Koa Health, Barcelona, Spain.
Universitat Pompeu Fabra, Department of Information and Communication Technologies, Barcelona, Spain.
Nat Med. 2022 Jun;28(6):1240-1248. doi: 10.1038/s41591-022-01811-5. Epub 2022 May 16.
The timely identification of patients who are at risk of a mental health crisis can lead to improved outcomes and to the mitigation of burdens and costs. However, the high prevalence of mental health problems means that the manual review of complex patient records to make proactive care decisions is not feasible in practice. Therefore, we developed a machine learning model that uses electronic health records to continuously monitor patients for risk of a mental health crisis over a period of 28 days. The model achieves an area under the receiver operating characteristic curve of 0.797 and an area under the precision-recall curve of 0.159, predicting crises with a sensitivity of 58% at a specificity of 85%. A follow-up 6-month prospective study evaluated our algorithm's use in clinical practice and observed predictions to be clinically valuable in terms of either managing caseloads or mitigating the risk of crisis in 64% of cases. To our knowledge, this study is the first to continuously predict the risk of a wide range of mental health crises and to explore the added value of such predictions in clinical practice.
及时识别有心理健康危机风险的患者可以改善治疗效果,并减轻负担和成本。然而,心理健康问题的高患病率意味着手动审查复杂的患者记录以做出主动护理决策在实践中是不可行的。因此,我们开发了一种机器学习模型,该模型使用电子健康记录在 28 天的时间段内连续监测患者的心理健康危机风险。该模型的受试者工作特征曲线下面积为 0.797,精度-召回曲线下面积为 0.159,预测危机的敏感性为 58%,特异性为 85%。一项后续的 6 个月前瞻性研究评估了我们的算法在临床实践中的使用情况,并观察到该算法在管理病例量或降低 64%案例的危机风险方面具有临床价值。据我们所知,这项研究首次连续预测广泛的心理健康危机风险,并探讨了此类预测在临床实践中的附加值。