1
|
Beames JR, Han J, Shvetcov A, Zheng WY, Slade A, Dabash O, Rosenberg J, O'Dea B, Kasturi S, Hoon L, Whitton AE, Christensen H, Newby JM. Use of smartphone sensor data in detecting and predicting depression and anxiety in young people (12-25 years): A scoping review. Heliyon 2024; 10:e35472. [PMID: 39166029 PMCID: PMC11334877 DOI: 10.1016/j.heliyon.2024.e35472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 08/22/2024] Open
Abstract
Digital phenotyping is a promising method for advancing scalable detection and prediction methods in mental health research and practice. However, little is known about how digital phenotyping data are used to make inferences about youth mental health. We conducted a scoping review of 35 studies to better understand how passive sensing (e.g., Global Positioning System, microphone etc) and electronic usage data (e.g., social media use, device activity etc) collected via smartphones are used in detecting and predicting depression and/or anxiety in young people between 12 and 25 years-of-age. GPS and/or Wifi association logs and accelerometers were the most used sensors, although a wide variety of low-level features were extracted and computed (e.g., transition frequency, time spent in specific locations, uniformity of movement). Mobility and sociability patterns were explored in more studies compared to other behaviours such as sleep, phone use, and circadian movement. Studies used machine learning, statistical regression, and correlation analyses to examine relationships between variables. Results were mixed, but machine learning indicated that models using feature combinations (e.g., mobility, sociability, and sleep features) were better able to predict and detect symptoms of youth anxiety and/or depression when compared to models using single features (e.g., transition frequency). There was inconsistent reporting of age, gender, attrition, and phone characteristics (e.g., operating system, models), and all studies were assessed to have moderate to high risk of bias. To increase translation potential for clinical practice, we recommend the development of a standardised reporting framework to improve transparency and replicability of methodology.
Collapse
Affiliation(s)
- Joanne R. Beames
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Belgium
| | - Jin Han
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Artur Shvetcov
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Wu Yi Zheng
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Aimy Slade
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Omar Dabash
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Jodie Rosenberg
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Bridianne O'Dea
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Suranga Kasturi
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Leonard Hoon
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Australia
| | - Alexis E. Whitton
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Jill M. Newby
- Black Dog Institute and School of Psychology, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
2
|
Nepal S, Liu W, Pillai A, Wang W, Vojdanovski V, Huckins JF, Rogers C, Meyer ML, Campbell AT. Capturing the College Experience: A Four-Year Mobile Sensing Study of Mental Health, Resilience and Behavior of College Students during the Pandemic. PROCEEDINGS OF THE ACM ON INTERACTIVE, MOBILE, WEARABLE AND UBIQUITOUS TECHNOLOGIES 2024; 8:38. [PMID: 39086982 PMCID: PMC11290409 DOI: 10.1145/3643501] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
Understanding the dynamics of mental health among undergraduate students across the college years is of critical importance, particularly during a global pandemic. In our study, we track two cohorts of first-year students at Dartmouth College for four years, both on and off campus, creating the longest longitudinal mobile sensing study to date. Using passive sensor data, surveys, and interviews, we capture changing behaviors before, during, and after the COVID-19 pandemic subsides. Our findings reveal the pandemic's impact on students' mental health, gender based behavioral differences, impact of changing living conditions and evidence of persistent behavioral patterns as the pandemic subsides. We observe that while some behaviors return to normal, others remain elevated. Tracking over 200 undergraduate students from high school to graduation, our study provides invaluable insights into changing behaviors, resilience and mental health in college life. Conducting a long-term study with frequent phone OS updates poses significant challenges for mobile sensing apps, data completeness and compliance. Our results offer new insights for Human-Computer Interaction researchers, educators and administrators regarding college life pressures. We also detail the public release of the de-identified College Experience Study dataset used in this paper and discuss a number of open research questions that could be studied using the public dataset.
