Development of a Convenient, Automated, Objective Measure of Depression

描述(由申请人提供)：抑郁症是一种严重的、使人衰弱的疾病，影响着数百万人，但目前结果衡量标准的有限可靠性阻碍了治疗研究，这些指标往往受到许多方法学和临床因素的偏见。这些考虑导致了项目公告06-016“心理健康研究和临床应用生物标记物的开发”的发布，旨在促进具有临床实用性的创新生物标记物技术的发展，以评估与精神疾病相关的心理功能和功能障碍。PA确定了对生物标记物的“迫切需要”，以此作为疾病严重程度变化的指标和/或治疗反应的预测指标，可以在个人基础上有效地应用。第一阶段SBIR研究成功地利用与患者的全结构交互式语音反应系统建立了抑郁症严重程度的计算机自动评估，并证明了通过电话获得的语音样本的声学分析获得抑郁症严重程度和治疗反应的有效测量的可行性。作为第一阶段试点研究成功的结果，Healthcare Technology Systems成功地说服了一家行业赞助商，将声学生物标记物作为一项注重方法学的随机临床试验的探索性措施。这一开放创造了一个机会，可以像最初设想的那样，以更快的速度推进声学生物标记物研究的发展，如果第二阶段的努力完全集中在随机双盲安慰剂对照试验中的技术评估上。拟议的第二阶段工作侧重于分析过程的高效自动化以降低交付成本，复制第一阶段的结果以供进一步验证，推广该技术以适用于其他患者群体(非英语使用者、儿童/年轻人和老年人)，以及派生/优化多变量声学模型以提高生物标记物对治疗反应的敏感性和对个别患者的反应可能性的预测。额外的数据收集、分析和结果展示将与马萨诸塞州综合医院的抑郁症临床和研究计划合作完成。描述了该产品的商业市场，并概述了产品投放的计划。超过60%的自杀与重度抑郁症有关，在美国和世界范围内，重度抑郁症是导致残疾调整后寿命的主要原因。临床试验中抑郁症治疗的开发和评估因使用不可靠的结果衡量标准而受到阻碍。建立一个有效的、非侵入性的、容易获得的、可推广的抑郁症严重程度和治疗反应的生物标志物将有助于更好地了解抑郁症和开发有效的治疗方法。

DESCRIPTION (provided by applicant): Depression is a serious, debilitating disorder that affects millions of people, but treatment research is hampered by the limited reliability of current outcome measures that are often biased by a number of methodological and clinical factors. Such considerations resulted in the issuance of Program Announcement 06-016, "Development of Biomarkers for Mental Health Research and Clinical Utilities" aimed at spurring development of innovative biomarker technologies with clinical utility to assess mental function and dysfunction related to mental illness. The PA identified an "urgent need" for biomarkers as indicators of changes in disorder severity and/or predictors of treatment response that could be effectively applied on an individual basis. Phase I SBIR research successfully established computer-automated assessment of depression severity using fully-structured interactive voice response system interactions with patients and demonstrated feasibility of obtaining valid measures of depression severity and treatment response through vocal acoustic analysis of speech samples obtained over the telephone. As a result of the Phase I pilot study success, Healthcare Technology Systems was successful in persuading an industry sponsor to include vocal acoustic biomarkers as exploratory measures in a methodologically focused randomized clinical trial. This opening creates an opportunity to advance development of vocal acoustic biomarker research faster than would have been possible if Phase II efforts focused solely on technology evaluation in a randomized double-blind placebo controlled trial, as initially envisioned. The Phase II efforts proposed focus on efficient automation of the analytic processes to reduce delivery costs, replication of Phase I results for further validation, generalized extension of the technology for applicability to other patient populations (non-English speakers, children/young adult, and geriatric), and derivation/optimization of multivariate acoustic models to enhance the biomarker sensitivity to treatment response and prediction of the response likelihood for individual patients. The additional data collection, analysis, and presentation of results will be done in collaboration with the Depression Clinical and Research Program at the Massachusetts General Hospital. The product's commercial market is described and a plan for product launch is outlined. Major depression is involved in over 60% of suicides and is a leading cause of disability adjusted life years in the US and worldwide. Development and evaluation of depression treatments in clinical trials is hampered by use of unreliable outcome measures. Establishing a valid, noninvasive, easily obtained, and generalizable biomarker of depression severity and treatment response will contribute to better understanding of depression and development of effective treatments.