The Early Psychosis Screener for Internet (EPSI)-SR: Predicting 12 month psychotic conversion using machine learning
The Early Psychosis Screener for Internet (EPSI)-SR: Predicting 12 month psychotic conversion using machine learning
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DOI：
10.1016/j.schres.2019.01.015
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发表时间：
2019-06-01
影响因子：
4.5
通讯作者：
Cadenhead, K. S.
中科院分区：
文献类型：
--
作者：
Brodey, B. B.;Girgis, R. R.;Cadenhead, K. S.
需要一种更快、更准确的早期精神病自我报告筛查方法，以促进早期识别和干预。方法：采用结构化访谈法（SIPS）对个体进行自我报告李克特量表调查，并在8家早期精神病诊所进行随访。先验分析方案包括谱聚类分析来减少项目池，然后开发支持向量机分类器。结果：交叉验证的EPSI阳性预测值（PPV）在默认临界值（76.5%）超过了临床使用的SIPS(68.5%)，用于区分12个月内不会转化为精神病的个体与12个月内转化为精神病的个体或已经经历过首次发作精神病（FEP）的个体。当在临床高风险参与者中与SIPS联合使用时，EPSI将合并PPV提高到86.6%。SVM将非临床低风险人群中的1%和临床低风险人群中的4%归为FEP/转换者。然而，EPSI的灵敏度在默认截止点为51%。讨论：与SIPS相比，EPSI可以在更短的时间和更少的资源中识别出在12个月内发展为精神障碍的高风险个体或已经患有精神障碍的个体。在它的默认截止点。EPSI漏诊了49%的当前或未来精神病病例。但是，可以根据目的调整截止日期。EPSI是第一个预测12个月精神病转化的有效评估。在线筛选系统www.eps.telesage.org正在开发中(C) 2019。Elsevier B.V.出版
Introduction: A faster and more accurate self-report screener for early psychosis is needed to promote early identification and intervention.Methods: Self-report Likert-scale survey items were administered to individuals being screened with the Structured Interview for Psychosis-risk Syndromes (SIPS) and followed at eight early psychosis clinics. An a priori analytic plan included Spectral Clustering Analysis to reduce the item pool, followed by development of Support Vector Machine (SVM) dassifiers.Results: The cross-validated positive predictive value (PPV) of the EPSI at the default cut-off (76.5%) exceeded that of the clinician-administered SIPS (68.5%) at separating individuals who would not convert to psychosis within 12 months from those who either would convert within 12 months or who had already experienced a first episode psychosis (FEP). When used in tandem with the SIPS on clinical high risk participants, the EPSI increased the combined PPV to 86.6%. The SVM classified as FEP/converters only 1% of individuals in non-clinical and 4% of clinical low risk populations. Sensitivity of the EPSI, however, was 51% at the default cut-off.Discussion: The EPSI identifies, comparably to the SIPS but in less time and with fewer resources, individuals who are either at very high risk to develop a psychotic disorder within 12 months or who are already psychotic. At its default cut-off. EPSI misses 49% of current or future psychotic cases. The cut-off can, however, be adjusted based on purpose. The EPSI is the first validated assessment to predict 12-month psychotic conversion. An online screening system, www.eps.telesage.org, is under development (C) 2019 The Authors. Published by Elsevier B.V.