Virtual neuro-psychological testing protocol

• US 20030167149A1
• Filed: 02/19/2003
• Published: 09/04/2003
• Est. Priority Date: 09/07/2000
• Status: Active Grant

• Current Assignee: Neuro TRAX Corporation
• Original Assignee: Neuro TRAX Corporation
• Inventors: Simon, Ely
• Granted Patent: US 6,820,037 B2
• Time in Patent Office: Days
• US Class Current: 702/182
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/16 Devices for psychotechnics using teaching or educational appliances G09B1/00 - G09B7/00; Testing reaction times ; Devices for evaluating the psychological state
• CPC Class Codes: A61B 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/4082 Diagnosing or monitoring movement diseases, e.g. Parkinson, Huntington or Tourette
• CPC Class Codes: A61B 5/4088 Diagnosing of monitoring cognitive diseases, e.g. Alzheimer, prion diseases or dementia

Abstract

The present invention software driven protocol for managing a virtual clinical neuro-psychological testing program delivers, to individual or small groups of certified Neuro-psychology professionals, an interface protocol for clinically monitoring and managing the neuro-psychological needs of very large numbers of individual patients. The preferred approach to such monitoring and testing, is within the scope of normal and routine activities. These patients are most often in need of regular testing, screening, and monitoring and, only occasionally, of referral or intervention. The protocol provides a majority of patients, with regular testing, screening, and monitoring services on a “virtual-out-patient” basis by interactively delivering individually configured batteries of tests to each patient; via the Internet. These tests include normal activity observation and monitoring. The delivery and respectively corresponding acceptance of the testing batteries is a substantially automatically scheduled feature of the protocol.

Claims

1. A software driven protocol for managing a virtual clinical neuro-psychological testing program, the protocol including for each client of a plurality of clients the steps:

a) evaluating of a prior history of the client;

b) according to the evaluated prior history, forming an appropriate battery of tests for testing the client wherein said battery incorporates pseudo-randomization of at least one representational or organizational parameter;

c) via a data-communications medium, interactively

i. delivering, to the client, the formed battery of tests, and

ii. accepting, from the client, a substantially completed response to the delivered formed battery of tests;

d) analyzing the accepted response; and

e) into the prior history of the client, integrating

i. the accepted substantially completed response or

ii. at least one analytical metric thereof.

2. The protocol according to claim 1 wherein forming an appropriate battery of tests includes choosing at least two tests for measuring at least one mental or motor function, and the tests are selected from the list of testing instruments for measuring:

mental health, intelligence, IQ, memory, immediate recall, memory encoding, memory retrieval, working memory, semantic memory, procedural learning, sequence learning, conditioned response, Pavlovian learning, associative learning, implicit learning, explicit learning, block learning, motor learning, pattern matching, judgment, attention, concentration, visual-spatial perception, velocity perception, distance perception, visual searching, calculational ability, mathematical ability, abstract thinking, symbolic thinking, adaptation, sensory-motor adaptation, language, reading, naming, comprehension, classification, direction-following, vigilance, motor, sensory-motor, coordination, psychomotor performance, dexterity, motor skills, tremor, physiological tremor, simple reaction time, choice reaction time, sustained attention, selected attention, divided attention, driving safety, ballistic movement, bradykinesia, hypokinesia, akinesia, hypometria, movement speed, movement smoothness, movement accuracy, repetitive movement, accurately timed movements, bimanual coordination, hand-eye coordination, personality, scholastic performance, depression, psychosis, neurosis, anxiety, stress, post-traumatic stress, dementia, static visual acuity, dynamic visual acuity, handwriting analysis, speech analysis, voice tremor, or metrics of interacting with a testing instrument.

3. The protocol according to claim 1 wherein forming includes for at least one test in the battery of tests defining a subset of equivalent validation of testing objects and therein pseudo randomization includes randomizing amongst the substantially validated testing objects.

