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Study to Evaluate the Safety and Efficacy of PEER Interactive to Inform Medication Prescription for Subjects With a Primary Diagnosis of Depression (SMART-MD)

Primary Purpose

Depression

Status
Suspended
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
PEER Interactive Report
Sponsored by
MYnd Analytics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Depression focused on measuring database, probability, response, depression, medication, quantitative, electroencephalogram

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male and female subjects between the ages of 18 - 65 years of age or older who speak and read English.
  2. Subjects able to provide written informed consent to participate in the study.
  3. Subjects with a primary diagnosis of a Diagnostic and Statistical Manual of Mental Disorders (DSM-V) depressive disorder. Please see Appendix D for definitions.
  4. Subjects with comorbidity of a non-psychotic behavioral disorder. Please see Appendix D for definitions.
  5. Subjects with comorbidity of mild traumatic brain injury (mTBI) are eligible for inclusion in this study.
  6. Subjects with comorbidity of post-traumatic stress disorder (PTSD) are eligible for inclusion in this study. A score of 45 or greater on the PTSD Checklist Civilian (PCL-C) measurement tool will qualify a subject for inclusion of diagnosis of PTSD as a comorbid condition.
  7. Able to stop specified medications, including drugs of abuse, for 5 half-lives of the medication(s). See Appendix E for a list of the withdrawal periods for medications. The potential subject's primary care physician may be consulted to make these determinations.
  8. Able to be washed out of medications within 14 days, i.e. 5 half-lives are not longer than 14 days (See Appendix E).
  9. Ability to comply with the requirements of the study.

    -

Exclusion Criteria:

  1. Male and female subjects less than 18 years old or greater than 65 years old.
  2. Subjects who cannot provide written informed consent.
  3. Diagnosis of a psychotic disorder. Please see Appendix D for definitions.
  4. History of, or current, open head brain trauma.
  5. Subjects with comorbidity of traumatic brain injury (TBI) who experienced greater than 30 minutes loss of consciousness, greater than 24 hour alteration in consciousness or mental status, greater than 24 hours of post traumatic amnesia, or a Glasgow Coma Scale (best available score in first 24 hours) of less than 13.
  6. Subjects who, in the opinion of the investigator would not be good candidates to be washed out of specified medications (Appendix E) and are unable to washout medications and/or supplements in a period of 14 days or less.
  7. History of: craniotomy, cerebral metastases, cerebrovascular accident; current diagnosis of seizure disorder, schizophrenia, schizo-affective disorder, dementia, mental retardation, or major depression with psychotic features; or use of depot neuroleptics in last 12 months.
  8. Clinically significant medical illness, including thyroid disorders, diabetes, etc., which cannot be remediated with medication, e.g. synthroid, insulin, etc.
  9. Participation in any other therapeutic drug study within 60 days preceding inclusion.
  10. Known pregnancy and/or lactation, or intent to become pregnant during this study.
  11. Chronic or acute pain requiring prescription pain medication(s) (narcotic or synthetic narcotic).
  12. Candidates with any metal, shrapnel or other similar objects in the head that could affect the QEEG.
  13. Candidates currently stable on current medications.
  14. Pre-entry subject whose urine drug screen is positive for drugs of abuse.

    -

Sites / Locations

  • Carolina Partners

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Active Comparator

Arm Label

Control

Treatment

Arm Description

The Control group subjects will undergo all procedures e.g. medication washout and baseline electroencephalogram, administered to the Treatment/Experimental group. A clinician treating a Control Group subject will NOT receive the Psychiatric Electroencephalogram Evaluation Registry (PEER) Interactive Report (of probable medication response) under investigation and will treat the Subject with Standard of Care. The subject will be blinded to group assignment and will provide the primary outcome measure - Quick Inventory of Depressive Symptomatology - Self Report 16 item questionnaire.

Intervention - Psychiatric Electroencephalogram Evaluation Registry (PEER) Interactive Report - Treatment group subjects will undergo all procedures e.g. medication washout and baseline electroencephalogram, administered to the Control group. A clinician treating a Treatment Group subject will receive the Psychiatric Electroencephalogram Evaluation Registry (PEER) Report (of probable medication response) under investigation and will incorporate the Report information during prescription of medications to the Subject. The subject will be blinded to group assignment and will provide the primary outcome measure - Quick Inventory of Depressive Symptomatology - Self Report 16 item questionnaire.