Collapse
Affiliation(s)
- Subigya Nepal
- Dartmouth College, Department of Computer Science, Hanover, NH, USA
| | - Wenjun Liu
- Dartmouth College, Department of Computer Science, Hanover, NH, USA
| | - Arvind Pillai
- Dartmouth College, Department of Computer Science, Hanover, NH, USA
| | - Weichen Wang
- Dartmouth College, Department of Computer Science, Hanover, NH, USA
| | | | | | - Courtney Rogers
- Dartmouth College, Psychological and Brain Sciences, Hanover, NH, USA
| | - Meghan L Meyer
- Columbia University, Department of Psychology, New York, NY, USA
| | | |
Collapse
|
3
|
Nestor BA, Chimoff J, Koike C, Weitzman ER, Riley BL, Uhl K, Kossowsky J. Adolescent and Parent Perspectives on Digital Phenotyping in Youths With Chronic Pain: Cross-Sectional Mixed Methods Survey Study. J Med Internet Res 2024; 26:e47781. [PMID: 38206665 PMCID: PMC10811597 DOI: 10.2196/47781] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/28/2023] [Accepted: 11/29/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Digital phenotyping is a promising methodology for capturing moment-to-moment data that can inform individually adapted and timely interventions for youths with chronic pain. OBJECTIVE This study aimed to investigate adolescent and parent endorsement, perceived utility, and concerns related to passive data stream collection through smartphones for digital phenotyping for clinical and research purposes in youths with chronic pain. METHODS Through multiple-choice and open-response survey questions, we assessed the perspectives of patient-parent dyads (103 adolescents receiving treatment for chronic pain at a pediatric hospital with an average age of 15.6, SD 1.6 years, and 99 parents with an average age of 47.8, SD 6.3 years) on passive data collection from the following 9 smartphone-embedded passive data streams: accelerometer, apps, Bluetooth, SMS text message and call logs, keyboard, microphone, light, screen, and GPS. RESULTS Quantitative and qualitative analyses indicated that adolescents and parent endorsement and perceived utility of digital phenotyping varied by stream, though participants generally endorsed the use of data collected by passive stream (35%-75.7% adolescent endorsement for clinical use and 37.9%-74.8% for research purposes; 53.5%-81.8% parent endorsement for clinical and 52.5%-82.8% for research purposes) if a certain level of utility could be provided. For adolescents and parents, adjusted logistic regression results indicated that the perceived utility of each stream significantly predicted the likelihood of endorsement of its use in both clinical practice and research (Ps<.05). Adolescents and parents alike identified accelerometer, light, screen, and GPS as the passive data streams with the highest utility (36.9%-47.5% identifying streams as useful). Similarly, adolescents and parents alike identified apps, Bluetooth, SMS text message and call logs, keyboard, and microphone as the passive data streams with the least utility (18.5%-34.3% identifying streams as useful). All participants reported primary concerns related to privacy, accuracy, and validity of the collected data. Passive data streams with the greatest number of total concerns were apps, Bluetooth, call and SMS text message logs, keyboard, and microphone. CONCLUSIONS Findings support the tailored use of digital phenotyping for this population and can help refine this methodology toward an acceptable, feasible, and ethical implementation of real-time symptom monitoring for assessment and intervention in youths with chronic pain.
Collapse
Affiliation(s)
- Bridget A Nestor
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Anesthesia, Harvard Medical School, Boston, MA, United States
| | - Justin Chimoff
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Camila Koike
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Elissa R Weitzman
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
- Division of Addiction Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Bobbie L Riley
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Anesthesia, Harvard Medical School, Boston, MA, United States
| | - Kristen Uhl
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, United States
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, United States
| | - Joe Kossowsky
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Anesthesia, Harvard Medical School, Boston, MA, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
4
|
Foley G, Ricciardelli R. Views on the Functionality and Use of the PeerConnect App Among Public Safety Personnel: Qualitative Analysis. JMIR Form Res 2023; 7:e46968. [PMID: 37930765 PMCID: PMC10660208 DOI: 10.2196/46968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/24/2023] [Accepted: 08/07/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Research supports that public safety personnel (PSP) are regularly exposed to potentially psychologically traumatic events and occupational stress, which can compromise their well-being. To help address PSP well-being and mental health, peer support is increasingly being adopted (and developed) in PSP organizations. Peer support apps have been developed to connect the peer and peer supporter anonymously and confidentially, but little is known about their effectiveness, utility, and uptake. OBJECTIVE We designed this study to evaluate the functionality and use of the PeerConnect app, which is a vehicle for receiving and administering peer support. The app connects peers but also provides information (eg, mental health screening tools, newsfeed) to users; thus, we wanted to understand why PSP adopted or did not adopt the app and the app's perceived utility. Our intention was to determine if the app served the purpose of connectivity for PSP organizations implementing peer support. METHODS A sample of PSP (N=23) participated in an interview about why they used or did not use the app. We first surveyed participants across PSP organizations in Ontario, Canada, and at the end of the survey invited participants to participate in a follow-up interview. Of the 23 PSP interviewed, 16 were PeerConnect users and 7 were nonusers. After transcribing all audio recordings of the interviews, we used an emergent theme approach to analyze themes within and across responses. RESULTS PSP largely viewed PeerConnect positively, with the Connect feature being most popular (this feature facilitated peer support), followed by the Newsfeed and Resources. App users appreciated the convenience of the app and felt the app helped reduce the stigma around peer support use and pressure on peer supporters while raising awareness of wellness. PSP who did not use the app attributed their nonuse to disinterest or uncertainty about the need for a peer support app and the web-based nature of the app. To increase app adoption, participants recommended increased communication and promotion of the app by the services and continued efforts to combat mental health stigma. CONCLUSIONS We provide contextual information about a peer support app's functionality and use. Our findings demonstrate that PSP are open to the use of mental health and peer support apps, but more education is required to reduce mental health stigma. Future research should continue to evaluate peer support apps for PSP to inform their design and ensure they are fulfilling their purpose.
