Lowering costs for large-scale screening in psychosis: a systematic review and meta-analysis of performance and value of information for speech-based psychiatric evaluation
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
;
42(6): 673-686, Nov.-Dec. 2020. tab, graf
Article
in English
| LILACS
| ID: biblio-1132145
ABSTRACT
Objective:
Obstacles for computational tools in psychiatry include gathering robust evidence and keeping implementation costs reasonable. We report a systematic review of automated speech evaluation for the psychosis spectrum and analyze the value of information for a screening program in a healthcare system with a limited number of psychiatrists (Maputo, Mozambique).Methods:
Original studies on speech analysis for forecasting of conversion in individuals at clinical high risk (CHR) for psychosis, diagnosis of manifested psychotic disorder, and first-episode psychosis (FEP) were included in this review. Studies addressing non-verbal components of speech (e.g., pitch, tone) were excluded.Results:
Of 168 works identified, 28 original studies were included. Valuable speech features included direct measures (e.g., relative word counting) and mathematical embeddings (e.g. word-to-vector, graphs). Accuracy estimates reported for schizophrenia diagnosis and CHR conversion ranged from 71 to 100% across studies. Studies used structured interviews, directed tasks, or prompted free speech. Directed-task protocols were faster while seemingly maintaining performance. The expected value of perfect information is USD 9.34 million. Imperfect tests would nevertheless yield high value.Conclusion:
Accuracy for screening and diagnosis was high. Larger studies are needed to enhance precision of classificatory estimates. Automated analysis presents itself as a feasible, low-cost method which should be especially useful for regions in which the physician pool is insufficient to meet demand.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Psychotic Disorders
/
Schizophrenia
Type of study:
Diagnostic study
/
Practice guideline
/
Health economic evaluation
/
Prognostic study
/
Qualitative research
/
Screening study
/
Systematic reviews
Limits:
Humans
Language:
English
Journal:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Journal subject:
Psychiatry
Year:
2020
Type:
Article
Affiliation country:
Brazil
/
Mozambique
/
United States
Institution/Affiliation country:
Brain Institute, Universidade Federal do Rio Grande do Norte/BR
/
Icahn School of Medicine at Mount Sinai/US
/
Medicina, Universidade Eduardo Mondlane/MZ
/
National Institute of Mental Health (NIMH)/US
/
Universidade Federal de São Paulo/BR
/
Universidade de São Paulo (USP)/BR
Similar
MEDLINE
...
LILACS
LIS