Diagnostic reliability of telepsychiatry in American Indian veterans.
OBJECTIVE
This study examined the reliability of the Structured Clinical Interview for DSM-III-R (SCID) in the administration of psychiatric assessments by real-time videoconferencing compared to face-to-face assessment within a rural American Indian community.


METHODS
The SCID was administered to 53 male American Indian veterans who were randomly assigned over two separate occasions by different interviewers to face-to-face and real-time interactive videoconferencing within 2 weeks. Comparisons were made with prevalences, the McNemar test, and the kappa statistic.


RESULTS
With the exception of past-year substance dependence and abuse/dependence combined, there were no significant differences between face-to-face and videoconference administration. The majority of kappas calculated (76%) indicated a good or fair level of agreement. Externalizing disorders tended to elicit greater concordance than internalizing disorders.


CONCLUSIONS
Overall, SCID assessment by live interactive videoconferencing did not differ significantly from face-to-face assessment in this population. Videoconferencing is a viable vehicle for clinical and research purposes.
Shore
Jay H
JH
American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Nighthorse Campbell Native Health Building, Mail Stop F800, P.O. Box 6508, Aurora, CO 80045-0508, USA. jay.shore@uchsc.edu
Savin
Daniel
D
Orton
Heather
H
Beals
Jan
J
Manson
Spero M
SM
D000368:Aged; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D010817:Physician-Patient Relations; D011569:Psychiatric Status Rating Scales / Q000592:standards / Q000706:statistics & numerical data*; D019114:Remote Consultation / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results; D014728:Veterans / Q000523:psychology*; D049269:Videoconferencing / Q000592:standards