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  • 标题:Data-based Decision Rules to Personalize Depression Follow-up
  • 本地全文:下载
  • 作者:Ying Lin ; Shuai Huang ; Gregory E. Simon
  • 期刊名称:Scientific Reports
  • 电子版ISSN:2045-2322
  • 出版年度:2018
  • 卷号:8
  • 期号:1
  • 页码:5064
  • DOI:10.1038/s41598-018-23326-1
  • 语种:English
  • 出版社:Springer Nature
  • 摘要:Depression is a common mental illness with complex and heterogeneous progression dynamics. Risk grouping of depression treatment population based on their longitudinal patterns has the potential to enable cost-effective monitoring policy design. This paper establishes a rule-based method to identify a set of risk predictive patterns from person-level longitudinal disease measurements by integrating the data transformation, rule discovery and rule evaluation. We further extend the identified rules to create rule-based monitoring strategies to adaptively monitor individuals with different disease severities. We applied the rule-based method on an electronic health record (EHR) dataset of depression treatment population containing person-level longitudinal Patient Health Questionnaire (PHQ)-9 scores for assessing depression severity. 12 risk predictive rules are identified, and the rule-based prognostic model based on identified rules enables more accurate prediction of disease severity than other prognostic models including RuleFit, logistic regression and Support Vector Machine. Two rule-based monitoring strategies outperform the latest PHQ-9 based monitoring strategy by providing higher sensitivity and specificity. The rule-based method can lead to a better understanding of disease dynamics, achieving more accurate prognostics of disease progressions, personalizing follow-up intervals, and designing cost-effective monitoring of patients in clinical practice.
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