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Predicting depressive symptom severity through individuals' nearby bluetooth device count data collected by mobile phones: Preliminary longitudinal study

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Yuezhou Zhang, Amos A. Folarin, Shaoxiong Sun, Nicholas Cummins, Yatharth Ranjan, Zulqarnain Rashid, Pauline Conde, Callum Stewart, Petroula Laiou, Faith Matcham, Carolin Oetzmann, Femke Lamers, Sara Siddi, Sara Simblett, Aki Rintala, David C. Mohr, Inez Myin-Germeys, Til Wykes, Josep Maria Haro, Brenda W.J.H. Penninx & 4 more Vaibhav A. Narayan, Peter Annas, Matthew Hotopf, Richard J.B. Dobson

Original languageEnglish
Article numbere29840
JournalJMIR mHealth and uHealth
Volume9
Issue number7
DOIs
PublishedJul 2021

Bibliographical note

Funding Information: The Remote Assessment of Disease and Relapse-Central Nervous System (RADAR-CNS) project has received funding from the Innovative Medicines Initiative (IMI) 2 Joint Undertaking under grant agreement number 115902. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation program and European Federation of Pharmaceutical Industries and Associations (EFPIA) (www.imi.europa.eu). This communication reflects the views of the RADAR-CNS consortium, and neither IMI nor the European Union and EFPIA are liable for any use that may be made of the information contained herein. The funding body was not involved in the design of the study, the collection or analysis of the data, or the interpretation of the data. Participants in the CIBER site came from the following four clinical communities in Spain: Parc Sanitari Sant Joan de Déu Network services, Institut Català de la Salut, Institut Pere Mata, and Hospital Clínico San Carlos. Participant recruitment in Amsterdam was partially accomplished through Hersenonderzoek.nl, a Dutch online registry that facilitates participant recruitment for neuroscience studies. Hersenonderzoek.nl is funded by ZonMw-Memorabel (project number 73305095003), a project in the context of the Dutch Deltaplan Dementie, Gieskes-Strijbis Foundation, the Alzheimer's Society in the Netherlands, and Brain Foundation Netherlands. This paper represents independent research partly funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, NIHR, or Department of Health and Social Care. We thank all the members of the RADAR-CNS patient advisory board for their contribution to the device selection procedures and for their invaluable advice throughout the study protocol design. This research was reviewed by a team with experience in mental health problems and their careers who have been specially trained to advise on research proposals and documentation through the Feasibility and Acceptability Support Team for Researchers (FAST-R), a free confidential service in England provided by the National Institute for Health Research Maudsley Biomedical Research Centre via King’s College London and South London and Maudsley NHS Foundation Trust. Remote Assessment of Disease and Relapse-Major Depressive Disorder (RADAR-MDD) will be conducted according to the Declaration of Helsinki and Good Clinical Practice, adhering to principles outlined in the NHS Research Governance Framework for Health and Social Care (2nd edition). Ethical approval has been obtained in London from the Camberwell St Giles Research Ethics Committee (REC reference: 17/LO/1154), in London from the CEIC Fundacio Sant Joan de Deu (CI: PIC-128-17), and in the Netherlands from the Medische Ethische Toetsingscommissie VUms (METc VUmc registratienummer: 2018.012 – NL63557.029.17). RJBD is supported by the following: (1) NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK; (2) Health Data Research UK, which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust; (3) The BigData@Heart Consortium, funded by the Innovative Medicines Initiative-2 Joint Undertaking under grant agreement number 116074. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation program and EFPIA; it is chaired by DE Grobbee and SD Anker, partnering with 20 academic and industry partners and the European Society of Cardiology; (4) The National Institute for Health Research University College London Hospitals Biomedical Research Centre; (5) The NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London; (6) The UK Research and Innovation London Medical Imaging & Artificial Intelligence Centre for Value Based Healthcare; (7) The NIHR Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. This paper represents independent research partly funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. MH and TW have been supported by NIHR Senior Investigator Awards. Funding Information: The Remote Assessment of Disease and Relapse-Central Nervous System (RADAR-CNS) project has received funding from the Innovative Medicines Initiative (IMI) 2 Joint Undertaking under grant agreement number 115902. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation program and European Federation of Pharmaceutical Industries and Associations (EFPIA) (www.imi.europa.eu). This communication reflects the views of the RADAR-CNS consortium, and neither IMI nor the European Union and EFPIA are liable for any use that may be made of the information contained herein. The funding body was not involved in the design of the study, the collection or analysis of the data, or the interpretation of the data. Participants in the CIBER site came from the following four clinical communities in Spain: Parc Sanitari Sant Joan de D?u Network services, Institut Catal? de la Salut, Institut Pere Mata, and Hospital Cl?nico San Carlos. Participant recruitment in Amsterdam was partially accomplished through Hersenonderzoek.nl, a Dutch online registry that facilitates participant recruitment for neuroscience studies. Hersenonderzoek.nl is funded by ZonMw-Memorabel (project number 73305095003), a project in the context of the Dutch Deltaplan Dementie, Gieskes-Strijbis Foundation, the Alzheimer's Society in the Netherlands, and Brain Foundation Netherlands. This paper represents independent research partly funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, NIHR, or Department of Health and Social Care. We thank all the members of the RADAR-CNS patient advisory board for their contribution to the device selection procedures and for their invaluable advice throughout the study protocol design. This research was reviewed by a team with experience in mental health problems and their careers who have been specially trained to advise on research proposals and documentation through the Feasibility and Acceptability Support Team for Researchers (FAST-R), a free confidential service in England provided by the National Institute for Health Research Maudsley Biomedical Research Centre via King's College London and South London and Maudsley NHS Foundation Trust. Remote Assessment of Disease and Relapse-Major Depressive Disorder (RADAR-MDD) will be conducted according to the Declaration of Helsinki and Good Clinical Practice, adhering to principles outlined in the NHS Research Governance Framework for Health and Social Care (2nd edition). Ethical approval has been obtained in London from the Camberwell St Giles Research Ethics Committee (REC reference: 17/LO/1154), in London from the CEIC Fundacio Sant Joan de Deu (CI: PIC-128-17), and in the Netherlands from the Medische Ethische Toetsingscommissie VUms (METc VUmc registratienummer: 2018.012 - NL63557.029.17). RJBD is supported by the following: (1) NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK; (2) Health Data Research UK, which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust; (3) The BigData@Heart Consortium, funded by the Innovative Medicines Initiative-2 Joint Undertaking under grant agreement number 116074. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation program and EFPIA; it is chaired by DE Grobbee and SD Anker, partnering with 20 academic and industry partners and the European Society of Cardiology; (4) The National Institute for Health Research University College London Hospitals Biomedical Research Centre; (5) The NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London; (6) The UK Research and Innovation London Medical Imaging & Artificial Intelligence Centre for Value Based Healthcare; (7) The NIHR Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. This paper represents independent research partly funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. MH and TW have been supported by NIHR Senior Investigator Awards. Publisher Copyright: © Yuezhou Zhang, Amos A Folarin, Shaoxiong Sun, Nicholas Cummins, Yatharth Ranjan, Zulqarnain Rashid, Pauline Conde, Callum Stewart, Petroula Laiou, Faith Matcham, Carolin Oetzmann, Femke Lamers, Sara Siddi, Sara Simblett, Aki Rintala, David C Mohr, Inez Myin-Germeys, Til Wykes, Josep Maria Haro, Brenda W J H Penninx, Vaibhav A Narayan, Peter Annas, Matthew Hotopf, Richard J B Dobson, RADAR-CNS Consortium. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 30.07.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on https://mhealth.jmir.org/, as well as this copyright and license information must be included. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

