Depression is a prevalent comorbidity in patients with severe physical disorders, such as cancer, stroke, and coronary diseases. Although it can significantly impact the course of the primary disease, the signs of depression are often underestimated and overlooked. The aim of this paper was to review algorithms for the automatic, uniform, and multimodal classification of signs of depression from human conversations and to evaluate their accuracy. For the scoping review, the PRISMA guidelines for scoping reviews were followed. In the scoping review, the search yielded 1095 papers, out of which 20 papers (8.26%) included more than two modalities, and 3 of those papers provided codes. Within the scope of this review, supported vector machine (SVM), random forest (RF), and long short-term memory network (LSTM; with gated and non-gated recurrent units) models, as well as different combinations of features, were identified as the most widely researched techniques. We tested the models using the DAIC-WOZ dataset (original training dataset) and using the SymptomMedia dataset to further assess their reliability and dependency on the nature of the training datasets. The best performance was obtained by the LSTM with gated recurrent units (F1-score of 0.64 for the DAIC-WOZ dataset). However, with a drop to an F1-score of 0.56 for the SymptomMedia dataset, the method also appears to be the most data-dependent.
Patient-reported outcomes (PROs) and their use in the clinical workflow can improve cancer survivors’ outcomes and quality of life. However, there are several challenges regarding efficient collection of the patient-reported outcomes and their integration into the clinical workflow. Patient adherence and interoperability are recognized as main barriers. This work implements a cancer-related study which interconnects artificial intelligence (spoken language algorithms, conversational intelligence) and natural sciences (embodied conversational agents) to create an omni-comprehensive system enabling symmetric computer-mediated interaction. Its goal is to collect patient information and integrate it into clinical routine as digital patient resources (the Fast Healthcare Interoperability Resources). To further increase convenience and simplicity of the data collection, a multimodal sensing network is delivered. In this paper, we introduce the main components of the system, including the mHealth application, the Open Health Connect platform, and algorithms to deliver speech enabled 3D embodied conversational agent to interact with the cancer survivors in five different languages. The system integrates cancer patients’ reported information as patient gathered health data into their digital clinical record. The value and impact of the integration will be further evaluated in the clinical study.
The importance and value of real-world data in healthcare cannot be overstated because it offers a valuable source of insights into patient experiences. Traditional patient-reported experience and outcomes measures (PREMs/PROMs) often fall short in addressing the complexities of these experiences due to subjectivity and their inability to precisely target the questions asked. In contrast, diary recordings offer a promising solution. They can provide a comprehensive picture of psychological well-being, encompassing both psychological and physiological symptoms. This study explores how using advanced digital technologies, i.e., automatic speech recognition and natural language processing, can efficiently capture patient insights in oncology settings. We introduce the MRAST framework, a simplified way to collect, structure, and understand patient data using questionnaires and diary recordings. The framework was validated in a prospective study with 81 colorectal and 85 breast cancer survivors, of whom 37 were male and 129 were female. Overall, the patients evaluated the solution as well made; they found it easy to use and integrate into their daily routine. The majority (75.3%) of the cancer survivors participating in the study were willing to engage in health monitoring activities using digital wearable devices daily for an extended period. Throughout the study, there was a noticeable increase in the number of participants who perceived the system as having excellent usability. Despite some negative feedback, 44.44% of patients still rated the app’s usability as above satisfactory (i.e., 7.9 on 1–10 scale) and the experience with diary recording as above satisfactory (i.e., 7.0 on 1–10 scale). Overall, these findings also underscore the significance of user testing and continuous improvement in enhancing the usability and user acceptance of solutions like the MRAST framework. Overall, the automated extraction of information from diaries represents a pivotal step toward a more patient-centered approach, where healthcare decisions are based on real-world experiences and tailored to individual needs. The potential usefulness of such data is enormous, as it enables better measurement of everyday experiences and opens new avenues for patient-centered care.
Background: Advance Care Planning (ACP) empowers individuals to make informed decisions about their future healthcare. However, barriers including time constraints and a lack of clarity on professional responsibilities for ACP hinder its implementation. The application of artificial intelligence (AI) could potentially optimise elements of ACP in practice by, for example, identifying patients for whom ACP may be relevant and aiding ACP-related decision-making. However, it is unclear how applications of AI for ACP are currently being used in the delivery of palliative care. Objectives: To explore the use of AI models for ACP, identifying key features that influence model performance, transparency of data used, source code availability, and generalizability. Methods: A scoping review was conducted using the Arksey and O’Malley framework and the PRISMA-ScR guidelines. Electronic databases (Scopus and Web of Science (WoS)) and seven preprint servers were searched to identify published research articles and conference papers in English, German and French for the last 10Â years’ records. Our search strategy was based on terms for ACP and artificial intelligence models (including machine learning). The GRADE approach was used to assess the quality of included studies. Results: Included studies ( N = 41) predominantly used retrospective cohort designs and real-world electronic health record data. Most studies ( n = 39) focused on identifying individuals who might benefit from ACP, while fewer studies addressed initiating ACP discussions ( n = 10) or documenting and sharing ACP information ( n = 8). Among AI and machine learning models, logistic regression was the most frequent analytical method ( n = 15). Most models ( n = 28) demonstrated good to very good performance. However, concerns remain regarding data and code availability, as many studies lacked transparency and reproducibility ( n = 17 and n = 36, respectively). Conclusion: Most studies report models with promising results for predicting patient outcomes and supporting decision-making, but significant challenges remain, particularly regarding data and code availability. Future research should prioritize transparency and open-source code to facilitate rigorous evaluation. There is scope to explore novel AI-based approaches to ACP, including to support processes surrounding the review and updating of ACP information.
Cancer survivors face numerous challenges, and digital health interventions can empower them by enhancing self-efficacy and patient activation. This prospective study aimed to assess the impact of a mHealth app on self-efficacy and patient activation in 166 breast and colorectal cancer survivors. Participants received a smart bracelet and used the app to access personalized care plans. Data were collected at baseline and follow-ups, including patient-reported outcomes and clinician feedback. The study demonstrated positive impacts on self-efficacy and patient activation. The overall trial retention rate was 75.3%. Participants reported high levels of activation (PAM levels 1–3: P = 1.0; level 4: P = 0.65) and expressed a willingness to stay informed about their disease (CASE-Cancer factor 1: P = 0.98; factor 2: P = 0.66; factor 3: P = 0.25). Usability of the app improved, with an increase in participants rating the system as having excellent usability (from 14.82% to 22.22%). Additional qualitative analysis revealed positive experiences from both patients and clinicians. This paper contributes significantly to cancer survivorship care by providing personalized care plans tailored to individual needs. The PERSIST platform shows promise in improving patient outcomes and enhancing self-management abilities in cancer survivors. Further research with larger and more diverse populations is needed to establish its effectiveness.
8 June 2010 in Computer Methods and Programs in Biomedicine