Outcomes

Primary Outcome Measures

Quick Inventory of Depressive Symptomatology - Self Report 16 questionnaire (QIDS-SR16)
A self reported survey - blinded subject acts as blinded rater/outcomes assessor. We will use this survey to measure the subject's self-reported change in symptoms of depression.

Secondary Outcome Measures

Clinical Global Impressions - Improvement (CGI-I)
Commonly used measure of symptom severity, treatment response and the efficacy of treatments in treatment studies of patients with mental disorders
Clinical Global Impressions - Severity (CGI-S)
Commonly used measure of symptom severity, treatment response and the efficacy of treatments in treatment studies of patients with mental disorders.
Concise Health Risk Tracking Scale - 7 item Self Report Survey (CHRT- SR7)
A 7 question self-report questionnaire that assesses suicidal risk of subjects in clinical practice

Full Information

First Posted
December 7, 2016
Last Updated
July 29, 2020
Sponsor
MYnd Analytics
Collaborators
Mount Sinai Hospital, New York
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1. Study Identification

Unique Protocol Identification Number
NCT02988076
Brief Title
Study to Evaluate the Safety and Efficacy of PEER Interactive to Inform Medication Prescription for Subjects With a Primary Diagnosis of Depression
Acronym
SMART-MD
Official Title
A Prospective, Double Blind, Randomized, Controlled, Multisite Study to Evaluate the Utility, Safety, and Efficacy of Using PEER Interactive to Inform Medication Prescription to Subjects With a Primary Diagnosis of a Depressive Disorder(SMART-MD)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2020
Overall Recruitment Status
Suspended
Why Stopped
Lack of recruiting at primary study site
Study Start Date
November 2016 (undefined)
Primary Completion Date
December 2019 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
MYnd Analytics
Collaborators
Mount Sinai Hospital, New York

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a prospective, multicenter, randomized, double-blind, controlled study to evaluate the effectiveness of Psychiatric Electroencephalogram Registry (PEER) Interactive to inform medication prescription in subjects with a primary diagnosis of depression with comorbidity of non-psychotic behavioral disorders versus treatment as usual, as determined by the investigator. The primary measurement for improvement of the subjects depression will be a self-evaluation questionnaire, the Quick Inventory of Depressive Symptomatology-Self Report 16 , but the investigators will also collect information on their clinical global improvement and any reduction in adverse events.
Detailed Description
This study is prospective in nature. Subjects in the control group will be treated according to treatment as usual and best judgment of the treating physician. For the experimental group the treating physician will follow the guidance of the subject's PEER Interactive Report as regards sensitivity to on-label medications and classes of medication. The subjects will be washed out of all current medications prior to having an electroencephalogram (EEG), which is necessary to generate the PEER Interactive Report. The wash out period for outpatients is no longer than 14 days. The subjects will be followed for 3 months after the initial treatment. The patient will be seen on a routine basis and assessments will be made at each interaction to evaluate the patient's improvement in mental health. The subjects will also be closely evaluated to determine if they are experiencing any psychiatric specific adverse events. The investigator is allowed to treat the patient according to their best medical judgment, which may include adding or changing medications, seeing the patient more frequently, or other interventions such as the use of sleep aids.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Depression
Keywords
database, probability, response, depression, medication, quantitative, electroencephalogram