Background: Research in mental health has found associations between depression and individuals' behaviors and statuses, such as social connections and interactions, working status, mobility, and social isolation and loneliness. These behaviors and statuses can be approximated by the nearby Bluetooth device count (NBDC) detected by Bluetooth sensors in mobile phones. Objective: This study aimed to explore the value of the NBDC data in predicting depressive symptom severity as measured via the 8-item Patient Health Questionnaire (PHQ-8). Methods: The data used in this paper included 2886 biweekly PHQ-8 records collected from 316 participants recruited from three study sites in the Netherlands, Spain, and the United Kingdom as part of the EU Remote Assessment of Disease and Relapse-Central Nervous System (RADAR-CNS) study. From the NBDC data 2 weeks prior to each PHQ-8 score, we extracted 49 Bluetooth features, including statistical features and nonlinear features for measuring the periodicity and regularity of individuals' life rhythms. Linear mixed-effect models were used to explore associations between Bluetooth features and the PHQ-8 score. We then applied hierarchical Bayesian linear regression models to predict the PHQ-8 score from the extracted Bluetooth features. Results: A number of significant associations were found between Bluetooth features and depressive symptom severity. Generally speaking, along with depressive symptom worsening, one or more of the following changes were found in the preceding 2 weeks of the NBDC data: (1) the amount decreased, (2) the variance decreased, (3) the periodicity (especially the circadian rhythm) decreased, and (4) the NBDC sequence became more irregular. Compared with commonly used machine learning models, the proposed hierarchical Bayesian linear regression model achieved the best prediction metrics (R2=0.526) and a root mean squared error (RMSE) of 3.891. Bluetooth features can explain an extra 18.8% of the variance in the PHQ-8 score relative to the baseline model without Bluetooth features (R2=0.338, RMSE=4.547). Conclusions: Our statistical results indicate that the NBDC data have the potential to reflect changes in individuals' behaviors and statuses concurrent with the changes in the depressive state. The prediction results demonstrate that the NBDC data have a significant value in predicting depressive symptom severity. These findings may have utility for the mental health monitoring practice in real-world settings.

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