Shoreham Examination Tool

Commission for Shoreham Chronic Pain Clinic

Clinical tool to examine patients for psycological conditions through the following tests: Anxiety Symptoms Questionnaire, Beck Anxiety Inventory, Beck Depression Inventory, P3, and MMPI-2.

Psychological Test Scoring Server

Overview

This Go-based web server processes and scores psychological assessments, including the Anxiety Symptoms Questionnaire (ASQ), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), P3, and Minnesota Multiphasic Personality Inventory (MMPI-2). The server calculates scores based on user inputs, determines severity levels (normal, moderate, severe), and provides indications for clinical interpretation. Results are stored in a database and can be updated or retrieved as needed.

This README explains the scoring logic and calculation methods for each test as defined in the models package.

Supported Tests

The server supports the following psychological tests, each with specific scoring rules and maximum scores:

• Anxiety Symptoms Questionnaire (ASQ): Max score = 38
• Beck Anxiety Inventory (BAI): Max score = 63
• Beck Depression Inventory (BDI): Max score = 33
• P3: Max score = 88 (with a 44-point adjustment)
• Minnesota Multiphasic Personality Inventory (MMPI-2): Max score = 567

Test Calculation Logic

General Scoring Approach

For ASQ, BAI, BDI, and P3, the scoring process involves:

1. Raw Score Input: The test score is provided as an integer input.
2. Percentage Calculation: The raw score is divided by the test's maximum score and multiplied by 100 to obtain a percentage.
3. Severity Determination: The percentage is compared against predefined thresholds to classify the result as "normal," "moderate," or "severe."
4. Result Compilation: A formatted string is generated, including the patient's name, percentage score, test name, duration (in minutes and seconds), and severity level.

The MMPI-2 test follows a more complex process, involving multiple scales, gender-specific scoring, and indications derived from a scales.json file.

Test-Specific Calculations

Anxiety Symptoms Questionnaire (ASQ)

• Max Score: 38
• Calculation:
  • Compute percentage: (score / 38) * 100
  • Determine severity:
    • Normal: Percentage ≤ 30.99%
    • Moderate: 31% ≤ Percentage ≤ 45%
    • Severe: Percentage > 45%
• Output: A string in the format: "The patient, [patient], scored [percentage]% on the Anxiety Symptom Questionnaire in [minutes] minutes at [seconds] seconds. This result is in the [severity] range."
• Thresholds:
  • Low: ~11.4 (30% of max score)
  • High: ~17.1 (45% of max score)

Beck Anxiety Inventory (BAI)

• Max Score: 63
• Calculation:
  • Compute percentage: (score / 63) * 100
  • Determine severity:
    • Normal: Percentage ≤ 21.99%
    • Moderate: 22% ≤ Percentage ≤ 35%
    • Severe: Percentage > 35%
• Output: A string in the format: "The patient, [patient], scored [percentage]% on the Beck Anxiety Inventory in [minutes] minutes at [seconds] seconds. This result is in the [severity] range."
• Thresholds:
  • Low: ~13.23 (21% of max score)
  • High: ~22.05 (35% of max score)

Beck Depression Inventory (BDI)

• Max Score: 33
• Calculation:
  • Compute percentage: (score / 33) * 100
  • Determine severity:
    • Normal: Percentage ≤ 9.99%
    • Moderate: 10% ≤ Percentage ≤ 18%
    • Severe: Percentage > 18%
• Output: A string in the format: "The patient, [patient], scored [percentage]% on the Beck Depression Inventory in [minutes] minutes at [seconds] seconds. This result is in the [severity] range."
• Thresholds:
  • Low: ~2.97 (9% of max score)
  • High: ~5.94 (18% of max score)

P3

• Max Score: 88 (with a 44-point adjustment subtracted from the score in some contexts, though not explicitly applied in the provided calculation function)
• Calculation:
  • Compute percentage: (score / 88) * 100
  • Determine severity:
    • Normal: Percentage ≤ 30.99%
    • Moderate: 31% ≤ Percentage ≤ 50%
    • Severe: Percentage > 50%
• Output: A string in the format: "The patient, [patient], scored [percentage]% on the P3 in [minutes] minutes at [seconds] seconds. This result is in the [severity] range."
• Thresholds:
  • Low: ~26.4 (30% of max score)
  • High: ~44 (50% of max score)
• Note: The P3_ADJUST constant (44) is defined to account for a non 0 starting value.

Minnesota Multiphasic Personality Inventory (MMPI-2)

• Max Score: 567
• Calculation:
  • Input: A string of answers (e.g., "TTFTFFT...") representing true/false responses to 567 questions.
  • Scales: The test uses multiple scales (e.g., Hs, D, Hy, Pd, Mf, Pa, Pt, Sc, Ma, Si, VRIN, TRIN, F, Fb, Fp) defined in a scales.json file. Each scale has:
    • A base score.
    • Gender-specific T-scores and score offsets.
    • K-correction factors (if applicable).
    • Associated questions and expected answers.
  • Scoring Process:
    1. Parse answers into a boolean array (T = true, F = false).
    2. For each scale in scales.json:
       • Check if the scale is gender-specific and matches the patient's sex.
       • Calculate raw score by comparing patient answers to expected answers for specific questions.
       • Apply K-correction (if applicable) using the K scale score.
       • Adjust raw score with gender-specific offsets.
       • Map the adjusted score to a T-score using gender-specific T-score tables.
    3. Derive indications based on scale scores and predefined thresholds (e.g., Hs ≥ 75, Mf < 45).
  • Indications: Specific clinical interpretations are derived for each scale based on score ranges, such as:
    • VRIN ≥ 80: Inconsistent responding.
    • Hs ≥ 75: Significant health concerns.
    • Mf < 45: Gender role non-conformity (for males/females).
    • Many others, as defined in the Indications struct.
  • Output: A structured MMPIResults object containing:
    • Patient ID, name, sex, and test duration.
    • Categories with scale results (name, description, purpose, score).
    • Derived indications for each category.

Database Integration

• Storage: Test results are stored in a database table localres with fields: id, patient, sex, page, answers, duration, and aid.
• Operations:
  • Save(): Inserts a new test result.
  • Update(): Updates an existing result with new page, answers, and duration.
  • Load(): Retrieves a result by ID.
  • Calculate(): Computes MMPI-2 results based on stored answers and scales.json.