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Masking Description
The subject is masked as to assignment to Control or Treatment Group. The subject acts as the blinded rater - providing the primary outcome measure - the Quick Inventory of Depressive Symptomatology - 16 Item Self report
Allocation
Randomized
Enrollment
468 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Control
Arm Type
No Intervention
Arm Description
The Control group subjects will undergo all procedures e.g. medication washout and baseline electroencephalogram, administered to the Treatment/Experimental group. A clinician treating a Control Group subject will NOT receive the Psychiatric Electroencephalogram Evaluation Registry (PEER) Interactive Report (of probable medication response) under investigation and will treat the Subject with Standard of Care. The subject will be blinded to group assignment and will provide the primary outcome measure - Quick Inventory of Depressive Symptomatology - Self Report 16 item questionnaire.
Arm Title
Treatment
Arm Type
Active Comparator
Arm Description
Intervention - Psychiatric Electroencephalogram Evaluation Registry (PEER) Interactive Report - Treatment group subjects will undergo all procedures e.g. medication washout and baseline electroencephalogram, administered to the Control group. A clinician treating a Treatment Group subject will receive the Psychiatric Electroencephalogram Evaluation Registry (PEER) Report (of probable medication response) under investigation and will incorporate the Report information during prescription of medications to the Subject. The subject will be blinded to group assignment and will provide the primary outcome measure - Quick Inventory of Depressive Symptomatology - Self Report 16 item questionnaire.
Intervention Type
Device
Intervention Name(s)
PEER Interactive Report
Other Intervention Name(s)
PEER Report
Intervention Description
A subinvestigator treating a Treatment Group subject will receive the Psychiatric Electroencephalogram Evaluation Registry (PEER) Interactive Report (of probable medication response) under investigation and will incorporate the Report information during prescription of medications to the Subject. A subinvestigator treating a Control Group subject will NOT receive the PEER Report and will treat the Subject with Standard of Care. The subject will be blinded to group assignment and will provide the primary outcome measure - Quick Inventory of Depressive Symptomatology - Self Report 16 item questionnaire.
Primary Outcome Measure Information:
Title
Quick Inventory of Depressive Symptomatology - Self Report 16 questionnaire (QIDS-SR16)
Description
A self reported survey - blinded subject acts as blinded rater/outcomes assessor. We will use this survey to measure the subject's self-reported change in symptoms of depression.
Time Frame
4 months
Secondary Outcome Measure Information:
Title
Clinical Global Impressions - Improvement (CGI-I)
Description
Commonly used measure of symptom severity, treatment response and the efficacy of treatments in treatment studies of patients with mental disorders
Time Frame
4 months
Title
Clinical Global Impressions - Severity (CGI-S)
Description
Commonly used measure of symptom severity, treatment response and the efficacy of treatments in treatment studies of patients with mental disorders.
Time Frame
4 months
Title
Concise Health Risk Tracking Scale - 7 item Self Report Survey (CHRT- SR7)
Description
A 7 question self-report questionnaire that assesses suicidal risk of subjects in clinical practice
Time Frame
4 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female subjects between the ages of 18 - 65 years of age or older who speak and read English. Subjects able to provide written informed consent to participate in the study. Subjects with a primary diagnosis of a Diagnostic and Statistical Manual of Mental Disorders (DSM-V) depressive disorder. Please see Appendix D for definitions. Subjects with comorbidity of a non-psychotic behavioral disorder. Please see Appendix D for definitions. Subjects with comorbidity of mild traumatic brain injury (mTBI) are eligible for inclusion in this study. Subjects with comorbidity of post-traumatic stress disorder (PTSD) are eligible for inclusion in this study. A score of 45 or greater on the PTSD Checklist Civilian (PCL-C) measurement tool will qualify a subject for inclusion of diagnosis of PTSD as a comorbid condition. Able to stop specified medications, including drugs of abuse, for 5 half-lives of the medication(s). See Appendix E for a list of the withdrawal periods for medications. The potential subject's primary care physician may be consulted to make these determinations. Able to be washed out of medications within 14 days, i.e. 5 half-lives are not longer than 14 days (See Appendix E). Ability to comply with the requirements of the study. - Exclusion Criteria: Male and female