| Title |
Accurately identifying patients who are excellent candidates or unsuitable for a medication: a novel approach
|
|---|---|
| Published in |
Neuropsychiatric Disease and Treatment, December 2017
|
| DOI | 10.2147/ndt.s139577 |
| Pubmed ID | |
| Authors |
Charles South, A John Rush, Thomas J Carmody, Manish K Jha, Madhukar H Trivedi |
| Abstract |
The objective of the study was to determine whether a unique analytic approach - as a proof of concept - could identify individual depressed outpatients (using 30 baseline clinical and demographic variables) who are very likely (75% certain) to not benefit (NB) or to remit (R), accepting that without sufficient certainty, no prediction (NP) would be made. Patients from the Combining Medications to Enhance Depression Outcomes trial treated with escitalopram (S-CIT) + placebo (n=212) or S-CIT + bupropion-SR (n=206) were analyzed separately to assess replicability. For each treatment, the elastic net was used to identify subsets of predictive baseline measures for R and NB, separately. Two different equations that estimate the likelihood of remission and no benefit were developed for each patient. The ratio of these two numbers characterized likely outcomes for each patient. The two treatment cells had comparable rates of remission (40%) and no benefit (22%). In S-CIT + bupropion-SR, 11 were predicted NB of which 82% were correct; 26 were predicted R - 85% correct (169 had NP). For S-CIT + placebo, 13 were predicted NB - 69% correct; 44 were predicted R - 75% correct (155 were NP). Overall, 94/418 (22%) patients were identified with a meaningful degree of certainty (69%-85% correct). Different variable sets with some overlap were predictive of remission and no benefit within and across treatments, despite comparable outcomes. In two separate analyses with two different treatments, this analytic approach - which is also applicable to pretreatment laboratory tests - identified a meaningful proportion (over 20%) of depressed patients for whom a treatment outcome was predicted with sufficient certainty that the clinician can elect to strongly recommend for or choose to avoid a particular treatment. Different persons seem to be remitting or not benefiting with these two different treatments. |
Mendeley readers
The data shown below were compiled from readership statistics for 21 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 21 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 4 | 19% |
| Student > Bachelor | 3 | 14% |
| Other | 2 | 10% |
| Professor | 1 | 5% |
| Librarian | 1 | 5% |
| Other | 4 | 19% |
| Unknown | 6 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 29% |
| Psychology | 4 | 19% |
| Computer Science | 1 | 5% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 5% |
| Business, Management and Accounting | 1 | 5% |
| Other | 1 | 5% |
| Unknown | 7 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 January 2018.
All research outputs
#22,764,772
of 25,382,440 outputs
Outputs from Neuropsychiatric Disease and Treatment
#2,583
of 3,131 outputs
Outputs of similar age
#384,359
of 444,941 outputs
Outputs of similar age from Neuropsychiatric Disease and Treatment
#55
of 67 outputs
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