Personalized treatment selection in routine care: Integrating machine learning and statistical algorithms to recommend cognitive behavioral or psychodynamic therapy.

Objective: This study aims at developing a treatment selection algorithm using a combination of machine learning and statistical inference to recommend patients' optimal treatment based on their pre-treatment characteristics. Methods: A disorder-heterogeneous, naturalistic sample of N = 1,379 outpat...

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Publicado en:Psychotherapy Research Vol. 31; no. 1; pp. 33 - 52
Autores principales: Schwartz, Brian, Cohen, Zachary D., Rubel, Julian A., Zimmermann, Dirk, Wittmann, Werner W., Lutz, Wolfgang
Formato: Artículo
Publicado: Taylor & Francis Ltd Jan2021
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2021
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      pub: Taylor & Francis Ltd
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        147857040
        10.1080/10503307.2020.1769219
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        atl: Personalized treatment selection in routine care: Integrating machine learning and statistical algorithms to recommend cognitive behavioral or psychodynamic therapy.
      aug:
        au:
          Schwartz, Brian
          Cohen, Zachary D.
          Rubel, Julian A.
          Zimmermann, Dirk
          Wittmann, Werner W.
          Lutz, Wolfgang
        affil:
          University of Trier, Germany
          University of California, Los Angeles, CA, United States
          Justus-Liebig-University Giessen, Germany
          University of Mannheim, Germany
      su:
        Cognitive therapy
        Patient selection
        Statistical learning
        Machine learning
        Behavior therapists
        Psychodynamic psychotherapy
        Random forest algorithms
      sug:
        subj:
          Cognitive therapy
          Patient selection
          Statistical learning
          Machine learning
          Behavior therapists
          Psychodynamic psychotherapy
          Random forest algorithms
      keyword:
        machine learning
        outcome prediction
        outpatient psychotherapy
        precision medicine
        random forest
        variable selection
        machine learning
        outcome prediction
        outpatient psychotherapy
        precision medicine
        random forest
        variable selection
      ab: Objective: This study aims at developing a treatment selection algorithm using a combination of machine learning and statistical inference to recommend patients' optimal treatment based on their pre-treatment characteristics. Methods: A disorder-heterogeneous, naturalistic sample of N = 1,379 outpatients treated with either cognitive behavioral therapy or psychodynamic therapy was analyzed. Based on a combination of random forest and linear regression, differential treatment response was modeled in the training data (n = 966) to indicate each individual's optimal treatment. A separate holdout dataset (n = 413) was used to evaluate personalized recommendations. Results: The difference in outcomes between patients treated with their optimal vs. non-optimal treatment was significant in the training data, but non-significant in the holdout data (b = –0.043, p =.280). However, for the 50% of patients with the largest predicted benefit of receiving their optimal treatment, the average percentage of change on the BSI in the holdout data was 52.6% for their optimal and 38.4% for their non-optimal treatment (p =.017; d = 0.33 [0.06, 0.61]). Conclusion: A treatment selection algorithm based on a combination of ML and statistical inference might improve treatment outcome for some, but not all outpatients and could support therapists' clinical decision-making.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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