Aifred Health, a Deep Learning Powered Clinical Decision Support System for Mental Health

Development of a differential treatment selection model for depression on consolidated and transformed clinical trial datasets

Major depressive disorder (MDD) is the leading cause of disability worldwide, yet treatment selection still proceeds via "trial and error". Given the varied presentation of MDD and heterogeneity of treatment response, the use of machine learning to understand complex, non-linear relationships in data may be key for treatment personalization. Well-organized, structured data from clinical trials with standardized outcome measures is useful for training machine learning models; however, combining data across trials poses numerous challenges. There is also persistent concern that machine learning models can propagate harmful biases. We have created a methodology for organizing and preprocessing depression clinical trial data such that transformed variables harmonized across disparate datasets can be used as input for feature selection. Using Bayesian optimization, we identified an optimal multi-layer dense neural network that used data from 21 clinical and sociodemographic features as input in order to perform differential treatment benefit prediction. With this combined dataset of 5032 individuals and 6 drugs, we created a differential treatment benefit prediction model. Our model generalized well to the held-out test set and produced similar accuracy metrics in the test and validation set with an AUC of 0.7 when predicting binary remission. To address the potential for bias propagation, we used a bias testing performance metric to evaluate the model for harmful biases related to ethnicity, age, or sex. We present a full pipeline from data preprocessing to model validation that was employed to create the first differential treatment benefit prediction model for MDD containing 6 treatment options.

Artificial intelligence in mental healthcare: an overview and future perspectives

Artificial intelligence is disrupting the field of mental healthcare through applications in computational psychiatry, which leverages quantitative techniques to inform our understanding, detection, and treatment of mental illnesses. This paper provides an overview of artificial intelligence technologies in modern mental healthcare and surveys recent advances made by researchers, focusing on the nascent field of digital psychiatry. We also consider the ethical implications of artificial intelligence playing a greater role in mental healthcare.

Deep learning assisted cognitive diagnosis for the D-Riska application

In this article, we expose a system developed that extends the Acquired Brain Injury (ABI) diagnostic application known as D-Riska with an artificial intelligence module that supports the diagnosis of ABI enabling therapists to evaluate patients in an assisted way. The application is in charge of collecting the data of the diagnostic tests of the patients, and due to a multi-class Convolutional Neural Network classifier (CNN), it is capable of making predictions that facilitate the diagnosis and the final score obtained in the test by the patient. To find out the best solution to this problem, different classifiers are used to compare the performance of the proposed model based on various classification metrics. The proposed CNN classifier makes predictions with 93 % of Accuracy, 94 % of Precision, 91 %, of Recall and 92% of F1-Score.

Using a simulation centre to evaluate preliminary acceptability and impact of an artificial intelligence-powered clinical decision support system for depression treatment on the physician-patient interaction

BACKGROUND

Recently, artificial intelligence-powered devices have been put forward as potentially powerful tools for the improvement of mental healthcare. An important question is how these devices impact the physician-patient interaction.

AIMS

Aifred is an artificial intelligence-powered clinical decision support system (CDSS) for the treatment of major depression. Here, we explore the use of a simulation centre environment in evaluating the usability of Aifred, particularly its impact on the physician-patient interaction.

METHOD

Twenty psychiatry and family medicine attending staff and residents were recruited to complete a 2.5-h study at a clinical interaction simulation centre with standardised patients. Each physician had the option of using the CDSS to inform their treatment choice in three 10-min clinical scenarios with standardised patients portraying mild, moderate and severe episodes of major depression. Feasibility and acceptability data were collected through self-report questionnaires, scenario observations, interviews and standardised patient feedback.

RESULTS

All 20 participants completed the study. Initial results indicate that the tool was acceptable to clinicians and feasible for use during clinical encounters. Clinicians indicated a willingness to use the tool in real clinical practice, a significant degree of trust in the system's predictions to assist with treatment selection, and reported that the tool helped increase patient understanding of and trust in treatment. The simulation environment allowed for the evaluation of the tool's impact on the physician-patient interaction.

CONCLUSIONS

The simulation centre allowed for direct observations of clinician use and impact of the tool on the clinician-patient interaction before clinical studies. It may therefore offer a useful and important environment in the early testing of new technological tools. The present results will inform further tool development and clinician training materials.