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
Artigo
em Inglês
| LILACS
| ID: biblio-1132145
Biblioteca responsável:
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.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
Problema de saúde:
Objetivo 4: Financiamento para a saúde
Base de dados:
LILACS
Assunto principal:
Transtornos Psicóticos
/
Esquizofrenia
Tipo de estudo:
Estudo diagnóstico
/
Guia de prática clínica
/
Avaliação econômica em saúde
/
Estudo prognóstico
/
Pesquisa qualitativa
/
Estudo de rastreamento
/
Revisão sistemática
Limite:
Humanos
Idioma:
Inglês
Revista:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Assunto da revista:
Psiquiatria
Ano de publicação:
2020
Tipo de documento:
Artigo
País de afiliação:
Brasil
/
Moçambique
/
Estados Unidos
Instituição/País de afiliação:
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