Abstract
The timely identification of patients who are at risk of a mental health crisis can lead to improved outcomes and to the mitigation of burdens and costs. However, the high prevalence of mental health problems means that the manual review of complex patient records to make proactive care decisions is not feasible in practice. Therefore, we developed a machine learning model that uses electronic health records to continuously monitor patients for risk of a mental health crisis over a period of 28 days. The model achieves an area under the receiver operating characteristic curve of 0.797 and an area under the precision-recall curve of 0.159, predicting crises with a sensitivity of 58% at a specificity of 85%. A follow-up 6-month prospective study evaluated our algorithm's use in clinical practice and observed predictions to be clinically valuable in terms of either managing caseloads or mitigating the risk of crisis in 64% of cases. To our knowledge, this study is the first to continuously predict the risk of a wide range of mental health crises and to explore the added value of such predictions in clinical practice.
Original language | English |
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Pages (from-to) | 1240-1248 |
Number of pages | 9 |
Journal | Nature medicine |
Volume | 28 |
Issue number | 6 |
Early online date | 16 May 2022 |
DOIs | |
Publication status | Published - Jun 2022 |
Bibliographical note
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.Funding: This work was supported by a Health Foundation grant (Call: Round 1 Advancing Applied Analytics Programme, award reference number 709246; project title: Using predictive analysis to prevent mental health crisis) and Koa Health (formerly Telefonica Alpha).
Keywords
- Electronic Health Records
- Humans
- Machine Learning
- Mental Health
- Prospective Studies
- ROC Curve