title: Developing patient-centered treatment protocols in brain stimulation: a rationale for combining quantitative and qualitative approaches in persons with HIV.
abstract: This article reports and discusses how quantitative (physiological and behavioral) and qualitative methods are being combined in an open-label pilot feasibility study. The study evaluates safety, tolerability, and acceptability of a protocol to treat depression in HIV-infected individuals, using a 2-week block of transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex. Major depressive disorder (MDD) is the second most prevalent psychiatric disorder after substance abuse among HIV-positive adults, and novel antidepressant treatments are needed for this vulnerable population. The authors describe the challenges and contributions derived from different research perspectives and methodological approaches and provide a philosophical framework for combining quantitative and qualitative measurements for a fuller examination of the disorder. Four methodological points are presented: (1) the value of combining quantitative and qualitative approaches; (2) the need for context-specific measures when studying patients with medical and psychiatric comorbidities; (3) the importance of research designs that integrate physiological, behavioral, and qualitative approaches when evaluating novel treatments; and (4) the need to explore the relationships between biomarkers, clinical symptom assessments, patient self-evaluations, and patient experiences when developing new, patient-centered protocols. The authors conclude that the complexity of studying novel treatments in complex and new patient populations requires complex research designs to capture the richness of data that inform translational research.
authors.affiliation: New York University College of Nursing, 246 Greene St, NY 10003, USA. mtr3@nyu.edu
authors.forename: Mary
authors.initials: M
authors.lastname: Rosedale
authors.forename: Dolores
authors.initials: D
authors.lastname: Malaspina
authors.forename: Daniel
authors.initials: D
authors.lastname: Malamud
authors.forename: Shiela M
authors.initials: SM
authors.lastname: Strauss
authors.forename: Jaclyn D
authors.initials: JD
authors.lastname: Horne
authors.forename: Salman
authors.initials: S
authors.lastname: Abouzied
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Cruciani
authors.forename: Helena
authors.initials: H
authors.lastname: Knotkova
mesh_terms: D000328:Adult; D015415:Biomarkers; D015400:Clinical Nursing Research / Q000379:methods*; D002985:Clinical Protocols; D016207:Cytokines / Q000378:metabolism; D003625:Data Collection / Q000379:methods; D003865:Major Depressive Disorder / Q000628:therapy*; D004599:Electric Stimulation Therapy; D005240:Feasibility Studies; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D018802:Patient-Centered Care; D010865:Pilot Projects; D017397:Prefrontal Cortex; D011569:Psychiatric Status Rating Scales; D036301:Qualitative Research; D012107:Research Design; D012449:Safety
chemical_list: D015415:Biomarkers; D016207:Cytokines