Collapse
Affiliation(s)
- Gillian Foley
- Fisheries and Marine Institute, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Rosemary Ricciardelli
- Fisheries and Marine Institute, Memorial University of Newfoundland, St. John's, NL, Canada
| |
Collapse
|
5
|
Marin-Dragu S, Forbes A, Sheikh S, Iyer RS, Pereira Dos Santos D, Alda M, Hajek T, Uher R, Wozney L, Paulovich FV, Campbell LA, Yakovenko I, Stewart SH, Corkum P, Bagnell A, Orji R, Meier S. Associations of active and passive smartphone use with measures of youth mental health during the COVID-19 pandemic. Psychiatry Res 2023; 326:115298. [PMID: 37327652 PMCID: PMC10256630 DOI: 10.1016/j.psychres.2023.115298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/18/2023]
Abstract
Smartphone use provides a significant amount of screen-time for youth, and there have been growing concerns regarding its impact on their mental health. While time spent in a passive manner on the device is frequently considered deleterious, more active engagement with the phone might be protective for mental health. Recent developments in mobile sensing technology provide a unique opportunity to examine behaviour in a naturalistic manner. The present study sought to investigate, in a sample of 451 individuals (mean age 20.97 years old, 83% female), whether the amount of time spent on the device, an indicator of passive smartphone use, would be associated with worse mental health in youth and whether an active form of smartphone use, namely frequent checking of the device, would be associated with better outcomes. The findings highlight that overall time spent on the smartphone was associated with more pronounced internalizing and externalizing symptoms in youth, while the number of unlocks was associated with fewer internalizing symptoms. For externalizing symptoms, there was also a significant interaction between the two types of smartphone use observed. Using objective measures, our results suggest interventions targeting passive smartphone use may contribute to improving the mental health of youth.
Collapse
Affiliation(s)
- Silvia Marin-Dragu
- IWK Health Centre Department of Psychiatry & Specific Care Clinics, Department of Psychiatry, Dalhousie University, 5850/5980 University Ave., PO Box 9700, Halifax, NS B3K 6R8, Canada; Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Alyssa Forbes
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Sana Sheikh
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | | | - Davi Pereira Dos Santos
- IWK Health Centre Department of Psychiatry & Specific Care Clinics, Department of Psychiatry, Dalhousie University, 5850/5980 University Ave., PO Box 9700, Halifax, NS B3K 6R8, Canada
| | - Martin Alda
- IWK Health Centre Department of Psychiatry & Specific Care Clinics, Department of Psychiatry, Dalhousie University, 5850/5980 University Ave., PO Box 9700, Halifax, NS B3K 6R8, Canada
| | - Tomas Hajek
- IWK Health Centre Department of Psychiatry & Specific Care Clinics, Department of Psychiatry, Dalhousie University, 5850/5980 University Ave., PO Box 9700, Halifax, NS B3K 6R8, Canada
| | - Rudolf Uher
- IWK Health Centre Department of Psychiatry & Specific Care Clinics, Department of Psychiatry, Dalhousie University, 5850/5980 University Ave., PO Box 9700, Halifax, NS B3K 6R8, Canada
| | | | | | - Leslie Anne Campbell
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Igor Yakovenko
- IWK Health Centre Department of Psychiatry & Specific Care Clinics, Department of Psychiatry, Dalhousie University, 5850/5980 University Ave., PO Box 9700, Halifax, NS B3K 6R8, Canada; Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Sherry H Stewart
- IWK Health Centre Department of Psychiatry & Specific Care Clinics, Department of Psychiatry, Dalhousie University, 5850/5980 University Ave., PO Box 9700, Halifax, NS B3K 6R8, Canada; Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Penny Corkum
- IWK Health Centre Department of Psychiatry & Specific Care Clinics, Department of Psychiatry, Dalhousie University, 5850/5980 University Ave., PO Box 9700, Halifax, NS B3K 6R8, Canada; Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Alexa Bagnell
- IWK Health Centre Department of Psychiatry & Specific Care Clinics, Department of Psychiatry, Dalhousie University, 5850/5980 University Ave., PO Box 9700, Halifax, NS B3K 6R8, Canada
| | - Rita Orji
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | - Sandra Meier
- IWK Health Centre Department of Psychiatry & Specific Care Clinics, Department of Psychiatry, Dalhousie University, 5850/5980 University Ave., PO Box 9700, Halifax, NS B3K 6R8, Canada.
