Evidence map›Paper›PMID 37693012›Full record

ArticleFrontiers in artificial intelligence2023

A risk identification model for detection of patients at risk of antidepressant discontinuation.

Ali Zolnour, Christina E Eldredge, Anthony Faiola, Yadollah Yaghoobzadeh, Masoud Khani, Doreen Foy, Maxim Topaz, Hadi Kharrazi, Kin Wah Fung, Paul Fontelo and 9 more

Abstract read
In one paragraph

Article in Frontiers in artificial intelligence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Ali ZolnourSchool of Electrical and Computer Engineering, University of Tehran, Tehran, Iran.
Christina E EldredgeSchool of Information, University of South Florida, Tampa, FL, United States.
Anthony FaiolaCollege of Health Sciences, University of Kentucky, Lexington, KY, United States.
Yadollah YaghoobzadehSchool of Electrical and Computer Engineering, University of Tehran, Tehran, Iran.
Masoud KhaniBiomedical and Health Informatics, University of Wisconsin-Milwaukee, Milwaukee, WI, United States.
Doreen FoySchool of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United States.
Maxim TopazSchool of Nursing and Data Science Institute, Columbia University, New York, NY, United States.
Hadi KharraziDepartment of Health Policy and Management, Johns Hopkins University, Baltimore, MD, United States.
Kin Wah FungLister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD, United States.
Paul FonteloLister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD, United States.
Anahita DavoudiCenter for Home Care Policy and Research, VNS Health, New York, NY, United States.
Azade TabaieCenter of Biostatistics, Informatics, and Data Science, MedStar Health Research Institute, Washington, DC, United States.
Scott A BreitingerDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.
Tyler S OesterleDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.
Masoud RouhizadehCollage of Pharmacy, University of Florida, Gainesville, FL, United States.
Zahra ZonnorDepartment of Biomechanics, Bu-Ali Sina University, Hamedan, Iran.
Hans MoenDepartment of Computer Science, Aalto University, Otaniemi, Finland.
Timothy B PatrickBiomedical and Health Informatics, University of Wisconsin-Milwaukee, Milwaukee, WI, United States.
Maryam ZolnooriSchool of Nursing and Data Science Institute, Columbia University, New York, NY, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Between 30 and 68% of patients prematurely discontinue their antidepressant treatment, posing significant risks to patient safety and healthcare outcomes. Online healthcare forums have the potential to offer a rich and unique source of data, revealing dimensions of antidepressant discontinuation that may not be captured by conventional data sources. Methods: We analyzed 891 patient narratives from the online healthcare forum, "askapatient.com," utilizing content analysis to create PsyRisk-a corpus highlighting the risk factors associated with antidepressant discontinuation. Leveraging PsyRisk, alongside PsyTAR [a publicly available corpus of adverse drug reactions (ADRs) related to antidepressants], we developed a machine learning-driven algorithm for proactive identification of patients at risk of abrupt antidepressant discontinuation. Results: From the analyzed 891 patients, 232 reported antidepressant discontinuation. Among these patients, 92% experienced ADRs, and 72% found these reactions distressful, negatively affecting their daily activities. Approximately 26% of patients perceived the antidepressants as ineffective. Most reported ADRs were physiological (61%, 411/673), followed by cognitive (30%, 197/673), and psychological (28%, 188/673) ADRs. In our study, we employed a nested cross-validation strategy with an outer 5-fold cross-validation for model selection, and an inner 5-fold cross-validation for hyperparameter tuning. The performance of our risk identification algorithm, as assessed through this robust validation technique, yielded an AUC-ROC of 90.77 and an F1-score of 83.33. The most significant contributors to abrupt discontinuation were high perceived distress from ADRs and perceived ineffectiveness of the antidepressants. Conclusion: The risk factors identified and the risk identification algorithm developed in this study have substantial potential for clinical application. They could assist healthcare professionals in identifying and managing patients with depression who are at risk of prematurely discontinuing their antidepressant treatment.

Indexed as

adverse drug eventsantidepressant discontinuationantidepressant effectivenesscontent analysismachine learningonline healthcare forums

Identifiers

PMID37693012
PMCPMC10484003

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.