16 research outputs found

    A New Machine Learning Framework for Understanding the Link between Cannabis Use and First-Episode Psychosis

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    Lately, several studies started to investigate the existence of links between cannabis use and psychotic disorders. This work proposes a refined Machine Learning framework for understanding the links between cannabis use and 1st episode psychosis. The novel framework concerns extracting predictive patterns from clinical data using optimised and post-processed models based on Gaussian Processes, Support Vector Machines, and Neural Networks algorithms. The cannabis use attributes’ predictive power is investigated, and we demonstrate statistically and with ROC analysis that their presence in the dataset enhances the prediction performance of the models with respect to models built on data without these specific attributes

    Utilising symptom dimensions with diagnostic categories improves prediction of time to first remission in first-episode psychosis

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    There has been much recent debate concerning the relative clinical utility of symptom dimensions versus conventional diagnostic categories in patients with psychosis. We investigated whether symptom dimensions rated at presentation for first-episode psychosis (FEP) better predicted time to first remission than categorical diagnosis over a four-year follow-up. The sample comprised 193 FEP patients aged 18–65 years who presented to psychiatric services in South London, UK, between 2006 and 2010. Psychopathology was assessed at baseline with the Positive and Negative Syndrome Scale and five symptom dimensions were derived using Wallwork/Fortgang's model; baseline diagnoses were grouped using DSM-IV codes. Time to start of first remission was ascertained from clinical records. The Bayesian Information Criterion (BIC) was used to find the best fitting accelerated failure time model of dimensions, diagnoses and time to first remission. Sixty percent of patients remitted over the four years following first presentation to psychiatric services, and the average time to start of first remission was 18.3 weeks (SD = 26.0, median = 8). The positive (BIC = 166.26), excited (BIC = 167.30) and disorganised/concrete (BIC = 168.77) symptom dimensions, and a diagnosis of schizophrenia (BIC = 166.91) predicted time to first remission. However, a combination of the DSM-IV diagnosis of schizophrenia with all five symptom dimensions led to the best fitting model (BIC = 164.35). Combining categorical diagnosis with symptom dimension scores in FEP patients improved the accuracy of predicting time to first remission. Thus our data suggest that the decision to consign symptom dimensions to an annexe in DSM-5 should be reconsidered at the earliest opportunity

    A Prediction Modelling and Pattern Detection Approach for the First-Episode Psychosis Associated to Cannabis Use

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    Over the last two decades, a significant body of research has established a link between cannabis use and psychotic outcomes. In this study, we aim to propose a novel symbiotic machine learning and statistical approach to pattern detection and to developing predictive models for the onset of first-episode psychosis. The data used has been gathered from real cases in cooperation with a medical research institution, and comprises a wide set of variables including demographic, drug-related, as well as several variables specifically related to the cannabis use. Our approach is built upon several machine learning techniques whose predictive models have been optimised in a computationally intensive framework. The ability of these models to predict first-episode psychosis has been extensively tested through large scale Monte Carlo simulations. Our results show that Boosted Classification Trees outperform other models in this context, and have significant predictive ability despite a large number of missing values in the data. Furthermore, we extended our approach by further investigating how different patterns of cannabis use relate to new cases of psychosis, via association analysis and Bayesian techniques

    A Prediction Modelling and Pattern Detection Approach for the First-Episode Psychosis Associated to Cannabis Use

    Get PDF
    Over the last two decades, a significant body of research has established a link between cannabis use and psychotic outcomes. In this study, we aim to propose a novel symbiotic machine learning and statistical approach to pattern detection and to developing predictive models for the onset of first-episode psychosis. The data used has been gathered from real cases in cooperation with a medical research institution, and comprises a wide set of variables including demographic, drug-related, as well as several variables specifically related to the cannabis use. Our approach is built upon several machine learning techniques whose predictive models have been optimised in a computationally intensive framework. The ability of these models to predict first-episode psychosis has been extensively tested through large scale Monte Carlo simulations. Our results show that Boosted Classification Trees outperform other models in this context, and have significant predictive ability despite a large number of missing values in the data. Furthermore, we extended our approach by further investigating how different patterns of cannabis use relate to new cases of psychosis, via association analysis and Bayesian techniques

    Utilising symptom dimensions with diagnostic categories improves prediction of time to first remission in first-episode psychosis

