You might remember last year OMF announced that we are working on an exciting new project to streamline the arduous diagnostic process for people living with chronic complex diseases.

The “Personalized Automated Symptom Summary – Computer Adaptive Test” (PASS/CAT) is a machine learning tool that will help patients more accurately and efficiently convey their symptoms to their treating physician.

We are excited to share the insights of one of our partners in this project, Dr. Mary Slavin, a national expert in metrics, who is working alongside Dr. Ronald Tompkins and Dr. Kazis at the OMF funded Harvard ME/CFS Collaboration and Linda Tannenbaum at Open Medicine Foundation (for patient engagement):

The Inspiration

People with complex chronic diseases often experience symptoms for years prior to receiving a diagnosis. They are often misdiagnosed, or physicians suggest that the symptoms they experience are psychological in nature and not due to an underlying illness.

Current assessments have several significant limitations. The assessments are not based on a sound foundation and most do not focus on hallmark symptoms experienced by persons with complex chronic conditions.

The concept for the PASS/CAT emerged from Dr. Tompkins’ vision to develop a new assessment tool that would provide greater efficiencies for the primary care physician in a highly time-sensitive environment. 

The PASS/CAT combines a person-centered approach with artificial intelligence and machine learning to assess the wide range of symptoms experienced by people with chronic complex diseases such as ME/CFS, Fibromyalgia and Post Treatment Lyme Disease Syndrome. When developing the PASS/CAT, we aim to overcome several limitations associated with the current diagnostic process by:

• Reviewing current assessments to identify items that could be included in the PASS/CAT
• Conducting interviews and focus group sessions with people living with complex chronic conditions to develop an “item bank” that captures their experiences 
• Administering a questionnaire to a large national sample of subjects with complex chronic conditions who range in symptoms and severity
• Using this data to develop complex computer-based algorithms that customize and target diagnostic questions to each person using the tool
• Developing reports that present an individual’s symptom profile and quantifies disease severity with recommendations for the patient

Person-Centered Approach

We conducted extensive interviews with people with chronic complex diseases. The research team analyzed the transcripts of the interviews and identified key themes, and we are using these analyses to develop new assessment items. These items will describe the patient’s experience of symptoms using terms that emerge from their interviews and focus group sessions.

Ultimately, interviews validated the frustration that people with complex chronic diseases experience due to a lack of understanding about them and the inability to obtain a diagnosis:

“…Unfortunately, doctors don’t trust what you’re saying. And then the other thing is, when you have an illness that affects your cognitive functioning, it makes it even harder for you to try to explain what’s going on.”

– Quote taken during patient interviews 

What is the vision for how the PASS/CAT will be used by patients and doctors? 

Since the assessment is computer-based, the physician can send a link to the patient for completion prior to their visit. The PASS/CAT physician report will quantify the level of the patient’s symptoms and summarize it in a symptom profile. Alternatively, a person with symptoms of chronic, complex diseases like ME/CFS will be able to go to Open Medicine Foundation’s website, complete the assessment and bring the report to their physician to review and discuss the results as a clinical test.

Read more about the PASS CAT project here.