Treatment selection using prototyping in latent-space with application to depression treatment.

Journal: PloS one
PMID:

Abstract

Machine-assisted treatment selection commonly follows one of two paradigms: a fully personalized paradigm which ignores any possible clustering of patients; or a sub-grouping paradigm which ignores personal differences within the identified groups. While both paradigms have shown promising results, each of them suffers from important limitations. In this article, we propose a novel deep learning-based treatment selection approach that is shown to strike a balance between the two paradigms using latent-space prototyping. Our approach is specifically tailored for domains in which effective prototypes and sub-groups of patients are assumed to exist, but groupings relevant to the training objective are not observable in the non-latent space. In an extensive evaluation, using both synthetic and Major Depressive Disorder (MDD) real-world clinical data describing 4754 MDD patients from clinical trials for depression treatment, we show that our approach favorably compares with state-of-the-art approaches. Specifically, the model produced an 8% absolute and 23% relative improvement over random treatment allocation. This is potentially clinically significant, given the large number of patients with MDD. Therefore, the model can bring about a much desired leap forward in the way depression is treated today.

Authors

  • Akiva Kleinerman
    Bar-Ilan University, Ramat-Gan, Israel.
  • Ariel Rosenfeld
    Bar-Ilan University, Ramat-Gan, Israel.
  • David Benrimoh
    McGill University, Montreal, Canada.
  • Robert Fratila
    McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, 3801 Rue University, Montreal, QC, H3A 2B4, Canada. Electronic address: robert.fratila@mail.mcgill.ca.
  • Caitrin Armstrong
    Aifred Health, Montreal, Canada.
  • Joseph Mehltretter
    Aifred Health, Montreal, Canada.
  • Eliyahu Shneider
    Bar-Ilan University, Ramat-Gan, Israel.
  • Amit Yaniv-Rosenfeld
    Shalvata Mental Health Center, Hod Hasharon, Israel.
  • Jordan Karp
    University of Arizona, Tucson, Arizona, United States of America.
  • Charles F Reynolds
    Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA.
  • Gustavo Turecki
    Department of Psychiatry, Douglas Institute, McGill University, Montreal, QC, Canada.
  • Adam Kapelner
    Queens College, New York City, NY, United States of America.