4. The protocol according to claim 1 wherein evaluating includes a disclosure of information by the client.

5. The protocol according to claim 1 wherein evaluating of a prior history of the client includes:

interactively merging practitioner recommendations for this client into the prior history.

6. The protocol according to claim 1 further including the step of scheduling a next evaluating of a prior history of the client.

7. The protocol according to claim 1 wherein analyzing the accepted response includes:

calculating an analytical metric of client performance using the accepted response in the formed battery of tests of at least one client performance parameter from the accepted response of a test in the formed battery of tests.

8. The protocol according to claim 1 wherein analyzing the accepted response includes:

calculating an analytical metric of client performance using the accepted response in the formed battery of tests of at least one convergence parameter from the accepted response of at least two tests in the formed battery of tests.

9. The protocol according to claim 1 wherein analyzing the accepted response includes for a client:

applying a rule-based criteria for quantifying at least one difference between a pair of metrics selected from the list;

a) the evaluated prior history of the client;

b) a metric of expected performance on at least one test of the formed battery of tests;

c) actual performance on at least one test of the formed battery of tests; and

d) normative values based on large body of data for at least one test of the formed battery of tests.

10. The protocol according to claim 1 wherein a test of the delivered and accepted formed battery of tests includes a metric of the clients interaction with a client'"'"'s peripheral device, and the device is selected from the list:

Color graphic display;

B/W graphic display;

Audio speaker;

Audio stereophonic headphones;

Mouse;

Joystick;

Roller-ball;

Keyboard;

Galvanic skin response monitor;

Web-cam camera;

Microphone;

personal communication device, Touch pad;

or Touch screen.

37. The protocol according to claim 1 further includes the steps of:

a) establishing, upgrading and maintaining as appropriate, a validity metric for a substantially non-validated test, for each client of an ensemble of clients;

b) introducing a substantially non-validated test into the formed battery of tests;

c) analyzing responses to the substantially non-validated tests; and

d) correlating responses with the responses from the other tests in the formed battery of tests.

38. The clinical protocol for normal-use activities according to claim 37, wherein establishing, upgrading and maintaining include:

a) for substantially each client in an ensemble of clients, monitoring at least one metric of normal-use activities;

b) for substantially each metric of the at least one metric of normal use activities, until a predetermined threshold of validation is achieved for an ensemble of clients, first managing a virtual clinical neuro-psychological testing program for substantially each client in the ensemble; and

correlating analytical metrics derived from the neuro-psychological testing program with the monitored metrics of normal-use activities, thereby validating at least one of the monitored metrics of normal-use activities as a neuro-psychological metric; and

c) for substantially each validated metric of the at least one metric of normal use activities, second managing a virtual clinical neuro-psychological testing program for at least one client wherein a validated normal-use activity metric is used as a classical testing instrument.

39. The clinical protocol for normal-use activities according to claim 38 wherein for substantially each client in an ensemble of clients, monitoring at least one metric of normal-use activities includes downloading a plug-in to the client'"'"'s machine, installing plug-ins, uploading data collected by the plug-in.

40. The clinical protocol according to claim 38 wherein a metric of normal use activity of the monitored at least one metric of normal use activities is calculated by measuring an activity selected from the list of copying, printing, pasting, editing, inserting, formatting, exchanging tasks, web surfing, backspacing, deleting and shifting.

41. The clinical protocol for normal-use activities according to claim 38 wherein for substantially each client in an ensemble of clients, monitoring at least one metric of normal-use activities includes copying, pasting, editing, inserting, formatting, backspacing, deleting, shifting and web surfing.

42. The clinical protocol according to claim 38 wherein for substantially each client in an ensemble of clients, monitoring at least one metric of normal-use activities includes computer related interactivity, wireless activity, voice prints frequency analysis, mouse tremor, Geographic Positioning System tremor, key strokes, and special case use.