| |
Collapse
|
6
|
Winkler T, Büscher R, Larsen ME, Kwon S, Torous J, Firth J, Sander LB. Passive Sensing in the Prediction of Suicidal Thoughts and Behaviors: Protocol for a Systematic Review. JMIR Res Protoc 2022; 11:e42146. [PMID: 36445737 PMCID: PMC9748797 DOI: 10.2196/42146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Suicide is a severe public health problem, resulting in a high number of attempts and deaths each year. Early detection of suicidal thoughts and behaviors (STBs) is key to preventing attempts. We discuss passive sensing of digital and behavioral markers to enhance the detection and prediction of STBs. OBJECTIVE The paper presents the protocol for a systematic review that aims to summarize existing research on passive sensing of STBs and evaluate whether the STB prediction can be improved using passive sensing compared to prior prediction models. METHODS A systematic search will be conducted in the scientific databases MEDLINE, PubMed, Embase, PsycINFO, and Web of Science. Eligible studies need to investigate any passive sensor data from smartphones or wearables to predict STBs. The predictive value of passive sensing will be the primary outcome. The practical implications and feasibility of the studies will be considered as secondary outcomes. Study quality will be assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST). If studies are sufficiently homogenous, we will conduct a meta-analysis of the predictive value of passive sensing on STBs. RESULTS The review process started in July 2022 with data extraction in September 2022. Results are expected in December 2022. CONCLUSIONS Despite intensive research efforts, the ability to predict STBs is little better than chance. This systematic review will contribute to our understanding of the potential of passive sensing to improve STB prediction. Future research will be stimulated since gaps in the current literature will be identified and promising next steps toward clinical implementation will be outlined. TRIAL REGISTRATION OSF Registries osf-registrations-hzxua-v1; https://osf.io/hzxua. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42146.
Collapse
Affiliation(s)
- Tanita Winkler
- Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Rebekka Büscher
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Mark Erik Larsen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Sam Kwon
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - John Torous
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Joseph Firth
- Division of Psychology and Mental Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Lasse B Sander
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
7
|
Choudhary S, Thomas N, Alshamrani S, Srinivasan G, Ellenberger J, Nawaz U, Cohen R. A Machine Learning Approach for Continuous Mining of Nonidentifiable Smartphone Data to Create a Novel Digital Biomarker Detecting Generalized Anxiety Disorder: Prospective Cohort Study. JMIR Med Inform 2022; 10:e38943. [PMID: 36040777 PMCID: PMC9472035 DOI: 10.2196/38943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/11/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Anxiety is one of the leading causes of mental health disability around the world. Currently, a majority of the population who experience anxiety go undiagnosed or untreated. New and innovative ways of diagnosing and monitoring anxiety have emerged using smartphone sensor-based monitoring as a metric for the management of anxiety. This is a novel study as it adds to the field of research through the use of nonidentifiable smartphone usage to help detect and monitor anxiety remotely and in a continuous and passive manner. OBJECTIVE This study aims to evaluate the accuracy of a novel mental behavioral profiling metric derived from smartphone usage for the identification and tracking of generalized anxiety disorder (GAD). METHODS Smartphone data and self-reported 7-item GAD anxiety assessments were collected from 229 participants using an Android operating system smartphone in an observational study over an average of 14 days (SD 29.8). A total of 34 features were mined to be constructed as a potential digital phenotyping marker from continuous smartphone usage data. We further analyzed the correlation of these digital behavioral markers against each item of the 7-item Generalized Anxiety Disorder Scale (GAD-7) and its influence on the predictions of machine learning algorithms. RESULTS A total of 229 participants were recruited in this study who had completed the GAD-7 assessment and had at least one set of passive digital data collected within a 24-hour period. The mean GAD-7 score was 11.8 (SD 5.7). Regression modeling was tested against classification modeling and the highest prediction accuracy was achieved from a binary XGBoost classification model (precision of 73%-81%; recall of 68%-87%; F1-score of 71%-79%; accuracy of 76%; area under the curve of 80%). Nonparametric permutation testing with Pearson correlation results indicated that the proposed metric (Mental Health Similarity Score [MHSS]) had a colinear relationship between GAD-7 Items 1, 3 and 7. CONCLUSIONS The proposed MHSS metric demonstrates the feasibility of using passively collected nonintrusive smartphone data and machine learning-based data mining techniques to track an individuals' daily anxiety levels with a 76% accuracy that directly relates to the GAD-7 scale.
