Research & clinical assessment with the IBCMT Embedded Research Program

1. Research & clinical assessmentwith the IBCMT Embedded Research Program

2. Research & clinical assessmentIBCMT’s Embedded Research Program • Medical, Scientific, Education and Research Committee (MSERC) • Partnership with Brain Resource Company • IntegNeuro Cognitive assessment system • Clinical assessment of patients - chargeable • Collection of research data from patients • Continuing professional development • The Neuroscience Trust

3. Embedded Research Program Aims and significance • Creating an IBCMT clinical database • Metal toxicity and neurocognitive function • Data collected by international college membership using IntegNeuro • Brain Resource normative database • Development of an objective, evidence-based” “gold standard” for clinical use: toxicology profiles to inform the clinician

4. Embedded Research Program Affiliation with Brain Resource Company (BRC) • IBMCT has entered partnership with BRC to develop the IBCMT clinical database • IBCMT-BRC memorandum of understanding permits Colleges to enter the alliance with BRC richard.clark@brainresource.com • Each College may enter memorandum of understanding with BRC • Accrual of research funds to IBCMT and affiliated Colleges based on the data contributed by clinicians to database

5. Toxicology groupings Collection of data of over 5000 patients from participating IBCMT clinics Cognitive, clinical, toxicological and diagnostic information Collated with Brain Resource Database Normal reference group 1500 normal cases to date using IntegNeuro assessment Aged 6– 85; males and females Embedded Research ProgramThe Database

6. Embedded Research ProgramTimeline • Phase 1 • Data collection phase from up to 100 clinics worldwide • Clinic: assessment of cognitive function & treatment efficacy • Phase 2 • IBCMT and College sponsored research investigations into data to determine toxicity profiles • Publication of discriminant analyses on metal toxins • Scientific enhancement of clinician’s diagnostic armory • Clinic: cognitive assessment and neurotoxicological profiling

7. Neurocognitive assessment of patients in the clinic using IntegNeuro

8. Neurocognitive assessment using IntegNeuro • Portable, computerized, automated assessment tool • Easily locatable in IBCMT clinics • Hardware components: • IBM Kiosk • Head phones and microphone • Web ready status • IntegNeuro software

9. Embedded Research ProgramData, tests and measurements • Web questionnaire • Medical and other history • IntegNeuro assessment • Neurocognitive function • Clinical information • Hair analysis - toxic and nutrient elements, blood and urine levels • Toxicological diagnosis • Clinical diagnosis

10. Neurocognitive assessment - staff training • No psychological training required • Staff involvement with patient is minimal • Patient orientation • Periodic patient monitoring • Other staff activities • Entering clinical, toxicological and diagnostic data • Data uploading and printing Report • Billing patient • Paying the Neuroscience Trust • Instructions on CD; internet and email support

11. Neurocognitive assessment – patient testing procedure • Patient allocated a unique code • Patient completes web questionnaire at home or in clinic • Patient completes IntegNeuro neurocognitive assessment in the clinic using the IntegNeuro Kiosk • Clinical, toxicological and diagnostic data entered into Kiosk • The data file is uploaded where it is automatically scored • Report prepared and emailed for printing

12. Neurocognitive assessmentData upload • The data uploading procedure is handled by internet connection • Upload procedure secure and encrypted – no patient name; only ID code used • Each upload takes a few minutes • Report returned by email from BRC within 72 hours • Invoice emailed for payment • Payment for report made via secure website at www.NeuroscienceTrust.com • Clinic charged 85% of recommended List Price

13. When to test and what to do if patient abnormal on IntegNeuro • Initial testing provides an objective and inexpensive baseline of cognitive function • If abnormal, then reassess patient after suitable interval to assess efficacy of treatment on these baseline measures as well as on toxicological measures • If deemed necessary, refer for full neuropsychological assessment

14. Web Upload to BRC IntegNeuro test using allocated patient code Encrypted, de-linked data scored and matched to database Patient auto tested using Kiosk (50min) Report payment Https (secure) website www.NeuroscienceTrust.com Internet IBCMT Clinic IntegNeuroSummary of procedures Report request uniquely linked to patient code Start Report delivery by email 72 hour turnaround

15. Installing IntegNeuro in the clinic

16. Steps to install IntegNeuro in clinic • Clinic applies to The Neuroscience Trust • Application forms available from richard.clark@neuroscience.com • IBM Kiosk and installed software delivered within 4-6 weeks of receipt of order • Installation and operation instructions provided with equipment and software; telephone and web help as required • IntegNeuro assessments can commence once equipment installed and connected to internet

17. Breakeven financial model for IntegNeuro installations Amounts have been converted to US dollars Kiosk sharing recommended if less than 2 tests per week

18. The Neuroscience Trust • Established to manage the IBCMT-BRC strategic alliance involving • Embedded research program • Clinical report ordering and payments • Distribution of research funds to IBCMT and participating National Colleges • Web presence: • Support facility for clinics (e.g. FAQ, test information, general procedures • Repository for research outputs • http://www.neurosciencetrust.com