使用机器学习来预测分级护理或常规护理的亚临床抑郁症患者的症状变化
Bruno T Scodari1, Sarah Chacko2, Rina Matsumura2
1Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
Journal of affective disorders
|August 4, 2023
概括
机器学习可以准确地预测临床下抑郁症 (SD) 患者的抑郁症状变化,这些患者接受逐步或常规护理. 这使得个性化治疗建议能够改善患者的治疗结果.
科学领域:
- 心理健康 心理健康
- 计算医学是一种计算医学.
- 临床心理学 临床心理学
背景情况:
- 亚临床抑郁症 (SD) 呈现出轻微的抑郁症状,通常在初级保健中进行管理,治疗反应不佳.
- 阶段性护理模式旨在优化SD的资源配置和患者结果,但可能是时间效率低下的.
- 机器学习 (ML) 提供了识别最佳治疗途径和为发生SD患者的临床决策提供信息的潜力.
研究的目的:
- 评估机器学习在预测患有亚临床抑郁症的患者抑郁症状变化的有效性.
- 为了比较阶段性护理的ML模型的预测性能,与通常的护理治疗方式相比.
- 为了确定患者的特征与更好的治疗反应在一个阶段性护理框架内相关.
主要方法:
- 步骤深入试验随机选择了SD的参与者,分别分别分别分别获得逐步护理 (N=96) 或常规护理 (N=140).
- 机器学习,特别是基于树的模型,被用来预测PHQ-9分数在一年时间内的变化.
- 使用相关系数 (r) 和平均绝对误差 (MAE) 评估模型性能.
主要成果:
- 基于树的ML模型在预测PHQ-9变化方面表现出有效性,无论是阶段性护理 (r=0.35-0.46) 还是常规护理 (r=0.34-0.49) 组.
- 预测准确性在两个治疗臂之间是可比的 (MAE=0.14-0.18).
- 在逐步治疗组中,积极的治疗反应与更高的基线PHQ-9相关,较低的HADS-A得分,较少的慢性疾病和内部控制位置.
结论:
- 机器学习显示出在不同治疗策略中预测SD患者抑郁症状轨迹的重大前景.
- 经过训练的ML模型可以根据初始信息预测个体患者的结果,从而个性化护理.
- 这些发现支持将ML纳入临床实践,以便在亚临床抑郁症中提供知情,个性化的治疗建议.
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