Depression is a worldwide health predicament, affecting more than 300 million adults. It is considered the leading cause of disability and contributor to the overall global burden of disease. Detecting people in need of advanced depression care is crucial.
Now, a team of researchers at the Regenstrief Institute found a way to help clinicians detect and identify patients in need of advanced care for depression. The new method, which uses machine learning or artificial intelligence (AI), can help reduce the number of people who experience depressive symptoms that could potentially lead to suicide.
The World Health Organization (WHO) reports that close to 800,000 people die due to suicide each year, making it the leading cause of death among people between the ages of 15 and 29 years old.
Major depression is one of the most common mental illness worldwide. In the United States, an estimated 17.3 million adults had at least one major depressive episode, accounting to about 7.1 percent of all adults in the country.
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Predicting patients who need treatment
The study, which was published in the Journal of Medical Internet Research, unveils a new way to determine patients who might need advanced care for depression. The decision model can predict who might need more treatment than what the primary care provider can offer.
Since some forms of depression are far more severe and need advanced care by certified medical health providers, knowing who is at risk is essential. But identifying these patients is very challenging. In line with this, the researchers formulated a method that scrutinizes a comprehensive range of patient-level diagnostic, behavioral, and demographic data, including past clinic visit history from a statewide health information.
Using the data, health care providers can now build a technique on properly predicting patients in need of advanced care. The machine learning algorithm combined both behavioral and clinical data from the statewide health information exchange, called the Indiana Network for Patient Care.
"Our goal was to build reproducible models that fit into clinical workflows," Dr. Suranga N. Kasthurirathne, a research scientist at Regenstrief Institute, and study author said.
"This algorithm is unique because it provides actionable information to clinicians, helping them to identify which patients may be more at risk for adverse events from depression,” he added.
The researchers used the new model to train random forest decision models that can predict if there’s a need for advanced care among the overall patient population and those at higher risk of depression-related adverse events.
It’s important to consider making models that can fit different patient populations. This way, the health care provider has the option to choose the best screening approach he or she needs.
“We demonstrated the ability to predict the need for advanced care for depression across various patient populations with considerable predictive performance. These efforts can easily be integrated into existing hospital workflows,” the investigators wrote in the paper.
Identifying patients in need of advanced care is important
With the high number of people who have depression, one of the most important things to do is determine who are at a higher risk of potential adverse effects, including suicide.
Depression has different types, depending on the level of risk involved. For instance, people with mild depression forms may not need assistance and can recover faster. On the other hand, those who have severe depression may require advanced care aside from what primary care providers can offer.
They may need to undergo treatment such as medications and therapies to improve their condition. Hence, the new method can act like a preventive measure to reduce the incidence of adverse events related to the condition such as suicide.
More importantly, training health care teams to successfully identify patients with severe depression can help resolve the problem. With the proper application of the novel technique, many people with depression can be treated accordingly, reducing serious complications.
Depression signs and symptoms
Health care providers need to properly identify patients with depression. The common signs and symptoms of depression include feelings of hopelessness and helplessness, loss of interest in daily activities, sleep changes, irritability, anger, appetite changes, weight changes, self-loathing, loss of energy, problems in concentrating, reckless behavior, memory problems, and unexplained pains and aches.
Suranga N Kasthurirathne, Paul G Biondich, Shaun J Grannis, Saptarshi Purkayastha, Joshua R Vest, Josette F Jones. (2019). Identification of Patients in Need of Advanced Care for Depression Using Data Extracted From a Statewide Health Information Exchange: A Machine Learning Approach. Journal of Medical Internet Research. https://www.jmir.org/2019/7/e13809/