Lowering costs for large-scale screening in psychosis: a systematic review and meta-analysis of performance and value of information for speech-based psychiatric evaluation.

Journal: Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)

Volume: 42

Issue: 6

Year of Publication: 2020

Affiliated Institutions:  Universidade Federal de São Paulo, São Paulo, SP, Brazil. Universidade de São Paulo (USP), São Paulo, SP, Brazil. Brain Institute, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil. Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique. National Institute of Mental Health (NIMH), Bethesda, MD, USA. Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Abstract summary 

Obstacles for computational tools in psychiatry include gathering robust evidence and keeping implementation costs reasonable. We report a systematic review of automated speech evaluation for the psychosis spectrum and analyze the value of information for a screening program in a healthcare system with a limited number of psychiatrists (Maputo, Mozambique).Original studies on speech analysis for forecasting of conversion in individuals at clinical high risk (CHR) for psychosis, diagnosis of manifested psychotic disorder, and first-episode psychosis (FEP) were included in this review. Studies addressing non-verbal components of speech (e.g., pitch, tone) were excluded.Of 168 works identified, 28 original studies were included. Valuable speech features included direct measures (e.g., relative word counting) and mathematical embeddings (e.g.: word-to-vector, graphs). Accuracy estimates reported for schizophrenia diagnosis and CHR conversion ranged from 71 to 100% across studies. Studies used structured interviews, directed tasks, or prompted free speech. Directed-task protocols were faster while seemingly maintaining performance. The expected value of perfect information is USD 9.34 million. Imperfect tests would nevertheless yield high value.Accuracy for screening and diagnosis was high. Larger studies are needed to enhance precision of classificatory estimates. Automated analysis presents itself as a feasible, low-cost method which should be especially useful for regions in which the physician pool is insufficient to meet demand.

Authors & Co-authors:  Argolo Felipe F Magnavita Guilherme G Mota Natalia Bezerra NB Ziebold Carolina C Mabunda Dirceu D Pan Pedro M PM Zugman André A Gadelha Ary A Corcoran Cheryl C Bressan Rodrigo A RA

Study Outcome 

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Citations :  Huys QJ, Maia TV, Frank MJ. Computational psychiatry as a bridge from neuroscience to clinical applications. Nat Neurosci. 2016;19:404–13.
Authors :  10
Identifiers
Doi : 10.1590/1516-4446-2019-0722
SSN : 1809-452X
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Study Design
Study Approach
Country of Study
Mozambique
Publication Country
Brazil