Lowering costs for large-scale screening in psychosis: A systematic review and meta-analysis of performance and value of information for speech-based psychiatric evaluation

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Abstract

Objective: Obstacles for computational tools in psychiatry include gathering robust evidence and keeping implementation costs reasonable. We report a systematic review of automated speech evaluation for the psychosis spectrum and analyze the value of information for a screening program in a healthcare system with a limited number of psychiatrists (Maputo, Mozambique). Methods: Original studies on speech analysis for forecasting of conversion in individuals at clinical high risk (CHR) for psychosis, diagnosis of manifested psychotic disorder, and first-episode psychosis (FEP) were included in this review. Studies addressing non-verbal components of speech (e.g., pitch, tone) were excluded. Results: Of 168 works identified, 28 original studies were included. Valuable speech features included direct measures (e.g., relative word counting) and mathematical embeddings (e.g.: word-to-vector, graphs). Accuracy estimates reported for schizophrenia diagnosis and CHR conversion ranged from 71 to 100% across studies. Studies used structured interviews, directed tasks, or prompted free speech. Directed-task protocols were faster while seemingly maintaining performance. The expected value of perfect information is USD 9.34 million. Imperfect tests would nevertheless yield high value. Conclusion: Accuracy for screening and diagnosis was high. Larger studies are needed to enhance precision of classificatory estimates. Automated analysis presents itself as a feasible, low-cost method which should be especially useful for regions in which the physician pool is insufficient to meet demand.

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APA

Argolo, F., Magnavita, G., Mota, N. B., Ziebold, C., Mabunda, D., Pan, P. M., … Bressan, R. A. (2020). Lowering costs for large-scale screening in psychosis: A systematic review and meta-analysis of performance and value of information for speech-based psychiatric evaluation. Brazilian Journal of Psychiatry, 42(6), 673–686. https://doi.org/10.1590/1516-4446-2019-0722

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