Risk modeling and shared decision making for postpartum depression

项目摘要 产后抑郁症(PPD)是一种非常常见的、潜在威胁生命的心理健康状况， 在美国，每5个母亲中就有1个受到影响。产后抑郁不仅对母亲，而且对她们的孩子都是严重的健康问题 还有他的家人。产后抑郁与婴儿死亡率上升、住院率上升、 母子依恋受损，儿童发育问题，以及家庭内压力增加。 然而，在现实中，育龄期间患抑郁症的风险很高的女性通常既不是 已被确认身份也未接受治疗。此外，即使当健康专业人员检测到抑郁症时，女性也很少获得 援助，尽管有广泛的治疗选择。在这个项目中，我们计划利用大规模、 来自纽约市临床数据研究网络的综合电子健康记录和索赔将开发 针对PPD的自动化、可扩展的风险预测模型。我们还将开发数字共享决策(SDM) 通过与医疗保健提供者和患者合作，提供PPD治疗工具。PPD风险模型 以及在STTR第一阶段项目中开发的用于PPD治疗的数字SDM工具将用于进行 未来的大型、前瞻性、多部位临床疗效试验，以测试其在常规临床中的可行性和实用性 在产后期间对妇女的护理。

PROJECT ABSTRACT Postpartum depression (PPD) is a strikingly common and potentially life-threatening mental health condition, affecting 1 in 5 mothers in the US. PPD poses serious health concerns, not only to mothers but also their children and the family. PPD has been associated with increased infant mortality, higher rates of hospitalizations, impaired mother-child attachment, developmental problems in children, and increased stress within families. However, in reality, women who are at high risk for depression during the childbearing years are usually neither identified nor treated. In addition, even when depression is detected by health professionals, women rarely obtain assistance, despite the wide availability of treatment choices. In this project, we plan to leverage large-scale, integrated electronic health record and claims from the New York City Clinical Data Research Network to develop automated, scalable risk prediction models for PPD. We will also develop a digital shared decision-making (SDM) tool for PPD treatment by working collaboratively with healthcare providers and patients. The PPD risk model and the digital SDM tool for PPD treatment developed in this STTR Phase I project will be used to conduct a future large, prospective, multi-site clinical effectiveness trial to test their feasibility and utility in routine clinical care of women during the postpartum period.