Transcript The Brief Psychiatric Rating Scale System

THE BRIEF PSYCHIATRIC
RATING SCALE SYSTEM
Senior Project by John Newman
The Brief Psychiatric Rating
Scale System
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Purposes:
1) To process B.P.R. Scale scores
2) To provide a diagnosis
3) To chart an individual’s psychiatric
progress
• 4) To provide treatment population stats
The Design Objectives
• 1) Build a SQL/Access database.
• 2) Build a Visual Basic 6 "front end" with
functionality described below.
• 3) Install this application in Window 98
operating system.
Functionality
• The software will provide input boxes for relevant
treatment factors for a recipient of services in the MORC,
Inc., treatment program.
• Takes input from option boxes in a "pop-up" user entry
grid for the 20 scores of the Brief Psychiatric Rating Scale
(BPRS ) that range from 1 to 7.
• Process these scores for each individual displaying the
total BPRS score, sub scale scores, and a single-point
graph of the diagnostic profile.
Functionality (continued)
• Describes the general severity of symptoms in the words; "Mild",
"Moderate" or "Severe", according to the total Brief Psychiatric Rating
Scale (BPRS) score.
• The VB 6 front end highlights and explains the Diagnostic Statistical
Manual diagnosis that most closely corresponds to the individual's
graphed diagnosis. The explanation will be done by means of text
displayed below the diagnosis to which the mouse is pointing.
• The software will have the capability of comparing the individuals'
single-point plot to the plots of the diagnoses. It will also allow the
user to compare several evaluation points on the same screen. These
points will be connected by lines to chart an individual's psychiatric
progress.
Error Reduction
• The user's access to various parts of the program will be limited during
certain “machine states” such as editing and saving, in order to reduce
user error. This will be accomplished by enabling or disabling menu
items depending on the edit mode.
• The user is required to complete all associated data before being
allowed to save an evaluation, thereby obtaining a relatively complete
picture of the person’s life factors and maintaining data integrity.
Method: The database checks the medication, symptom qualifiers, and
staff intervention tables for entries associated with the multiple key
index of Case Number and Profile Number. These tables have one-toone relationships with the BPRS evaluation tables.
Connectivity
• The connectivity will be MS Jet
OLEDB.3.51 for Access 97. The program
utilizes ActiveX Data Objects in the form of
ADO Data Controls.
• The plan is to allow connectivity to other
types of databases by enabling selection of
database provider.
The Brief Psychiatric Rating Scale System
Test Cases (1 - 3)
• 1) A password entry box will appear that requires
the user to enter a password to access the database.
• 2) When the program begins, the first diagnostic
point will be graphed for the first person’s data.
• 3) The single-point graph that represents an
individual's symptom profile appears on the same
graph as the standard diagnoses plots.
Test Cases (4 - 5)
• 4) The software determines the standard diagnostic point
that is closest to the plot of the individual's symptom
profile. It highlights, with bold font at the right of the
graph, the diagnosis from the psychiatric Diagnostic
Statistical Manual (D.S.M.), that corresponds to that
closest diagnostic reference point.
• 5) After pointing the mouse on the DSM diagnosis, the
user will see "help" text displayed that describes the
symptoms associated with that diagnosis according to the
D.S.M.
Test cases (6 - 7)
• 6) There is a toggle button on the BPRS Profiles screen
that gives the user the option of selecting sequential
graphing of several evaluations on the same graph versus
graphing a single evaluation at one time. The user will be
able to graph sequential profiles on the same graph without
connecting them with lines.
• 7) During the sequential graphing, the user has the option
via a second toggle button to "connect the dots", thereby
displaying the progress over more than one evaluation.
The user will be able to graph sequential profiles on the
same graph and “connect the dots.”
Test Cases (8 - 10)
• 8) The user can see the words "Mild", "Moderate" or
"Severe" displayed, when the total BPRS score is
calculated. (i.e. This is a one-word verbal description of
the individual's total BPRS score based on certain ranges.)
• 9) The user will be able to see approximately according to
a progress bar, how far the user has moved through the
database.
• 10) The user will be able to see exactly the relative
position in the database of the row being displayed by
words such as “5 of 17” in a label.
Test Cases (11 - 14)
• 11) The records will be ordered alphabetically by last name
and then by increasing profile number.
• 12) The user will be able to edit records, e.g., the user can
update the individual's name. (I.e., This is needed if it was
spelled incorrectly when entered initially.)
• 13) When the user is in record Edit or Add New record
mode, the editable boxes will change color.
• 14) In Add New mode, the user will be limited from
accessing all menu items.
Test Cases (15 - 17)
• 15) The user will be required to enter symptom qualifier
data, staff interventions data, and medication data to
accompany the BPRS evaluation profile.
• 16) The user will be able to delete a record.
• 17) The user will be able to select from one of a list of
English descriptions of SQL queries that will be listed in a
drop down box. After clicking the “Run Standard Query
button”, the user will be able to see the query, that he/she
selected, appear in the Ad Hoc Query text box in SQL.
(I.e., The software provides this edit feature in the Ad Hoc
query box to facilitate changing of the date range or other
selection criteria.)
Test Cases (18 - 20)
• 18) The user will see the results of the query in the Query
Results Grid.
• 19) The user can perform then ad hoc SQL queries of the
database by editing the text in the Ad Hoc Query text box.
The user can clear the text in the Ad Hoc query box, type a
new ad hoc query, and obtain the results by clicking the
“Run Ad Hoc Query” button.
• 20) The user will be able to see in the “Record Count” box
a count of the number of rows returned by the query.
SUMMARY
Value to Scientific Inquiry
• This software enables within a relational database
for the first time a detailed analysis of how level
of staffing, the medications, the type of day
program interventions, a person’s physical
problems, and their personality disorders /Axis 2
diagnosis affect progress.
• It also allows one to analysis the relative health or
illness of the treatment population over time.
Unique Attributes
• The author took a creative approach
engineering solutions with functions such as
a Distance Finder to determine the closest,
reference diagnostic point to the
individual’s graph.
• The software conveys with a simple
graphical display the changes in a person’s
psychiatric condition.
Robustness
• In many places, the software prohibits user
impairment of program operation by:
• 1) Validating input
• 2) Facilitating correct user input with
default suggestions
• 3) Controlling access of user to only those
areas needed during specific operations
New Technology
• Utilizes Microsoft’s ActivX Data
Objects(ADO) primarily in the form of
Activx Data Object Data Control
(ADODC), which makes this program
amenable to development as a web-based
program with OLEDB connectivity.
Extraordinary Experience Utilized in
the Development
• The author utilized 20 years of masters level
clinical background in psychiatric social work,
knowledge of statistics obtained as part of
Masters in Social Work and a Bachelors in
Psychology, as well as statistics studied in
chemical quantitative analysis in making this
program. His extensive contacts in the field of
psychiatry and his own clinical experience were
extremely valuable in facilitating clinically
relevant functionality.
The End