Time to get personal? The impact of researchers choices on the selection of treatment targets using the experience
Jojanneke A Bastiaansen1, Yoram K Kunkels2, Frank J Blaauw3
1Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands; Department of Education and Research, Friesland Mental Health Care Services, Leeuwarden, the Netherlands.
Objective:
One of the promises of the experience sampling methodology (ESM) is that a statistical analysis of an individual's emotions, cognitions and behaviors in everyday-life could be used to identify relevant treatment targets. A requisite for clinical implementation is that outcomes of such person-specific time-series analyses are not wholly contingent on the researcher performing them.
Methods:
To evaluate this, we crowdsourced the analysis of one individual patient's ESM data to 12 prominent research teams, asking them what symptom(s) they would advise the treating clinician to target in subsequent treatment.
Results:
Variation was evident at different stages of the analysis, from preprocessing steps (e.g., variable selection, clustering, handling of missing data) to the type of statistics and rationale for selecting targets. Most teams did include a type of vector autoregressive model, examining relations between symptoms over time. Although most teams were confident their selected targets would provide useful information to the clinician, not one recommendation was similar: both the number (0-16) and nature of selected targets varied widely.
Conclusion:
This study makes transparent that the selection of treatment targets based on personalized models using ESM data is currently highly conditional on subjective analytical choices and highlights key conceptual and methodological issues that need to be addressed in moving towards clinical implementation.
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