43. The clinical protocol for normal-use activities according to claim 38 wherein that first managing and second managing include the steps:

a) evaluating of a prior history of the client;

b) according to the evaluated prior history, forming an appropriate battery of tests for testing the client wherein said battery incorporates pseudo-randomization of at least one representational or organizational parameter;

c) via a data-communications medium, interactively

i. delivering, to the client, the formed battery of tests, and

ii. accepting, from the client, a substantially completed response to the delivered formed battery of tests;

d) analyzing the accepted response; and

e) into the prior history of the client, integrating

i. the accepted substantially completed response or

ii. at least one analytical metric thereof.

11. A clinical protocol for normal-use activities, the protocol including the steps of:

a) for substantially each client in an ensemble of clients, monitoring at least one metric of normal-use activities;

b) for substantially each metric of the at least one metric of normal use activities, until a predetermined threshold of validation is achieved for an ensemble of clients, first managing a virtual clinical neuro-psychological testing program for substantially each client in the ensemble; and

correlating analytical metrics derived from the neuro-psychological testing program with the monitored metrics of normal-use activities, thereby validating at least one of the monitored metrics of normal-use activities as a neuro-psychological metric; and

c) for substantially each validated metric of the at least one metric of normal use activities, second managing a virtual clinical neuro-psychological testing program for at least one client wherein a validated normal-use activity metric is used as a classical testing instrument.

12. The clinical protocol according to claim 11 wherein for substantially each client in an ensemble of clients, monitoring at least one metric of normal-use activities includes downloading a plug-in to the client'"'"'s machine, installing the plug-in, or uploading data collected by the plug-in.

13. The clinical protocol according to claim 11 wherein a metric of normal use activity of the monitored at least one metric of normal use activities is calculated by measuring an activity selected from the list of copying, printing, pasting, editing, inserting, formatting, exchanging tasks, web surfing, backspacing, deleting or shifting.

14. The clinical protocol according to claim 11 wherein for substantially each client in an ensemble of clients, monitoring at least one metric of normal-use activities includes, copying, pasting, editing, inserting, formatting, exchanging tasks, web surfing, backspacing, deleting or shifting.

15. The clinical protocol according to claim 11 wherein for substantially each client in an ensemble of clients, monitoring at least one metric of normal-use activities includes computer related interactivity, wireless activity, voice prints frequency analysis, mouse tremor, Geographic Positioning System tremor, key strokes, or special case use.

16. The clinical protocol for normal-use activities according to claim 11 wherein that first managing and second managing include the steps:

a) evaluating of a prior history of the client;

b) according to the evaluated prior history, forming an appropriate battery of tests wherein said battery incorporates pseudo-randomization of at least one representational or organizational parameter;

c) via a data-communications system, interactively

i. delivering, to the client, the formed battery of tests, and

ii. accepting, from the client, a substantially completed response to the delivered formed battery of tests;

d) analyzing the accepted response; and

e) into the prior testing history of the client, integrating

i. the accepted substantially completed response or

ii. at least one analytical metric thereof.

17. The protocol according to claim 16 wherein forming an appropriate battery of tests includes choosing at least two tests for measuring at least one mental or motor function, and the tests are selected from the list of testing instruments for measuring:

mental health, intelligence, IQ, memory, immediate recall, memory encoding, memory retrieval, working memory, semantic memory, procedural learning, sequence learning, conditioned response, Pavlovian learning, associative learning, implicit learning, explicit learning, block learning, motor learning, pattern matching, judgment, attention, concentration, visual-spatial perception, velocity perception, distance perception, visual searching, calculational ability, mathematical ability, abstract thinking, symbolic thinking, adaptation, sensory-motor adaptation, language, reading, naming, comprehension, classification, direction-following, vigilance, motor, sensory-motor, coordination, psychomotor performance, dexterity, motor skills, tremor, physiological tremor, simple reaction time, choice reaction time, sustained attention, selected attention, divided attention, driving safety, ballistic movement, bradykinesia, hypokinesia, akinesia, hypometria, movement speed, movement smoothness, movement accuracy, repetitive movement, accurately timed movements, bimanual coordination, hand-eye coordination, personality, scholastic performance, depression, psychosis, neurosis, anxiety, stress, post-traumatic stress, dementia, static visual acuity, dynamic visual acuity, handwriting analysis, speech analysis, voice tremor, or metrics of interacting with a testing instrument.

