| 1. |
- Gogoulou, Evangelia, et al.
(author)
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Predicting treatment outcome from patient texts : The case of internet-based cognitive behavioural therapy
- 2021
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In: EACL 2021 - 16th Conference of the European Chapter of the Association for Computational Linguistics, Proceedings of the Conference. - : Association for Computational Linguistics (ACL). - 9781954085022 ; , s. 575-580
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Conference paper (peer-reviewed)abstract
- We investigate the feasibility of applying standard text categorisation methods to patient text in order to predict treatment outcome in Internet-based cognitive behavioural therapy. The data set is unique in its detail and size for regular care for depression, social anxiety, and panic disorder. Our results indicate that there is a signal in the depression data, albeit a weak one. We also perform terminological and sentiment analysis, which confirm those results. © 2021 Association for Computational Linguistics
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| 2. |
- Boman, Magnus, et al.
(author)
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Learning machines in Internet-delivered psychological treatment
- 2019
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In: Progress in Artificial Intelligence. - : Springer Verlag. - 2192-6352 .- 2192-6360. ; 8:4, s. 475-485
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Journal article (peer-reviewed)abstract
- A learning machine, in the form of a gating network that governs a finite number of different machine learning methods, is described at the conceptual level with examples of concrete prediction subtasks. A historical data set with data from over 5000 patients in Internet-based psychological treatment will be used to equip healthcare staff with decision support for questions pertaining to ongoing and future cases in clinical care for depression, social anxiety, and panic disorder. The organizational knowledge graph is used to inform the weight adjustment of the gating network and for routing subtasks to the different methods employed locally for prediction. The result is an operational model for assisting therapists in their clinical work, about to be subjected to validation in a clinical trial.
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| 3. |
- Forsell, Erik, et al.
(author)
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Predicting Treatment Failure in Regular Care Internet-Delivered Cognitive Behavior Therapy for Depression and Anxiety Using Only Weekly Symptom Measures
- 2020
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In: Journal of Consulting and Clinical Psychology. - : American Psychological Association (APA). - 0022-006X .- 1939-2117. ; 88:4, s. 311-321
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Journal article (peer-reviewed)abstract
- Objective: Therapist guided Internet-Delivered Cognitive Behavior Therapy (ICBT) is effective, but as in traditional CBT, not all patients improve, and clinicians generally fail to identify them early enough. We predict treatment failure in 12-week regular care ICBT for Depression, Panic disorder and Social anxiety disorder, using only patients' weekly symptom ratings to identify when the accuracy of predictions exceed 2 benchmarks: (a) chance, and (b) empirically derived clinician preferences for actionable predictions. Method: Screening, pretreatment and weekly symptom ratings from 4310 regular care ICBT-patients from the Internet Psychiatry Clinic in Stockholm, Sweden was analyzed in a series of regression models each adding 1 more week of data. Final score was predicted in a holdout test sample, which was then categorized into Success or Failure (failure defined as the absence of both remitter and responder status). Classification analyses with Balanced Accuracy and 95% Confidence intervals was then compared to predefined benchmarks. Results: Benchmark 1 (better than chance) was reached 1 week into all treatments. Social anxiety disorder reached Benchmark 2 (>65%) at week 5, whereas Depression and Panic Disorder reached it at week 6. Conclusions: For depression, social anxiety and panic disorder, prediction with only patient-rated symptom scores can detect treatment failure 6 weeks into ICBT, with enough accuracy for a clinician to take action. Early identification of failing treatment attempts may be a viable way to increase the overall success rate of existing psychological treatments by providing extra clinical resources to at-risk patients, within a so-called Adaptive Treatment Strategy.
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| 4. |
- Safinianaini, Negar, et al.
(author)
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Gated hidden markov models for early prediction of outcome of internet-based cognitive behavioral therapy
- 2019
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In: 17th Conference on Artificial Intelligence in Medicine, AIME 2019. - Cham : Springer Verlag. - 9783030216412 - 9783030216429 ; , s. 160-169
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Conference paper (peer-reviewed)abstract
- Depression is a major threat to public health and its mitigation is considered to be of utmost importance. Internet-based Cognitive Behavioral Therapy (ICBT) is one of the employed treatments for depression. However, for the approach to be effective, it is crucial that the outcome of the treatment is accurately predicted as early as possible, to allow for its adaptation to the individual patient. Hidden Markov models (HMMs) have been commonly applied to characterize systematic changes in multivariate time series within health care. However, they have limited capabilities in capturing long-range interactions between emitted symbols. For the task of analyzing ICBT data, one such long-range interaction concerns the dependence of state transition on fractional change of emitted symbols. Gated Hidden Markov Models (GHMMs) are proposed as a solution to this problem. They extend standard HMMs by modifying the Expectation Maximization algorithm; for each observation sequence, the new algorithm regulates the transition probability update based on the fractional change, as specified by domain knowledge. GHMMs are compared to standard HMMs and a recently proposed approach, Inertial Hidden Markov Models, on the task of early prediction of ICBT outcome for treating depression; the algorithms are evaluated on outcome prediction, up to 7 weeks before ICBT ends. GHMMs are shown to outperform both alternative models, with an improvement of AUC ranging from 12 to 23%. These promising results indicate that considering fractional change of the observation sequence when updating state transition probabilities may indeed have a positive effect on early prediction of ICBT outcome.
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| 5. |
- Wallert, John, et al.
(author)
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Predicting remission after internet-delivered psychotherapy in patients with depression using machine learning and multi-modal data
- 2022
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In: Translational Psychiatry. - : Springer Nature. - 2158-3188. ; 12:1
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Journal article (peer-reviewed)abstract
- This study applied supervised machine learning with multi-modal data to predict remission of major depressive disorder {MDD) after psychotherapy. Genotyped adult patients (n = 894, 65.5% women, age 18-75 years) diagnosed with mild-to-moderate MDD and treated with guided Internet-based Cognitive Behaviour Therapy (ICBT) at the Internet Psychiatry Clinic in Stockholm were included (2008-2016). Predictor types were demographic, clinical, process (e.g., time to complete online questionnaires), and genetic (polygenic risk scores). Outcome was remission status post ICBT (cut-off <= 10 on MADRS-S). Data were split into train (60%) and validation (40%) given ICBT start date. Predictor selection employed human expertise followed by recursive feature elimination. Model derivation was internally validated through cross-validation. The final random forest model was externally validated against a (i) null, (ii) logit, (iii) XGBoost, and {iv) blended meta-ensemble model on the hold-out validation set. Feature selection retained 45 predictors representing all four predictor types. With unseen validation data, the final random forest model proved reasonably accurate at classifying post ICBT remission (Accuracy 0.656 [0.604, 0.705], P vs null model = 0.004; AUC 0.687 [0.631, 0.743]), slightly better vs logit (bootstrap D = 1.730, P = 0.084) but not vs XGBoost (D = 0.463, P = 0.643). Transparency analysis showed model usage of all predictor types at both the group and individual patient level. A new, multi-modal classifier for predicting MDD remission status after ICBT treatment in routine psychiatric care was derived and empirically validated. The multi-modal approach to predicting remission may inform tailored treatment, and deserves further investigation to attain clinical usefulness.
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