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
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| LILACS
| ID: biblio-1132145
Biblioteca responsable:
BR1.1
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.Palabras clave
Texto completo:
1
Banco de datos:
LILACS
Asunto principal:
Trastornos Psicóticos
/
Esquizofrenia
Tipo de estudio:
Diagnostic_studies
/
Guideline
/
Health_economic_evaluation
/
Prognostic_studies
/
Qualitative_research
/
Screening_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Asunto de la revista:
PSIQUIATRIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Brasil
/
Mozambique
/
Estados Unidos