic tool of the telepsychiatry application has potential to empower non-psychiatrist doctors and paramedics to diagnose psychiatric disorders accurately and reliably in remote sites," according to the article published on the study in the Indian Journal of Medical Research.
CDSS covered 18 mental disorders that were most commonly observed: psychosis delirium, generalized anxiety disorder, depression, dysthymia, dementia, panic disorder, mania, obsessive-compulsive disorder, somato form disorder, phobias, dissociative disorder, severe stress response and adjustment disorder, alcohol dependence, neurasthenia, substance dependence, sexual dysfunctions and mental retardation. "Mental health care is mostly unavailable or inaccessible in most parts of the country. About 90 percent [of] patients in need of psychiatric treatment do not get it due to lack of psychiatrists. One system fills that gap by creating a virtual psychiatrist," according to lead researcher Savita Malhorta.
The lack of psychiatrists appears to be making India the leader in what might be a burgeoning trend in medical diagnostic technology worldwide. The US is already making similar progress but from a different angle, given that America isn't pressed by a dearth of psychologists to fill in any particular gap. Micah Mazurek, in fact, is a clinical psychologist and associate professor at the University of Virginia, and she's been laboring over a project in the Curry School of Education — a Virginia University college — that aims to teach and train primary care providers in her community to more efficiently diagnose autism. This comes in response to an abrupt uptick in autism according to a report from the US Centers for Disease Control and Prevention. It's no ordinary increase, measuring to the tune of 120 percent since 2002.
Mazurek just fielded several questions on the subject of her own research, which started back in 2015. These are questions like "Why is diagnosing autism a critical and sometimes frustrating process?" and "Can you tell us about the idea you had to help reduce the backlog?" She answered these questions with the results she currently has on hand in the context of an uptick in autism diagnoses so large that it is considered by many experts to be an indicator of autism diagnosis being particularly challenging and possibly inaccurate. "For children with autism," Mazurek answers in response to the first question, "early intervention is critically important. The earlier we can begin working with a child with autism, the better the outcome."
Mazurek adds that these interventions are important for improving autistic children's communication skills and social interaction capabilities as early as possible so that they aren't left behind by their peers. "In many cases, parents are already noticing signs of autism by age 1, and we can make a verifiable diagnosis by the age of 2. Yet the average age of diagnosis is between 4 and 6. This means that we are missing the most important window for intervention." She then goes on to explain her backlog mitigation idea inspired by Project ECHO, the innovative, virtual training model developed by the University of New Mexico's Dr. Sanjeev Arora to train physicians and nurses statewide to effectively treat hepatitis C. Mazurek is taking the same approach for virtually training non-psychiatrist physicians on how to diagnose and treat autism early.
"ECHO Autism connects local primary care providers to an interdisciplinary team of autism experts, using video conferencing technology," Mazurek explains. In other words, it's a model that takes advantage of the fact that experts in the field are not few or far between in the U.S. "In developing the model, we wanted to ensure that the expert 'hub' team was composed of members with essential types of expertise in autism."