Technology transfer of behavioral economic tasks for assessing alcohol reinforcer pathology: Development and feasibility of a commercially-available tool for clinical practice

PROJECT SUMMARY
Alcohol use disorderAUDcontributes to excessive disabilitymorbidityand mortality in the United StatesAs
one of the nation s leading preventable causes of deaththe first line of defense against AUD must be
standardized screening provided by the patient s primary care physicianpsychiatristand or counselorStandardized screeninghoweveris simply under performedReform proposals call for improved technology for
electronic screening to save time and improve standards of careMoreoverthe National Institute of Mental
Health s Research Domain CriteriaRDoCframework prescribes a focus on defining the underlying functional
dynamics of AUD instead of using symptom based tools as biomarkers for diseaseThereforethe present
proposal aims to develop a validatedtheoretically guided toolwhich provides clinicians with information beyond
AUD symptomsReinforcer pathology is a measure of severity derived from the synergy between two distinct
decision making processespreference for immediately available small rewardsi eexcessive delay
discountingandover valuation of alcohol rewardsi ehigh behavioral economic demandParamount to
this proposaldecades of research have concluded that delay discounting and demand are highly correlated with
alcohol use severity and important predictors of AUD treatment successIn order to develop a feasible and
acceptable reinforcer pathology based mobile tablet applicationBEACONfor use in the clinicthe present
proposal aims to recruit clinicians to provide feedback via focus group sessionsAimand integrate the
BEACON into their practiceAimaexecuted by BEAM DiagnosticsIncDevelopmentiterationand
maintenance of the appincluding the user interface and back endsecure databasescore calculationand
associated web portal will be built and maintained by Virginia Tech Carilion Research InstituteAimA total of
three tool prototype iterationsbased on clinician focus group feedbackwill be administered to clinic patients
throughout the testing period to collect reinforcer pathology scores and patient feedbackAimbBEAM
DiagnosticsIncThis reinforcement pathology assessment tool is innovative given its propensity to by pass
self report of past drinking behavior AUD symptoms and prospectively predict severity based on a theoretical
frameworkmaking this Phase I STTR application both timely and necessary PROJECT NARRATIVE
Alcohol misuse and alcohol use disorderAUDare major contributors to disabilitymorbidityand mortalityyet
the current standardized screening measures in clinical practice are under performed and test only symptoms
of past behaviorInsteadand in response to National Institute of Health s call for increased translation of
theoretically based screening tools that examine core functions of AUDthe reinforcer pathology framework
examines an individual s decision making processes about alcohol providing the clinician with more information
about patient AUD severity and prospective riskThe current proposal seeks to develop and test the feasibility
of a reinforcer pathology mobile tablet application to rapidly assess AUD severity and riskproviding improved
screening of vulnerable patients