Objectives: This study aimed at identifying distinct quitting trajectories over 29 days after an unassisted smoking ces- sation attempt by ecological momentary assessment (EMA). In order to validate these trajectories...Objectives: This study aimed at identifying distinct quitting trajectories over 29 days after an unassisted smoking ces- sation attempt by ecological momentary assessment (EMA). In order to validate these trajectories we tested if they predict smoking frequency up to six months later. Methods: EMA via mobile phones was used to collect real time data on smoking (yes/no) after an unassisted quit attempt over 29 days. Smoking frequency one, three and six months after the quit attempt was assessed with online questionnaires. Latent class growth modeling was used to analyze the data of 230 self-quitters. Results: Four different quitting trajectories emerged: quitter (43.9%), late quitter (11.3%), returner (17%) and persistent smoker (27.8%). The quitting trajectories predicted smoking frequency one, three and six months after the quit attempt (all p < 0.001). Conclusions: Outcome after a smoking cessation attempt is better described by four distinct trajectories instead of a binary variable for abstinence or relapse. In line with the relapse model by Marlatt and Gordon, late quitter may have learned how to cope with lapses during one month after the quitting attempt. This group would have been allocated to the relapse group in traditional outcome studies.展开更多
Depression is a serious medical condition and is a leading cause of disability worldwide.Current depression diagnostics and assessment has significant limitations due to heterogeneity of clinical presentations,lack of...Depression is a serious medical condition and is a leading cause of disability worldwide.Current depression diagnostics and assessment has significant limitations due to heterogeneity of clinical presentations,lack of objective assessments,and assessments that rely on patients'perceptions,memory,and recall.Digital phenotyping(DP),especially assessments conducted using mobile health technologies,has the potential to greatly improve accuracy of depression diagnostics by generating objectively measurable endophenotypes.DP includes two primary sources of digital data generated using ecological momentary assessments(EMA),assessments conducted in real-time,in subjects'natural environment.This includes active EMA,data that require active input by the subject,and passive EMA or passive sensing,data passively and automatically collected from subjects'personal digital devices.The raw data is then analyzed using machine learning algorithms to identify behavioral patterns that correlate with patients'clinical status.Preliminary investigations have also shown that linguistic and behavioral clues from social media data and data extracted from the electronic medical records can be used to predict depression status.These other sources of data and recent advances in telepsychiatry can further enhance DP of the depressed patients.Success of DP endeavors depends on critical contributions from both psychiatric and engineering disciplines.The current review integrates important perspectives from both disciplines and discusses parameters for successful interdisciplinary collaborations.A clinically-relevant model for incorporating DP in clinical setting is presented.This model,based on investigations conducted by our group,delineates development of a depression prediction system and its integration in clinical setting to enhance depression diagnostics and inform the clinical decision making process.Benefits,challenges,and opportunities pertaining to clinical integration of DP of depression diagnostics are discussed from interdisciplinary perspectives.展开更多
基金thank the Swiss National Science Founda-tion for funding this study(grant number SNF 100014_126648/1).
文摘Objectives: This study aimed at identifying distinct quitting trajectories over 29 days after an unassisted smoking ces- sation attempt by ecological momentary assessment (EMA). In order to validate these trajectories we tested if they predict smoking frequency up to six months later. Methods: EMA via mobile phones was used to collect real time data on smoking (yes/no) after an unassisted quit attempt over 29 days. Smoking frequency one, three and six months after the quit attempt was assessed with online questionnaires. Latent class growth modeling was used to analyze the data of 230 self-quitters. Results: Four different quitting trajectories emerged: quitter (43.9%), late quitter (11.3%), returner (17%) and persistent smoker (27.8%). The quitting trajectories predicted smoking frequency one, three and six months after the quit attempt (all p < 0.001). Conclusions: Outcome after a smoking cessation attempt is better described by four distinct trajectories instead of a binary variable for abstinence or relapse. In line with the relapse model by Marlatt and Gordon, late quitter may have learned how to cope with lapses during one month after the quitting attempt. This group would have been allocated to the relapse group in traditional outcome studies.
文摘Depression is a serious medical condition and is a leading cause of disability worldwide.Current depression diagnostics and assessment has significant limitations due to heterogeneity of clinical presentations,lack of objective assessments,and assessments that rely on patients'perceptions,memory,and recall.Digital phenotyping(DP),especially assessments conducted using mobile health technologies,has the potential to greatly improve accuracy of depression diagnostics by generating objectively measurable endophenotypes.DP includes two primary sources of digital data generated using ecological momentary assessments(EMA),assessments conducted in real-time,in subjects'natural environment.This includes active EMA,data that require active input by the subject,and passive EMA or passive sensing,data passively and automatically collected from subjects'personal digital devices.The raw data is then analyzed using machine learning algorithms to identify behavioral patterns that correlate with patients'clinical status.Preliminary investigations have also shown that linguistic and behavioral clues from social media data and data extracted from the electronic medical records can be used to predict depression status.These other sources of data and recent advances in telepsychiatry can further enhance DP of the depressed patients.Success of DP endeavors depends on critical contributions from both psychiatric and engineering disciplines.The current review integrates important perspectives from both disciplines and discusses parameters for successful interdisciplinary collaborations.A clinically-relevant model for incorporating DP in clinical setting is presented.This model,based on investigations conducted by our group,delineates development of a depression prediction system and its integration in clinical setting to enhance depression diagnostics and inform the clinical decision making process.Benefits,challenges,and opportunities pertaining to clinical integration of DP of depression diagnostics are discussed from interdisciplinary perspectives.
