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Emergence of digital biomarkers to predict and modify treatment efficacy: machine learning study.


ABSTRACT:

Objectives

Development of digital biomarkers to predict treatment response to a digital behavioural intervention.

Design

Machine learning using random forest classifiers on data generated through the use of a digital therapeutic which delivers behavioural therapy to treat cardiometabolic disease. Data from 13 explanatory variables (biometric and engagement in nature) generated in the first 28 days of a 12-week intervention were used to train models. Two levels of response to treatment were predicted: (1) systolic change ?10 mm Hg (SC model), and (2) shift down to a blood pressure category of elevated or better (ER model). Models were validated using leave-one-out cross validation and evaluated using area under the curve receiver operating characteristics (AUROC) and specificity- sensitivity. Ability to predict treatment response with a subset of nine variables, including app use and baseline blood pressure, was also tested (models SC-APP and ER-APP).

Setting

Data generated through ad libitum use of a digital therapeutic in the USA.

Participants

Deidentified data from 135 adults with a starting blood pressure ?130/80, who tracked blood pressure for at least 7 weeks using the digital therapeutic.

Results

The SC model had an AUROC of 0.82 and a sensitivity of 58% at a specificity of 90%. The ER model had an AUROC of 0.69 and a sensitivity of 32% at a specificity at 91%. Dropping explanatory variables related to blood pressure resulted in an AUROC of 0.72 with a sensitivity of 42% at a specificity of 90% for the SC-APP model and an AUROC of 0.53 for the ER-APP model.

Conclusions

Machine learning was used to transform data from a digital therapeutic into digital biomarkers that predicted treatment response in individual participants. Digital biomarkers have potential to improve treatment outcomes in a digital behavioural intervention.

SUBMITTER: Guthrie NL 

PROVIDER: S-EPMC6661657 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Emergence of digital biomarkers to predict and modify treatment efficacy: machine learning study.

Guthrie Nicole L NL   Carpenter Jason J   Edwards Katherine L KL   Appelbaum Kevin J KJ   Dey Sourav S   Eisenberg David M DM   Katz David L DL   Berman Mark A MA  

BMJ open 20190723 7


<h4>Objectives</h4>Development of digital biomarkers to predict treatment response to a digital behavioural intervention.<h4>Design</h4>Machine learning using random forest classifiers on data generated through the use of a digital therapeutic which delivers behavioural therapy to treat cardiometabolic disease. Data from 13 explanatory variables (biometric and engagement in nature) generated in the first 28 days of a 12-week intervention were used to train models. Two levels of response to treat  ...[more]

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