Cargando…
The potential of digital behavioural tests as a diagnostic aid for psychosis
Timely interventions have a proven benefit for people experiencing psychotic illness. One bottleneck to accessing timely interventions is the referral process to the specialist team for early psychosis (STEP). Many general practitioners lack awareness or confidence in recognising psychotic symptoms...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503702/ https://www.ncbi.nlm.nih.gov/pubmed/37713385 http://dx.doi.org/10.1371/journal.pdig.0000339 |
_version_ | 1785106575968436224 |
---|---|
author | Słowiński, Piotr White, Alexander Lison, Sian Sullivan, Sarah Emmens, Tobit Self, Philip Wileman, Jane Karl, Anke Tsaneva-Atanasova, Krasimira |
author_facet | Słowiński, Piotr White, Alexander Lison, Sian Sullivan, Sarah Emmens, Tobit Self, Philip Wileman, Jane Karl, Anke Tsaneva-Atanasova, Krasimira |
author_sort | Słowiński, Piotr |
collection | PubMed |
description | Timely interventions have a proven benefit for people experiencing psychotic illness. One bottleneck to accessing timely interventions is the referral process to the specialist team for early psychosis (STEP). Many general practitioners lack awareness or confidence in recognising psychotic symptoms or state. Additionally, referrals for people without apparent psychotic symptoms, although beneficial at a population level, lead to excessive workload for STEPs. There is a clear unmet need for accurate stratification of STEPs users and healthy cohorts. Here we propose a new approach to addressing this need via the application of digital behavioural tests. To demonstrate that digital behavioural tests can be used to discriminate between the STEPs users (SU; n = 32) and controls (n = 32, age and sex matched), we compared performance of five different classifiers applied to objective, quantitative and interpretable features derived from the ‘mirror game’ (MG) and trail making task (TMT). The MG is a movement coordination task shown to be a potential socio-motor biomarker of schizophrenia, while TMT is a neuropsychiatric test of cognitive function. All classifiers had AUC in the range of 0.84–0.92. The best of the five classifiers (linear discriminant classifier) achieved an outstanding performance, AUC = 0.92 (95%CI 0.75–1), Sensitivity = 0.75 (95%CI 0.5–1), Specificity = 1 (95%CI 0.75–1), evaluated on 25% hold-out and 1000 folds. Performance of all analysed classifiers is underpinned by the large effect sizes of the differences between the cohorts in terms of the features used for classification what ensures generalisability of the results. We also found that MG and TMT are unsuitable in isolation to successfully differentiate between SU with and without at-risk-mental-state or first episode psychosis with sufficient level of performance. Our findings show that standardised batteries of digital behavioural tests could benefit both clinical and research practice. Including digital behavioural tests into healthcare practice could allow precise phenotyping and stratification of the highly heterogenous population of people referred to STEPs resulting in quicker and more personalised diagnosis. Moreover, the high specificity of digital behavioural tests could facilitate the identification of more homogeneous clinical high-risk populations, benefiting research on prognostic instruments for psychosis. In summary, our study demonstrates that cheap off-the-shelf equipment (laptop computer and a leap motion sensor) can be used to record clinically relevant behavioural data that could be utilised in digital mental health applications. |
format | Online Article Text |
id | pubmed-10503702 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-105037022023-09-16 The potential of digital behavioural tests as a diagnostic aid for psychosis Słowiński, Piotr White, Alexander Lison, Sian Sullivan, Sarah Emmens, Tobit Self, Philip Wileman, Jane Karl, Anke Tsaneva-Atanasova, Krasimira PLOS Digit Health Research Article Timely interventions have a proven benefit for people experiencing psychotic illness. One bottleneck to accessing timely interventions is the referral process to the specialist team for early psychosis (STEP). Many general practitioners lack awareness or confidence in recognising psychotic symptoms or state. Additionally, referrals for people without apparent psychotic symptoms, although beneficial at a population level, lead to excessive workload for STEPs. There is a clear unmet need for accurate stratification of STEPs users and healthy cohorts. Here we propose a new approach to addressing this need via the application of digital behavioural tests. To demonstrate that digital behavioural tests can be used to discriminate between the STEPs users (SU; n = 32) and controls (n = 32, age and sex matched), we compared performance of five different classifiers applied to objective, quantitative and interpretable features derived from the ‘mirror game’ (MG) and trail making task (TMT). The MG is a movement coordination task shown to be a potential socio-motor biomarker of schizophrenia, while TMT is a neuropsychiatric test of cognitive function. All classifiers had AUC in the range of 0.84–0.92. The best of the five classifiers (linear discriminant classifier) achieved an outstanding performance, AUC = 0.92 (95%CI 0.75–1), Sensitivity = 0.75 (95%CI 0.5–1), Specificity = 1 (95%CI 0.75–1), evaluated on 25% hold-out and 1000 folds. Performance of all analysed classifiers is underpinned by the large effect sizes of the differences between the cohorts in terms of the features used for classification what ensures generalisability of the results. We also found that MG and TMT are unsuitable in isolation to successfully differentiate between SU with and without at-risk-mental-state or first episode psychosis with sufficient level of performance. Our findings show that standardised batteries of digital behavioural tests could benefit both clinical and research practice. Including digital behavioural tests into healthcare practice could allow precise phenotyping and stratification of the highly heterogenous population of people referred to STEPs resulting in quicker and more personalised diagnosis. Moreover, the high specificity of digital behavioural tests could facilitate the identification of more homogeneous clinical high-risk populations, benefiting research on prognostic instruments for psychosis. In summary, our study demonstrates that cheap off-the-shelf equipment (laptop computer and a leap motion sensor) can be used to record clinically relevant behavioural data that could be utilised in digital mental health applications. Public Library of Science 2023-09-15 /pmc/articles/PMC10503702/ /pubmed/37713385 http://dx.doi.org/10.1371/journal.pdig.0000339 Text en © 2023 Słowiński et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Słowiński, Piotr White, Alexander Lison, Sian Sullivan, Sarah Emmens, Tobit Self, Philip Wileman, Jane Karl, Anke Tsaneva-Atanasova, Krasimira The potential of digital behavioural tests as a diagnostic aid for psychosis |
title | The potential of digital behavioural tests as a diagnostic aid for psychosis |
title_full | The potential of digital behavioural tests as a diagnostic aid for psychosis |
title_fullStr | The potential of digital behavioural tests as a diagnostic aid for psychosis |
title_full_unstemmed | The potential of digital behavioural tests as a diagnostic aid for psychosis |
title_short | The potential of digital behavioural tests as a diagnostic aid for psychosis |
title_sort | potential of digital behavioural tests as a diagnostic aid for psychosis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503702/ https://www.ncbi.nlm.nih.gov/pubmed/37713385 http://dx.doi.org/10.1371/journal.pdig.0000339 |
work_keys_str_mv | AT słowinskipiotr thepotentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT whitealexander thepotentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT lisonsian thepotentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT sullivansarah thepotentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT emmenstobit thepotentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT selfphilip thepotentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT wilemanjane thepotentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT karlanke thepotentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT tsanevaatanasovakrasimira thepotentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT słowinskipiotr potentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT whitealexander potentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT lisonsian potentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT sullivansarah potentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT emmenstobit potentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT selfphilip potentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT wilemanjane potentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT karlanke potentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis AT tsanevaatanasovakrasimira potentialofdigitalbehaviouraltestsasadiagnosticaidforpsychosis |