    Get PDF
    There has been much recent debate concerning the relative clinical utility of symptom dimensions versus conventional diagnostic categories in patients with psychosis. We investigated whether symptom dimensions rated at presentation for first-episode psychosis (FEP) better predicted time to first remission than categorical diagnosis over a four-year follow-up. The sample comprised 193 FEP patients aged 18-65 years who presented to psychiatric services in South London, UK, between 2006 and 2010. Psychopathology was assessed at baseline with the Positive and Negative Syndrome Scale and five symptom dimensions were derived using Wallwork/Fortgang’s model; baseline diagnoses were grouped using DSM-IV codes. Time to start of first remission was ascertained from clinical records. The Bayesian Information Criterion (BIC) was used to find the best fitting accelerated failure time model of dimensions, diagnoses and time to first remission. Sixty percent of patients remitted over the four years following first presentation to psychiatric services, and the average time to start of first remission was 18.3 weeks (SD=26.0, median=8). The positive (BIC=166.26), excited (BIC=167.30) and disorganised/concrete (BIC=168.77) symptom dimensions, and a diagnosis of schizophrenia (BIC=166.91) predicted time to first remission. However, a combination of the DSM-IV diagnosis of schizophrenia with all five symptom dimensions led to the best fitting model (BIC=164.35). Combining categorical diagnosis with symptom dimension scores in FEP patients improved the accuracy of predicting time to first remission. Thus our data suggest that the decision to consign symptom dimensions to an annexe in DSM-5 should be reconsidered at the earliest opportunity

    Evacetrapib and Cardiovascular Outcomes in High-Risk Vascular Disease

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    BACKGROUND: The cholesteryl ester transfer protein inhibitor evacetrapib substantially raises the high-density lipoprotein (HDL) cholesterol level, reduces the low-density lipoprotein (LDL) cholesterol level, and enhances cellular cholesterol efflux capacity. We sought to determine the effect of evacetrapib on major adverse cardiovascular outcomes in patients with high-risk vascular disease. METHODS: In a multicenter, randomized, double-blind, placebo-controlled phase 3 trial, we enrolled 12,092 patients who had at least one of the following conditions: an acute coronary syndrome within the previous 30 to 365 days, cerebrovascular atherosclerotic disease, peripheral vascular arterial disease, or diabetes mellitus with coronary artery disease. Patients were randomly assigned to receive either evacetrapib at a dose of 130 mg or matching placebo, administered daily, in addition to standard medical therapy. The primary efficacy end point was the first occurrence of any component of the composite of death from cardiovascular causes, myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina. RESULTS: At 3 months, a 31.1% decrease in the mean LDL cholesterol level was observed with evacetrapib versus a 6.0% increase with placebo, and a 133.2% increase in the mean HDL cholesterol level was seen with evacetrapib versus a 1.6% increase with placebo. After 1363 of the planned 1670 primary end-point events had occurred, the data and safety monitoring board recommended that the trial be terminated early because of a lack of efficacy. After a median of 26 months of evacetrapib or placebo, a primary end-point event occurred in 12.9% of the patients in the evacetrapib group and in 12.8% of those in the placebo group (hazard ratio, 1.01; 95% confidence interval, 0.91 to 1.11; P=0.91). CONCLUSIONS: Although the cholesteryl ester transfer protein inhibitor evacetrapib had favorable effects on established lipid biomarkers, treatment with evacetrapib did not result in a lower rate of cardiovascular events than placebo among patients with high-risk vascular disease. (Funded by Eli Lilly; ACCELERATE ClinicalTrials.gov number, NCT01687998 .)

    A prediction modelling and pattern detection approach for the first-episode psychosis associated to cannabis use

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    Over the last two decades, a significant body of research has established a link between cannabis use and psychotic outcomes. In this study, we aim to propose a novel symbiotic machine learning and statistical approach to pattern detection and to developing predictive models for the onset of first-episode psychosis. The data used has been gathered from real cases in cooperation with a medical research institution, and comprises a wide set of variables including demographic, drug-related, as well as several variables specifically related to the cannabis use. Our approach is built upon several machine learning techniques whose predictive models have been optimised in a computationally intensive framework. The ability of these models to predict first-episode psychosis has been extensively tested through large scale Monte Carlo simulations. Our results show that Boosted Classification Trees outperform other models in this context, and have significant predictive ability despite a large number of missing values in the data. Furthermore, we extended our approach by further investigating how different patterns of cannabis use relate to new cases of psychosis, via association analysis and Bayesian techniques
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