Risk modeling and shared decision making for postpartum depression

项目摘要 产后抑郁症（PPD）是一种非常常见且可能危及生命的心理健康状况， 影响美国五分之一的母亲。产后抑郁症不仅对母亲而且对她们的孩子都构成严重的健康问题 还有家人PPD与婴儿死亡率增加、住院率升高、 母子关系受损、儿童发育问题和家庭压力增加。 然而，在现实中，在生育年龄处于抑郁症高风险的女性通常既不是 被发现或治疗。此外，即使卫生专业人员发现了抑郁症，妇女也很少获得 尽管有广泛的治疗选择，但援助仍然不足。在这个项目中，我们计划利用大规模， 整合电子健康记录和来自纽约市临床数据研究网络的索赔， 自动化、可扩展的PPD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，为PPD治疗提供工具。PPD风险模型 以及在STTR第一阶段项目中开发的PPD治疗数字SDM工具，将用于进行 未来的大型、前瞻性、多中心临床有效性试验，以测试其在常规临床中的可行性和实用性 妇女产后护理。

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.