18. The protocol according to claim 16 wherein forming includes for at least one test in the battery of tests defining a subset of equivalent validation of testing objects and therein pseudo randomization includes randomizing amongst the substantially validated testing objects.

19. The protocol according to claim 16 wherein evaluating includes a disclosure of information by the client.

20. The protocol according to claim 16 wherein evaluating of a prior history of the client includes:

interactively merging practitioner recommendations for this client into the prior history.

21. The protocol according to claim 16 further including the step of scheduling a next evaluating of a prior history of the client.

22. The protocol according to claim 16 wherein analyzing the accepted response includes:

calculating an analytical metric of client'"'"'s performance using the accepted response in the formed battery of tests of at least one client performance parameter from the accepted response of a test in the formed battery of tests.

23. The protocol according to claim 16 wherein analyzing the accepted response includes:

calculating an analytical metric of client'"'"'s performance using the accepted response in the formed battery of tests of at least one convergence parameter from the accepted response of at least two tests in the formed battery of tests.

24. The protocol according to claim 16 wherein analyzing the accepted response includes for a client:

applying a rule-based criteria for quantifying at least one difference between a pair of metrics selected from the list;

a) the evaluated prior history of the client;

b) a metric of expected performance on at least one test of the formed battery of tests;

c) actual performance on at least one test of the formed battery of tests; and

d) normative values based on large body of data for at least one test of the formed battery of tests.

25. The protocol according to claim 16 wherein a test of the delivered and accepted formed battery of tests includes a metric of the clients interaction with a client'"'"'s peripheral device, and the device is selected from the list:

Color graphic display;

B/W graphic display;

Audio speaker;

Audio stereophonic headphones;

Mouse;

Joystick;

Roller-ball;

Keyboard;

Galvanic skin response monitor;

Web-cam camera;

Microphone;

personal communication device, Touch pad;

or Touch screen.

26. The clinical protocol for validating a new testing instrument according to claim 11 wherein first managing and second managing include the steps:

a) evaluating of a prior history of the client;

b) according to the evaluated prior history, forming an appropriate battery of tests for testing the client wherein said battery incorporates pseudo-randomization of at least one representational or organizational parameter;

c) via a data-communications medium, interactively

i. delivering, to the client, the formed battery of tests, and

ii. accepting, from the client, a substantially completed response to the delivered formed battery of tests;

d) analyzing the accepted response; and

e) into the prior history of the client, integrating

i. the accepted substantially completed response or

ii. at least one analytical metric thereof.

27. A software driven protocol for managing a virtual clinical neuro-psychological dynamic hierarchical testing program, the protocol including for each client of a plurality of clients the steps:

a) evaluating of a prior history of the client;

b) according to the evaluated prior history,

i. interactively forming an appropriate battery of tests for testing the client wherein said battery incorporates pseudo-randomization of at least one representational or organizational parameter,

ii. via a data-communications medium, interactively delivering, to the client, the formed battery of tests,

iii. accepting, from the client, a substantially completed response to the delivered formed battery of tests,

iv. analyzing the accepted response, and

v. returning to step b)i until complete; and

c) into the prior history of the client, integrating

i. the accepted substantially completed response or

ii. at least one analytical metric thereof.