Collapse
Affiliation(s)
- Soumya Choudhary
- Department of Research, Behavidence, Inc., New York, NY, United States
| | - Nikita Thomas
- Department of Data Science, Behavidence, Inc., New York, NY, United States
| | - Sultan Alshamrani
- Department of Data Science, Behavidence, Inc., New York, NY, United States
| | - Girish Srinivasan
- Department of Data Science, Behavidence, Inc., New York, NY, United States
| | | | - Usman Nawaz
- Department of Data Science, Behavidence, Inc., New York, NY, United States
| | - Roy Cohen
- Department of Research, Behavidence, Inc., New York, NY, United States
| |
Collapse
|
8
|
Mullick T, Radovic A, Shaaban S, Doryab A. Predicting Depression in Adolescents Using Mobile and Wearable Sensors: Multimodal Machine Learning-Based Exploratory Study. JMIR Form Res 2022; 6:e35807. [PMID: 35749157 PMCID: PMC9270714 DOI: 10.2196/35807] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/21/2022] [Accepted: 05/22/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Depression levels in adolescents have trended upward over the past several years. According to a 2020 survey by the National Survey on Drug Use and Health, 4.1 million US adolescents have experienced at least one major depressive episode. This number constitutes approximately 16% of adolescents aged 12 to 17 years. However, only 32.3% of adolescents received some form of specialized or nonspecialized treatment. Identifying worsening symptoms earlier using mobile and wearable sensors may lead to earlier intervention. Most studies on predicting depression using sensor-based data are geared toward the adult population. Very few studies look into predicting depression in adolescents. OBJECTIVE The aim of our work was to study passively sensed data from adolescents with depression and investigate the predictive capabilities of 2 machine learning approaches to predict depression scores and change in depression levels in adolescents. This work also provided an in-depth analysis of sensor features that serve as key indicators of change in depressive symptoms and the effect of variation of data samples on model accuracy levels. METHODS This study included 55 adolescents with symptoms of depression aged 12 to 17 years. Each participant was passively monitored through smartphone sensors and Fitbit wearable devices for 24 weeks. Passive sensors collected call, conversation, location, and heart rate information daily. Following data preprocessing, 67% (37/55) of the participants in the aggregated data set were analyzed. Weekly Patient Health Questionnaire-9 surveys answered by participants served as the ground truth. We applied regression-based approaches to predict the Patient Health Questionnaire-9 depression score and change in depression severity. These approaches were consolidated using universal and personalized modeling strategies. The universal strategies consisted of Leave One Participant Out and Leave Week X Out. The personalized strategy models were based on Accumulated Weeks and Leave One Week One User Instance Out. Linear and nonlinear machine learning algorithms were trained to model the data. RESULTS We observed that personalized approaches performed better on adolescent depression prediction compared with universal approaches. The best models were able to predict depression score and weekly change in depression level with root mean squared errors of 2.83 and 3.21, respectively, following the Accumulated Weeks personalized modeling strategy. Our feature importance investigation showed that the contribution of screen-, call-, and location-based features influenced optimal models and were predictive of adolescent depression. CONCLUSIONS This study provides insight into the feasibility of using passively sensed data for predicting adolescent depression. We demonstrated prediction capabilities in terms of depression score and change in depression level. The prediction results revealed that personalized models performed better on adolescents than universal approaches. Feature importance provided a better understanding of depression and sensor data. Our findings can help in the development of advanced adolescent depression predictions.
