Predicting remission after internet-delivered psychotherapy in patients with depression using machine learning and multi-modal dataShow others and affiliations
2022 (English)In: Translational Psychiatry, E-ISSN 2158-3188, Vol. 12, no 1, article id 357Article in journal (Refereed) Published
Abstract [en]
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. © 2022, The Author(s).
Place, publisher, year, edition, pages
Springer Nature , 2022. Vol. 12, no 1, article id 357
National Category
Neurology
Identifiers
URN: urn:nbn:se:ri:diva-60170DOI: 10.1038/s41398-022-02133-3Scopus ID: 2-s2.0-85137074379OAI: oai:DiVA.org:ri-60170DiVA, id: diva2:1699898
Note
Funding details: SLS-941192 JW; Funding details: Familjen Erling-Perssons Stiftelse, 2016-01961; Funding details: Stockholms Läns Landsting, SLL20170708; Funding details: Vetenskapsrådet, VR, 2021-06377 JW; 2018-02487 CR; Funding details: Forskningsrådet om Hälsa, Arbetsliv och Välfärd, FORTE, 2018-00221 CR; Funding details: Center for Innovative Medicine, CIMED, 954440 CR, 96328; Funding text 1: JW and CR gratefully acknowledge funding from the Söderström-König Foundation (SLS-941192 JW), FORTE (2018-00221 CR), the Swedish Research Council (2021-06377 JW; 2018-02487 CR) and the Center for innovative medicine (CIMED 96328 JW; 954440 CR). MB and VK gratefully acknowledge the Stockholm County Council (funding through the Swedish Medical Training and Research Agreement (ALF) (SLL20170708) and infrastructure via the Internet Psychiatry Clinic), the Erling-Persson Family Foundation, and the Swedish Research Council (2016-01961). MB is partially funded by the WASP (Wallenberg Autonomous Systems and Software Program). Open access funding provided by Karolinska Institute.
2022-09-292022-09-292024-01-17Bibliographically approved