28. The protocol according to claim 27 wherein forming an appropriate battery of tests includes choosing at least two tests for measuring at least one mental or motor function, and the tests are selected from the list of testing instruments for measuring:

mental health, intelligence, IQ, memory, immediate recall, memory encoding, memory retrieval, working memory, semantic memory, procedural learning, sequence learning, conditioned response, Pavlovian learning, associative learning, implicit learning, explicit learning, block learning, motor learning, pattern matching, judgment, attention, concentration, visual-spatial perception, velocity perception, distance perception, visual searching, calculational ability, mathematical ability, abstract thinking, symbolic thinking, adaptation, sensory-motor adaptation, language, reading, naming, comprehension, classification, direction-following, vigilance, motor, sensory-motor, coordination, psychomotor performance, dexterity, motor skills, tremor, physiological tremor, simple reaction time, choice reaction time, sustained attention, selected attention, divided attention, driving safety, ballistic movement, bradykinesia, hypokinesia, akinesia, hypometria, movement speed, movement smoothness, movement accuracy, repetitive movement, accurately timed movements, bimanual coordination, hand-eye coordination, personality, scholastic performance, depression, psychosis, neurosis, anxiety, stress, post-traumatic stress, dementia, static visual acuity, dynamic visual acuity, handwriting analysis, speech analysis, voice tremor, or metrics of interacting with a testing instrument.

29. The protocol according to claim 27 wherein forming includes for at least one test in the battery of tests defining a subset of equivalent validation of testing objects and therein pseudo randomization includes randomizing amongst the substantially validated testing objects.

30. The protocol according to claim 27 wherein evaluating includes a disclosure of information by the client.

31. The protocol according to claim 27 wherein evaluating of a prior history of the client includes:

interactively merging practitioner recommendations for this client into the prior history.

32. The protocol according to claim 27 further including the step of scheduling a next evaluating of a prior history of the client.

33. The protocol according to claim 27 wherein analyzing the accepted response includes:

calculating an analytical metric of client performance using the accepted response in the formed battery of tests of at least one client performance parameter from the accepted response of a test in the formed battery of tests.

34. The protocol according to claim 27 wherein analyzing the accepted response includes:

calculating an analytical metric of client performance using the accepted response in the formed battery of tests of at least one of at least one convergence parameter from the accepted response of at least two tests in the formed battery of tests.

35. The protocol according to claim 27 wherein analyzing the accepted response includes for a client, applying a rule-based criteria for quantifying at least one difference between a pair of metrics selected from the list:

a) the evaluated prior history of the client;

b) a metric of expected performance on at least one test of the formed battery of tests;

c) actual performance on at least one test of the formed battery of tests; and

d) normative values based on large body of data for at least one test of the formed battery of tests.

36. The protocol according to claim 27 wherein a test of the delivered and accepted formed battery of tests includes a metric of the clients interaction with a client'"'"'s peripheral device, and the device is selected from the list:

Color graphic display;

B/W graphic display;

Audio speaker;

Audio stereophonic headphones;

Mouse;

Joystick;

Roller-ball;

Keyboard;

Galvanic skin response monitor;

Web-cam camera;

Microphone;

personal communications device, Touch pad;

or Touch screen.

56. The clinical protocol according to claim 44 wherein for substantially each client in an ensemble of clients, monitoring at least one metric of normal-use activities includes computer related interactivity, wireless activity, voice prints frequency analysis, mouse tremor, Geographic Positioning System tremor, key strokes, or special case use.

The protocol according to claim 27 further includes the steps of:

a) establishing, upgrading and maintaining as appropriate, a validity metric for a substantially non-validated test, for each client of an ensemble of clients;

b) introducing a substantially non-validated test into the formed battery of tests;

c) analyzing responses to the substantially non-validated tests; and

d) correlating responses with the responses from the other tests in the formed battery of tests.

44. A software driven protocol for managing a virtual clinical neuro-psychological testing program based on normal use activities, the protocol including for each client of a plurality of clients the steps:

a) evaluating of a prior history of the client;

b) according to the evaluated prior history, forming at least one normal use activity factor of tests for testing the client wherein said at least one normal use activity factor incorporates pseudo-randomization of at least one representational or organizational parameter;

c) via a data-communications medium, interactively

i. delivering the formed at least one normal use activity factor tests to the client,

ii. the client substantially completing the normal use activity factor tests, and

iii. accepting, from the client, a substantially completed response to the delivered normal use activity factor tests;

d) analyzing the accepted response; and

e) into the prior history of the client, integrating

i. the accepted substantially completed response or

ii. at least one analytical metric thereof.