Collapse
Affiliation(s)
- Tahsin Mullick
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, United States
| | - Ana Radovic
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Afsaneh Doryab
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, United States
| |
Collapse
|
9
|
Kulkarni P, Kirkham R, McNaney R. Opportunities for Smartphone Sensing in E-Health Research: A Narrative Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:3893. [PMID: 35632301 PMCID: PMC9147201 DOI: 10.3390/s22103893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 12/10/2022]
Abstract
Recent years have seen significant advances in the sensing capabilities of smartphones, enabling them to collect rich contextual information such as location, device usage, and human activity at a given point in time. Combined with widespread user adoption and the ability to gather user data remotely, smartphone-based sensing has become an appealing choice for health research. Numerous studies over the years have demonstrated the promise of using smartphone-based sensing to monitor a range of health conditions, particularly mental health conditions. However, as research is progressing to develop the predictive capabilities of smartphones, it becomes even more crucial to fully understand the capabilities and limitations of using this technology, given its potential impact on human health. To this end, this paper presents a narrative review of smartphone-sensing literature from the past 5 years, to highlight the opportunities and challenges of this approach in healthcare. It provides an overview of the type of health conditions studied, the types of data collected, tools used, and the challenges encountered in using smartphones for healthcare studies, which aims to serve as a guide for researchers wishing to embark on similar research in the future. Our findings highlight the predominance of mental health studies, discuss the opportunities of using standardized sensing approaches and machine-learning advancements, and present the trends of smartphone sensing in healthcare over the years.
Collapse
Affiliation(s)
- Pranav Kulkarni
- Department of Human Centered Computing, Faculty of IT, Monash University, Clayton, VIC 3168, Australia; (R.K.); (R.M.)
| | | | | |
Collapse
|
10
|
Castro R, Ribeiro-Alves M, Oliveira C, Romero CP, Perazzo H, Simjanoski M, Kapciznki F, Balanzá-Martínez V, De Boni RB. What Are We Measuring When We Evaluate Digital Interventions for Improving Lifestyle? A Scoping Meta-Review. Front Public Health 2022; 9:735624. [PMID: 35047469 PMCID: PMC8761632 DOI: 10.3389/fpubh.2021.735624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/29/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Lifestyle Medicine (LM) aims to address six main behavioral domains: diet/nutrition, substance use (SU), physical activity (PA), social relationships, stress management, and sleep. Digital Health Interventions (DHIs) have been used to improve these domains. However, there is no consensus on how to measure lifestyle and its intermediate outcomes aside from measuring each behavior separately. We aimed to describe (1) the most frequent lifestyle domains addressed by DHIs, (2) the most frequent outcomes used to measure lifestyle changes, and (3) the most frequent DHI delivery methods. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) Extension for Scoping Reviews. A literature search was conducted using MEDLINE, Cochrane Library, EMBASE, and Web of Science for publications since 2010. We included systematic reviews and meta-analyses of clinical trials using DHI to promote health, behavioral, or lifestyle change. Results: Overall, 954 records were identified, and 72 systematic reviews were included. Of those, 35 conducted meta-analyses, 58 addressed diet/nutrition, and 60 focused on PA. Only one systematic review evaluated all six lifestyle domains simultaneously; 1 systematic review evaluated five lifestyle domains; 5 systematic reviews evaluated 4 lifestyle domains; 14 systematic reviews evaluated 3 lifestyle domains; and the remaining 52 systematic reviews evaluated only one or two domains. The most frequently evaluated domains were diet/nutrition and PA. The most frequent DHI delivery methods were smartphone apps and websites. Discussion: The concept of lifestyle is still unclear and fragmented, making it hard to evaluate the complex interconnections of unhealthy behaviors, and their impact on health. Clarifying this concept, refining its operationalization, and defining the reporting guidelines should be considered as the current research priorities. DHIs have the potential to improve lifestyle at primary, secondary, and tertiary levels of prevention-but most of them are targeting clinical populations. Although important advances have been made to evaluate DHIs, some of their characteristics, such as the rate at which they become obsolete, will require innovative research designs to evaluate long-term outcomes in health.
Collapse
Affiliation(s)
- Rodolfo Castro
- Escola Nacional de Saúde Pública Sergio Arouca, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
- Instituto de Saúde Coletiva, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcelo Ribeiro-Alves
- Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Cátia Oliveira
- Centro de Desenvolvimento Tecnológico em Saúde, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Carmen Phang Romero
- Centro de Desenvolvimento Tecnológico em Saúde, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Hugo Perazzo
- Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Mario Simjanoski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Flavio Kapciznki
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - Raquel B. De Boni
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| |
Collapse
|