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AI-assisted prediction of differential response to antidepressant classes using electronic health records.

作者信息

Sheu Yi-Han, Magdamo Colin, Miller Matthew, Das Sudeshna, Blacker Deborah, Smoller Jordan W

机构信息

Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.

出版信息

NPJ Digit Med. 2023 Apr 26;6(1):73. doi: 10.1038/s41746-023-00817-8.


DOI:10.1038/s41746-023-00817-8
PMID:37100858
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10133261/
Abstract

Antidepressant selection is largely a trial-and-error process. We used electronic health record (EHR) data and artificial intelligence (AI) to predict response to four antidepressants classes (SSRI, SNRI, bupropion, and mirtazapine) 4 to 12 weeks after antidepressant initiation. The final data set comprised 17,556 patients. Predictors were derived from both structured and unstructured EHR data and models accounted for features predictive of treatment selection to minimize confounding by indication. Outcome labels were derived through expert chart review and AI-automated imputation. Regularized generalized linear model (GLM), random forest, gradient boosting machine (GBM), and deep neural network (DNN) models were trained and their performance compared. Predictor importance scores were derived using SHapley Additive exPlanations (SHAP). All models demonstrated similarly good prediction performance (AUROCs ≥ 0.70, AUPRCs ≥ 0.68). The models can estimate differential treatment response probabilities both between patients and between antidepressant classes for the same patient. In addition, patient-specific factors driving response probabilities for each antidepressant class can be generated. We show that antidepressant response can be accurately predicted from real-world EHR data with AI modeling, and our approach could inform further development of clinical decision support systems for more effective treatment selection.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d2/10133261/8f7e672ed1be/41746_2023_817_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d2/10133261/4e68543babab/41746_2023_817_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d2/10133261/0956617e5811/41746_2023_817_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d2/10133261/f886f4d41eda/41746_2023_817_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d2/10133261/8f7e672ed1be/41746_2023_817_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d2/10133261/4e68543babab/41746_2023_817_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d2/10133261/0956617e5811/41746_2023_817_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d2/10133261/f886f4d41eda/41746_2023_817_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d2/10133261/8f7e672ed1be/41746_2023_817_Fig4_HTML.jpg

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本文引用的文献

[1]
Development of a model to predict antidepressant treatment response for depression among Veterans.

Psychol Med. 2023-8

[2]
Initial antidepressant choice by non-psychiatrists: Learning from large-scale electronic health records.

Gen Hosp Psychiatry. 2023

[3]
Electroencephalographic Network Topologies Predict Antidepressant Responses in Patients With Major Depressive Disorder.

IEEE Trans Neural Syst Rehabil Eng. 2022

[4]
Predicting escitalopram treatment response from pre-treatment and early response resting state fMRI in a multi-site sample: A CAN-BIND-1 report.

Neuroimage Clin. 2022

[5]
Dynamic Resting-State Network Biomarkers of Antidepressant Treatment Response.

Biol Psychiatry. 2022-10-1

[6]
Predicting the Treatment Outcomes of Antidepressants Using a Deep Neural Network of Deep Learning in Drug-Naïve Major Depressive Patients.

J Pers Med. 2022-4-26

[7]
Treatment selection using prototyping in latent-space with application to depression treatment.

PLoS One. 2021

[8]
Measuring brain glucose metabolism in order to predict response to antidepressant or placebo: A randomized clinical trial.

Neuroimage Clin. 2021

[9]
Optimizing prediction of response to antidepressant medications using machine learning and integrated genetic, clinical, and demographic data.

Transl Psychiatry. 2021-7-8

[10]
Replication of machine learning methods to predict treatment outcome with antidepressant medications in patients with major depressive disorder from STAR*D and CAN-BIND-1.

PLoS One. 2021

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