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Uncovering Social States in Healthy and Clinical Populations Using Digital Phenotyping and Hidden Markov Models: Observational Study.

作者信息

Leaning Imogen E, Costanzo Andrea, Jagesar Raj, Reus Lianne M, Visser Pieter Jelle, Kas Martien J H, Beckmann Christian F, Ruhé Henricus G, Marquand Andre F

机构信息

Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.

Department for Medical Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.

出版信息

J Med Internet Res. 2025 Apr 28;27:e64007. doi: 10.2196/64007.


DOI:10.2196/64007
PMID:40294408
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12070022/
Abstract

BACKGROUND: Brain-related disorders are characterized by observable behavioral symptoms, for example, social withdrawal. Smartphones can passively collect behavioral data reflecting digital activities such as communication app usage and calls. These data are collected objectively in real time, avoiding recall bias, and may, therefore, be a useful tool for measuring behaviors related to social functioning. Despite promising clinical utility, analyzing smartphone data is challenging as datasets often include a range of temporal features prone to missingness. OBJECTIVE: Hidden Markov models (HMMs) provide interpretable, lower-dimensional temporal representations of data, allowing for missingness. This study aimed to investigate the HMM as a method for modeling smartphone time series data. METHODS: We applied an HMM to an aggregate dataset of smartphone measures designed to assess phone-related social functioning in healthy controls (HCs) and participants with schizophrenia, Alzheimer disease (AD), and memory complaints. We trained the HMM on a subset of HCs (91/348, 26.1%) and selected a model with socially active and inactive states. Then, we generated hidden state sequences per participant and calculated their "total dwell time," that is, the percentage of time spent in the socially active state. Linear regression models were used to compare the total dwell time to social and clinical measures in a subset of participants with available measures, and logistic regression was used to compare total dwell times between diagnostic groups and HCs. We primarily reported results from a 2-state HMM but also verified results in HMMs with more hidden states and trained on the whole participant dataset. RESULTS: We identified lower total dwell times in participants with AD (26/257, 10.1%) versus withheld HCs (156/257, 60.7%; odds ratio 0.95, 95% CI 0.92-0.97; false discovery rate [FDR]-corrected P<.001), as well as in participants with memory complaints (57/257, 22.2%; odds ratio 0.97, 95% CI 0.96-0.99; FDR-corrected P=.004). The result in the AD group was very robust across HMM variations, whereas the result in the memory complaints group was less robust. We also observed an interaction between the AD group and total dwell time when predicting social functioning (FDR-corrected P=.02). No significant relationships regarding total dwell time were identified for participants with schizophrenia (18/257, 7%; P>.99). CONCLUSIONS: We found the HMM to be a practical, interpretable method for digital phenotyping analysis, providing an objective phenotype that is a possible indicator of social functioning.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/fcad5af4f8ff/jmir_v27i1e64007_fig10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/05b76a708c87/jmir_v27i1e64007_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/fc1b92b3089a/jmir_v27i1e64007_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/c6d0f28f1733/jmir_v27i1e64007_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/daad061a6bb8/jmir_v27i1e64007_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/527c5fb7ef0d/jmir_v27i1e64007_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/c318beebec49/jmir_v27i1e64007_fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/e4782e80514d/jmir_v27i1e64007_fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/dd50d567f3a8/jmir_v27i1e64007_fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/a62f63e930f6/jmir_v27i1e64007_fig9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/fcad5af4f8ff/jmir_v27i1e64007_fig10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/05b76a708c87/jmir_v27i1e64007_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/fc1b92b3089a/jmir_v27i1e64007_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/c6d0f28f1733/jmir_v27i1e64007_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/daad061a6bb8/jmir_v27i1e64007_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/527c5fb7ef0d/jmir_v27i1e64007_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/c318beebec49/jmir_v27i1e64007_fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/e4782e80514d/jmir_v27i1e64007_fig7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/dd50d567f3a8/jmir_v27i1e64007_fig8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/a62f63e930f6/jmir_v27i1e64007_fig9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7bd/12070022/fcad5af4f8ff/jmir_v27i1e64007_fig10.jpg

相似文献

[1]
Uncovering Social States in Healthy and Clinical Populations Using Digital Phenotyping and Hidden Markov Models: Observational Study.

J Med Internet Res. 2025-4-28

[2]
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JMIR Public Health Surveill. 2024-10-11

[3]
Utility of Digital Phenotyping Based on Wrist Wearables and Smartphones in Psychosis: Observational Study.

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[4]
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[5]
Digital phenotyping of social functioning and employment in people with schizophrenia: Pilot data from an international sample.

Psychiatry Clin Neurosci. 2025-3

[6]
Toward a Mobile Platform for Real-world Digital Measurement of Depression: User-Centered Design, Data Quality, and Behavioral and Clinical Modeling.

JMIR Ment Health. 2021-8-10

[7]
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JMIR Ment Health. 2025-2-21

[8]
Predicting Emotional States Using Behavioral Markers Derived From Passively Sensed Data: Data-Driven Machine Learning Approach.

JMIR Mhealth Uhealth. 2021-3-22

[9]
Examining the Correlation Between Depression and Social Behavior on Smartphones Through Usage Metadata: Empirical Study.

JMIR Mhealth Uhealth. 2021-1-6

[10]
Flexible modeling of headache frequency fluctuations in migraine with hidden Markov models.

Headache. 2025-1

本文引用的文献

[1]
From smartphone data to clinically relevant predictions: A systematic review of digital phenotyping methods in depression.

Neurosci Biobehav Rev. 2024-3

[2]
Digital behavioural signatures reveal trans-diagnostic clusters of Schizophrenia and Alzheimer's disease patients.

Eur Neuropsychopharmacol. 2024-1

[3]
Decreased step count prior to the first visit for MDD treatment: a retrospective, observational, longitudinal cohort study of continuously measured walking activity obtained from smartphones.

Front Public Health. 2023

[4]
Challenges in Using mHealth Data From Smartphones and Wearable Devices to Predict Depression Symptom Severity: Retrospective Analysis.

J Med Internet Res. 2023-8-14

[5]
Intraindividual phenotyping of depression in high-risk youth: An application of a multilevel hidden Markov model.

Dev Psychopathol. 2023-5-23

[6]
Evidence for embracing normative modeling.

Elife. 2023-3-13

[7]
Relapse prediction in schizophrenia with smartphone digital phenotyping during COVID-19: a prospective, three-site, two-country, longitudinal study.

Schizophrenia (Heidelb). 2023-1-27

[8]
Assessment of Social Behavior Using a Passive Monitoring App in Cognitively Normal and Cognitively Impaired Older Adults: Observational Study.

JMIR Aging. 2022-5-20

[9]
Differences in mobility patterns according to machine learning models in patients with bipolar disorder and patients with unipolar disorder.

J Affect Disord. 2022-6-1

[10]
Fluctuations in behavior and affect in college students measured using deep phenotyping.

Sci Rep. 2022-2-4

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