Optimizing the Prediction of Depression Remission: A Longitudinal Machine Learning Approach.

IF 1.6 3区 医学 Q3 GENETICS & HEREDITY American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Pub Date : 2024-10-29 DOI:10.1002/ajmg.b.33014
Ewan Carr, Marcella Rietschel, Ole Mors, Neven Henigsberg, Katherine J Aitchison, Wolfgang Maier, Rudolf Uher, Anne Farmer, Peter McGuffin, Raquel Iniesta
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Abstract

Decisions about when to change antidepressant treatment are complex and benefit from accurate prediction of treatment outcome. Prognostic accuracy can be enhanced by incorporating repeated assessments of symptom severity collected during treatment. Participants (n = 714) from the Genome-Based Therapeutic Drugs for Depression study received escitalopram or nortriptyline over 12 weeks. Remission was defined as scoring ≤ 7 on the Hamilton Rating Scale. Predictors included demographic, clinical, and genetic variables (at 0 weeks) and measures of symptom severity (at 0, 2, 4, and 6 weeks). Longitudinal descriptors extracted with growth curves and topological data analysis were used to inform prediction of remission. Repeated assessments produced gradual and drug-specific improvements in predictive performance. By Week 4, models' discrimination in all samples reached levels that might usefully inform treatment decisions (area under the receiver operating curve (AUC) = 0.777 for nortriptyline; AUC = 0.807 for escitalopram; AUC = 0.794 for combined sample). Decisions around switching or modifying treatments for depression can be informed by repeated symptom assessments collected during treatment, but not until 4 weeks after the start of treatment.

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优化抑郁症缓解预测:纵向机器学习方法。
决定何时更换抗抑郁治疗方法是一项复杂的工作,需要对治疗结果进行准确预测。通过在治疗过程中对症状严重程度进行反复评估,可以提高预测的准确性。基于基因组的抑郁症治疗药物研究的参与者(n = 714)接受了为期 12 周的艾司西酞普兰或去甲替林治疗。汉密尔顿评分量表得分≤7分即为缓解。预测因素包括人口统计学、临床和遗传变异(0 周时)以及症状严重程度测量(0、2、4 和 6 周时)。利用生长曲线和拓扑数据分析提取的纵向描述符为缓解预测提供了依据。通过重复评估,预测性能逐步提高,并针对特定药物。到第4周时,所有样本中模型的辨别力都达到了可为治疗决策提供有用信息的水平(去甲替林的接收者工作曲线下面积(AUC)=0.777;艾司西酞普兰的接收者工作曲线下面积(AUC)=0.807;综合样本的接收者工作曲线下面积(AUC)=0.794)。在治疗过程中,可通过重复收集症状评估结果来决定是否更换或修改抑郁症治疗方法,但要等到治疗开始 4 周后。
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来源期刊
CiteScore
5.90
自引率
7.10%
发文量
40
审稿时长
4-8 weeks
期刊介绍: Neuropsychiatric Genetics, Part B of the American Journal of Medical Genetics (AJMG) , provides a forum for experimental and clinical investigations of the genetic mechanisms underlying neurologic and psychiatric disorders. It is a resource for novel genetics studies of the heritable nature of psychiatric and other nervous system disorders, characterized at the molecular, cellular or behavior levels. Neuropsychiatric Genetics publishes eight times per year.
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Issue Information - TOC Contribution of Rare and Potentially Functionally Relevant Sequence Variants in Schizophrenia Risk-Locus Xq28,distal. Optimizing the Prediction of Depression Remission: A Longitudinal Machine Learning Approach. New Insights Into TRMT10A Syndrome: Case Report and Literature Review. Characterization of Two Novel PNKP Splice-Site Variants in a Proband With Microcephaly, Intellectual Disability, and Multiple Malformations.
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