Department of Psychiatry and Public Health Sciences, University of Rochester Medical Center.
Department of Psychiatry, School of Nursing, University of Rochester Medical Center.
Personal Disord. 2019 Jan;10(1):46-58. doi: 10.1037/per0000300.
The age of "big data" in health has ushered in an era of prediction models promising to forecast individual health events. Although many models focus on enhancing the predictive power of medical risk factors with genomic data, a recent proposal is to augment traditional health predictors with psychosocial data, such as personality measures. In this article we provide a general overview of the medical risk prediction models and then discuss the rationale for integrating personality data. We suggest three principles that should guide work in this area if personality data is ultimately to be useful within risk prediction as it is actually practiced in the health care system. These include (a) prediction of specific, priority health outcomes; (b) sufficient incremental validity beyond established biomedical risk factors; and (c) technically responsible model-building that does not overfit the data. We then illustrate the application of these principles in the development of a personality-augmented prediction model for the occurrence of mild cognitive impairment, designed for a primary care setting. We evaluate the results, drawing conclusions for the direction an iterative, programmatic approach would need to take to eventually achieve clinical utility. Although there is great potential for personality measurement to play a key role in the coming era of risk prediction models, the final section reviews the many challenges that must be faced in real-world implementation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
健康领域的“大数据”时代迎来了一个充满希望的时代,预测模型可以预测个人健康事件。尽管许多模型专注于利用基因组数据来提高医疗风险因素的预测能力,但最近有人提议用心理社会数据(如人格测量)来扩充传统的健康预测因素。在本文中,我们对医学风险预测模型进行了概述,然后讨论了整合人格数据的基本原理。如果人格数据最终要像在医疗保健系统中实际应用的那样,对风险预测有用,我们建议在该领域开展工作时应遵循三个原则。这些原则包括:(a)预测特定的、优先的健康结果;(b)在既定的生物医学风险因素之外具有足够的增量有效性;(c)技术上负责任的模型构建,避免过度拟合数据。然后,我们将这些原则应用于一个用于轻度认知障碍发生的人格增强预测模型的开发,该模型设计用于初级保健环境。我们评估了结果,为迭代、计划性方法的方向得出结论,以最终实现临床应用。尽管人格测量在即将到来的风险预测模型时代具有很大的潜力,但最后一部分回顾了在实际实施中必须面对的许多挑战。(美国心理协会,2019)