Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA; email:
Annu Rev Clin Psychol. 2018 May 7;14:209-236. doi: 10.1146/annurev-clinpsy-050817-084746. Epub 2018 Mar 1.
Mental health researchers and clinicians have long sought answers to the question "What works for whom?" The goal of precision medicine is to provide evidence-based answers to this question. Treatment selection in depression aims to help each individual receive the treatment, among the available options, that is most likely to lead to a positive outcome for them. Although patient variables that are predictive of response to treatment have been identified, this knowledge has not yet translated into real-world treatment recommendations. The Personalized Advantage Index (PAI) and related approaches combine information obtained prior to the initiation of treatment into multivariable prediction models that can generate individualized predictions to help clinicians and patients select the right treatment. With increasing availability of advanced statistical modeling approaches, as well as novel predictive variables and big data, treatment selection models promise to contribute to improved outcomes in depression.
心理健康研究人员和临床医生长期以来一直在寻找“对谁有效?”的答案。精准医学的目标是为这个问题提供基于证据的答案。抑郁症的治疗选择旨在帮助每个个体从现有选择中获得最有可能对他们产生积极结果的治疗。尽管已经确定了对治疗反应有预测作用的患者变量,但这些知识尚未转化为实际的治疗建议。个性化优势指数(PAI)和相关方法将治疗开始前获得的信息结合到多变量预测模型中,这些模型可以生成个性化预测,帮助临床医生和患者选择正确的治疗方法。随着先进统计建模方法以及新的预测变量和大数据的日益普及,治疗选择模型有望改善抑郁症的治疗效果。