BackgroundDepression and anxiety create a large health burden and increase the risk of premature mortality. Mental health screening is vital, but more sophisticated screening and monitoring methods are needed. The Ellipsis Health App addresses this need by using semantic information from recorded speech to screen for depression and anxiety.ObjectivesThe primary aim of this study is to determine the feasibility of collecting weekly voice samples for mental health screening. Additionally, we aim to demonstrate portability and improved performance of Ellipsis’ machine learning models for patients of various ages.MethodsStudy participants were current patients at Desert Oasis Healthcare, mean age 63 years (SD = 10.3). Two non-randomized cohorts participated: one with a documented history of depression within 24 months prior to the study (Group Positive), and the other without depression (Group Negative). Participants recorded 5-min voice samples weekly for 6 weeks via the Ellipsis Health App. They also completed PHQ-8 and GAD-7 questionnaires to assess for depression and anxiety, respectively.ResultsProtocol completion rate was 61% for both groups. Use beyond protocol was 27% for Group Positive and 9% for Group Negative. The Ellipsis Health App showed an AUC of 0.82 for the combined groups when compared to the PHQ-8 and GAD-7 with a threshold score of 10. Performance was high for senior participants as well as younger age ranges. Additionally, many participants spoke longer than the required 5 min.ConclusionThe Ellipsis Health App demonstrated feasibility in using voice recordings to screen for depression and anxiety among various age groups and the machine learning models using Transformer methodology maintain performance and improve over LSTM methodology when applied to the study population.
Adolescents and young adults (AYAs) diagnosed with cancer are an age-defined population, with studies reporting up to 45% of the population experiencing psychological distress. Although it is essential to screen and monitor for psychological distress throughout AYAs’ cancer journeys, many cancer centers fail to effectively implement distress screening protocols largely due to busy clinical workflow and survey fatigue. Recent advances in mobile technology and speech science have enabled flexible and engaging methods to monitor psychological distress. However, patient-centered research focusing on these methods’ feasibility and acceptability remains lacking. Therefore, in this project, we aim to evaluate the feasibility and acceptability of an artificial intelligence (AI)-enabled and speech-based mobile application to monitor psychological distress among AYAs diagnosed with cancer. We use a single-arm prospective cohort design with a stratified sampling strategy. We aim to recruit 60 AYAs diagnosed with cancer and to monitor their psychological distress using an AI-enabled speech-based distress monitoring tool over a 6 month period. The primary feasibility endpoint of this study is defined by the number of participants completing four out of six monthly distress assessments, and the acceptability endpoint is defined both quantitatively using the acceptability of intervention measure and qualitatively using semi-structured interviews.
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