Beschreibung:
<jats:sec><jats:title>Introduction</jats:title><jats:p>Digital health interventions are an effective way to treat depression, but it is still largely unclear how patients’ individual symptoms evolve dynamically during such treatments. Data-driven forecasts of depressive symptoms would allow to greatly improve the personalisation of treatments. In current forecasting approaches, models are often trained on an entire population, resulting in a general model that works overall, but does not translate well to each individual in clinically heterogeneous, real-world populations. Model fairness across patient subgroups is also frequently overlooked. Personalised models tailored to the individual patient may therefore be promising.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We investigate different personalisation strategies using transfer learning, subgroup models, as well as subject-dependent standardisation on a newly-collected, longitudinal dataset of depression patients undergoing treatment with a digital intervention (<jats:inline-formula><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM1"><mml:mi>N</mml:mi><mml:mo>=</mml:mo><mml:mn>65</mml:mn></mml:math></jats:inline-formula> patients recruited). Both passive mobile sensor data as well as ecological momentary assessments were available for modelling. We evaluated the models’ ability to predict symptoms of depression (Patient Health Questionnaire-2; PHQ-2) at the end of each day, and to forecast symptoms of the next day.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In our experiments, we achieve a best mean-absolute-error (MAE) of <jats:inline-formula><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM2"><mml:mn>0.801</mml:mn></mml:math></jats:inline-formula> (25% improvement) for predicting PHQ-2 values at the end of the day with subject-dependent standardisation compared to a non-personalised baseline (<jats:inline-formula><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM3"><mml:mrow><mml:mi mathvariant="normal">MAE</mml:mi></mml:mrow><mml:mo>=</mml:mo><mml:mn>1.062</mml:mn></mml:math></jats:inline-formula>). For one day ahead-forecasting, we can improve the baseline of <jats:inline-formula><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM4"><mml:mn>1.539</mml:mn></mml:math></jats:inline-formula> by <jats:inline-formula><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM5"><mml:mn>12</mml:mn><mml:mtext>%</mml:mtext></mml:math></jats:inline-formula> to a MAE of <jats:inline-formula><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM6"><mml:mn>1.349</mml:mn></mml:math></jats:inline-formula> using a transfer learning approach with shared common layers. In addition, personalisation leads to fairer models at group-level.</jats:p></jats:sec><jats:sec><jats:title>Discussion</jats:title><jats:p>Our results suggest that personalisation using subject-dependent standardisation and transfer learning can improve predictions and forecasts, respectively, of depressive symptoms in participants of a digital depression intervention. We discuss technical and clinical limitations of this approach, avenues for future investigations, and how personalised machine learning architectures may be implemented to improve existing digital interventions for depression.</jats:p></jats:sec>