45. The protocol according to claim 44 wherein forming an appropriate battery of tests includes choosing at least two tests for measuring at least one mental or motor function, and the tests are selected from the list of testing instruments for measuring:

mental health, intelligence, IQ, memory, immediate recall, memory encoding, memory retrieval, working memory, semantic memory, procedural learning, sequence learning, conditioned response, Pavlovian learning, associative learning, implicit learning, explicit learning, block learning, motor learning, pattern matching, judgment, attention, concentration, visual-spatial perception, velocity perception, distance perception, visual searching, calculational ability, mathematical ability, abstract thinking, symbolic thinking, adaptation, sensory-motor adaptation, language, reading, naming, comprehension, classification, direction-following, vigilance, motor, sensory-motor, coordination, psychomotor performance, dexterity, motor skills, tremor, physiological tremor, simple reaction time, choice reaction time, sustained attention, selected attention, divided attention, driving safety, ballistic movement, bradykinesia, hypokinesia, akinesia, hypometria, movement speed, movement smoothness, movement accuracy, repetitive movement, accurately timed movements, bimanual coordination, hand-eye coordination, personality, scholastic performance, depression, dynamic visual acuity, handwriting analysis, speech analysis, voice tremor, or metrics of interacting with a testing instrument.

46. The protocol according to claim 44 wherein forming includes for at least one test in the battery of tests defining a subset of equivalent validation of testing objects and therein pseudo randomization includes randomizing amongst the substantially validated testing objects.

47. The protocol according to claim 44 wherein evaluating includes a disclosure of information by the client.

48. The protocol according to claim 44 wherein evaluating of a prior history of the client, includes interactively merging practitioner recommendations for this client into the prior history.

49. The protocol according to claim 44 further including the step of scheduling a next evaluating of a prior history of the client.

50. The protocol according to claim 44 wherein analyzing the accepted response includes:

calculating an analytical metric of client performance using the accepted response in the formed battery of tests of at least one client performance parameter from the accepted response of a test in the formed battery of tests.

51. The protocol according to claim 44 wherein analyzing the accepted response includes:

calculating an analytical metric of client performance using the accepted response in the formed battery of tests of at least one convergence parameter from the accepted response of at least two tests in the formed battery of tests.

52. The protocol according to claim 44 wherein analyzing the accepted response includes:

applying a rule-based criteria for quantifying at least one difference between a pair of metrics selected from the list;

a) the evaluated prior history of the client;

b) the client'"'"'s expected performance on at least one test of the formed battery of tests;

c) the clients actual performance on at least one test of the formed battery of tests; and

d) normative values based on large body of data for at least one test of the formed battery of tests.

53. The protocol according to claim 44 wherein a test of the delivered and accepted formed battery of tests includes a metric of the clients interaction with a client'"'"'s peripheral device, and the device is selected from the list:

Color graphic display;

B/W graphic display;

Audio speaker;

Audio stereophonic headphones;

Mouse;

Joystick;

Roller-ball;

Keyboard;

Galvanic skin response monitor;

Web-cam camera;

Microphone;

personal communication device;

Touch pad;

or Touch screen.

54. The clinical protocol for normal-use activities according to claim 44 wherein for substantially each client in an ensemble of clients, monitoring at least one metric of normal-use activities includes downloading a plug-in to the client'"'"'s machine, installing plug-ins or uploading data collected by the plug-in.

55. The clinical protocol for normal-use activities according to claim 44 wherein for substantially each client in an ensemble of clients, monitoring at least one metric of normal-use activities includes copying, pasting, editing, inserting, formatting, backspacing, deleting, shifting or web surfing.