subjects less than 18 years old or greater than 65 years old. Subjects who cannot provide written informed consent. Diagnosis of a psychotic disorder. Please see Appendix D for definitions. History of, or current, open head brain trauma. Subjects with comorbidity of traumatic brain injury (TBI) who experienced greater than 30 minutes loss of consciousness, greater than 24 hour alteration in consciousness or mental status, greater than 24 hours of post traumatic amnesia, or a Glasgow Coma Scale (best available score in first 24 hours) of less than 13. Subjects who, in the opinion of the investigator would not be good candidates to be washed out of specified medications (Appendix E) and are unable to washout medications and/or supplements in a period of 14 days or less. History of: craniotomy, cerebral metastases, cerebrovascular accident; current diagnosis of seizure disorder, schizophrenia, schizo-affective disorder, dementia, mental retardation, or major depression with psychotic features; or use of depot neuroleptics in last 12 months. Clinically significant medical illness, including thyroid disorders, diabetes, etc., which cannot be remediated with medication, e.g. synthroid, insulin, etc. Participation in any other therapeutic drug study within 60 days preceding inclusion. Known pregnancy and/or lactation, or intent to become pregnant during this study. Chronic or acute pain requiring prescription pain medication(s) (narcotic or synthetic narcotic). Candidates with any metal, shrapnel or other similar objects in the head that could affect the QEEG. Candidates currently stable on current medications. Pre-entry subject whose urine drug screen is positive for drugs of abuse. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel Iosifescu, PhD
Organizational Affiliation
Mount Sinai Hospital, New York, N.Y.
Official's Role
Principal Investigator
Facility Information:
Facility Name
Carolina Partners
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27609
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
20598710
Citation
DeBattista C, Kinrys G, Hoffman D, Goldstein C, Zajecka J, Kocsis J, Teicher M, Potkin S, Preda A, Multani G, Brandt L, Schiller M, Iosifescu D, Fava M. The use of referenced-EEG (rEEG) in assisting medication selection for the treatment of depression. J Psychiatr Res. 2011 Jan;45(1):64-75. doi: 10.1016/j.jpsychires.2010.05.009. Epub 2010 Jul 3.
Results Reference
background
PubMed Identifier
19333404
Citation
Demyttenaere K, Desaiah D, Petit C, Croenlein J, Brecht S. Patient-assessed versus physician-assessed disease severity and outcome in patients with nonspecific pain associated with major depressive disorder. Prim Care Companion J Clin Psychiatry. 2009;11(1):8-15. doi: 10.4088/pcc.08m00670.
Results Reference
background
PubMed Identifier
443765
Citation
Duffy FH, Burchfiel JL, Lombroso CT. Brain electrical activity mapping (BEAM): a method for extending the clinical utility of EEG and evoked potential data. Ann Neurol. 1979 Apr;5(4):309-21. doi: 10.1002/ana.410050402.
Results Reference
background
PubMed Identifier
10333991
Citation
Hughes JR, John ER. Conventional and quantitative electroencephalography in psychiatry. J Neuropsychiatry Clin Neurosci. 1999 Spring;11(2):190-208. doi: 10.1176/jnp.11.2.190.
Results Reference
background
PubMed Identifier
22802691
Citation
Hoffman DA, Debattista C, Valuck RJ, Iosifescu DV. Measuring severe adverse events and medication selection using a "PEER Report" for nonpsychotic patients: a retrospective chart review. Neuropsychiatr Dis Treat. 2012;8:277-84. doi: 10.2147/NDT.S31665. Epub 2012 Jun 21.
Results Reference
background
PubMed Identifier
16199008
Citation
Rush AJ, Bernstein IH, Trivedi MH, Carmody TJ, Wisniewski S, Mundt JC, Shores-Wilson K, Biggs MM, Woo A, Nierenberg AA, Fava M. An evaluation of the quick inventory of depressive symptomatology and the hamilton rating scale for depression: a sequenced treatment alternatives to relieve depression trial report. Biol Psychiatry. 2006 Mar 15;59(6):493-501. doi: 10.1016/j.biopsych.2005.08.022. Epub 2005 Sep 30.
Results Reference
background
Available IPD and Supporting Information:
Available IPD/Information Type
Study Protocol
Available IPD/Information URL
http://myndanalytics.com
Available IPD/Information Identifier
CNSR012 Protocol
Available IPD/Information Comments
Please email snavarre@myndanalytics.com for approved version of the protocol
Available IPD/Information Type
Informed Consent Form
Available IPD/Information URL
http://myndanalytics.com
Available IPD/Information Identifier
CNSR012 ICD
Available IPD/Information Comments
Please email snavarre@myndanalytics.com for approved version of ICD

Learn more about this trial

Study to Evaluate the Safety and Efficacy of PEER Interactive to Inform Medication Prescription for Subjects With a Primary Diagnosis of Depression

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