IEEE J Biomed Health Inform. 2021 Aug;25(8):2866-2876. doi: 10.1109/JBHI.2021.3053909. Epub 2021 Aug 6.
Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition resulting from threatening or horrifying events. We hypothesized that circadian rhythm changes, measured by a wrist-worn research watch are predictive of post-trauma outcomes.
1618 post-trauma patients were enrolled after admission to emergency departments (ED). Three standardized questionnaires were administered at week eight to measure post-trauma outcomes related to PTSD, sleep disturbance, and pain interference with daily life. Pulse activity and movement data were captured from a research watch for eight weeks. Standard and novel movement and cardiovascular metrics that reflect circadian rhythms were derived using this data. These features were used to train different classifiers to predict the three outcomes derived from week-eight surveys. Clinical surveys administered at ED were also used as features in the baseline models.
The highest cross-validated performance of research watch-based features was achieved for classifying participants with pain interference by a logistic regression model, with an area under the receiver operating characteristic curve (AUC) of 0.70. The ED survey-based model achieved an AUC of 0.77, and the fusion of research watch and ED survey metrics improved the AUC to 0.79.
This work represents the first attempt to predict and classify post-trauma symptoms from passive wearable data using machine learning approaches that leverage the circadian desynchrony in a potential PTSD population.
创伤后应激障碍(PTSD)是一种由威胁或恐怖事件引起的精神疾病。我们假设,通过佩戴在手腕上的研究用表测量的昼夜节律变化可预测创伤后的结果。
1618 名创伤后患者在急诊部(ED)入院后被纳入研究。在第八周,使用三个标准化问卷评估与 PTSD、睡眠障碍和疼痛对日常生活的干扰相关的创伤后结果。使用研究用表采集八周的脉搏活动和运动数据。使用这些数据得出反映昼夜节律的标准和新型运动和心血管指标。使用这些特征来训练不同的分类器,以预测第八周调查得出的三个结果。ED 就诊时进行的临床调查也被用作基线模型中的特征。
基于研究用表特征的分类器在预测疼痛干扰方面表现最佳,逻辑回归模型的受试者工作特征曲线下面积(AUC)为 0.70。基于 ED 调查的模型的 AUC 为 0.77,融合研究用表和 ED 调查指标将 AUC 提高至 0.79。
这项工作代表了首次尝试使用机器学习方法从被动可穿戴数据中预测和分类创伤后症状,这些方法利用了潜在 PTSD 人群中的昼夜节律失调。