AI genetic test aims to detect postpartum depression before symptoms appear

Researchers from Dionysus' academic partners, the Royal Institute of Mental Health and UVA Health, announced: peer reviewed paper Affirming their findings, the company is partnering with the Department of Defense and the National Institutes of Health on clinical trials, with the goal of eventually making the $250 test widely available and covered by insurance. But women's health experts say a better diagnosis of postpartum depression may not be helpful if mothers don't have access to treatment and support.

1 in 7 people Mothers experience postpartum depression. When doctors screen for this condition, they usually look for statements such as “I'm looking forward to things as much as I've always been,” or “I've been needlessly blaming myself when things haven't gone well.” A questionnaire is used that asks patients about their level of empathy. ”

If properly diagnosed, mothers rarely receive the care they need. In one widely cited study, exactly one third Of the pregnant patients who showed signs of a mental disorder, most who received treatment received verbal “reassurance” from their health care provider.

“Our goal is to get people to treatment before they experience symptoms,” Vivian Min, co-founder and chief scientist at Dionysus, said in an interview with The Washington Post. “Now we prove it's not just in your head.”

Min is one of many researchers using artificial intelligence to explore new approaches to complex health problems. Delfi Diagnostics, based in Palo Alto, California, offers tests such as: use artificial intelligence Detect signs of lung cancer.Researchers at Washington National Children's Hospital We built an AI tool Diagnose rheumatic heart disease in children.

However, AI systems can easily exacerbate existing biases and inequities in healthcare.a 2019 survey It turns out that an algorithm that recommends C-sections was incorrectly flagging black women as being at high risk. Another algorithm tasked with predicting the medical needs of a diverse group of patients consistently recommended less care for Black patients. another study showed that.

Mr Min acknowledged concerns about bias, cost and effectiveness. It will likely take years for Dionysus to get approval from the Food and Drug Administration and to get insurance companies and employers to agree to pay for the test, Min said. Meanwhile, the company said it received a $6 billion grant from the Department of Defense to validate the test in more environments. The Department of Defense did not respond to requests for comment.

Dionysus envisions a world where health care providers perform blood tests during the second and third trimesters of pregnancy, flagging women who are at high risk for postpartum depression. Other perinatal mood disorders. Combined with other diagnostic methods, this could potentially help health systems funnel vulnerable mothers toward treatment and even preventive care.

The American College of Obstetricians and Gynecologists recommends that health care providers screen patients for postpartum depression multiple times during and after pregnancy, but women's health experts say this isn't always the case. said psychiatrist Elizabeth LaRusso.Some people can complete their prenatal and postnatal checkups without a provider. I've mentioned depression before..Low-income women and women of color are less likely to be tested than white mothers, LaRusso study I found.

LaRusso said she welcomes any tools that can help identify postpartum depression before it leads to hospitalization, unemployment or suicide. But identifying at-risk mothers is only the first step. She says more testing won't make a difference if patients can't access the care they need, including treatment and medication.

The impact of the Dionysus test will depend on the affordability of the test and whether insurance companies will cover the cost of the test. Perinatal mood and anxiety disorders cost $14 billion in lost wages and additional costs each year. Researcher's estimate. Insurers may be incentivized to pay for testing if reporting more cases of depression can reduce subsequent medical costs, Min said.

But Wendell Potter, a former insurance executive and advocate for industry reform, said insurers could see depression diagnoses as a path to higher medical costs as patients seek treatments they couldn't get. Yes, he said. Ultimately, insurance companies and employers will decide on a case-by-case basis what new medical technologies to cover. Mr Potter said tests like the Dionysus test could exacerbate existing inequalities in maternal care if patients had to pay out of pocket to screen for postnatal depression. .

“It's questionable how much money most Americans can withdraw from their bank accounts.” [the test] “It’s going to be expensive,” he said.

Is this a safe use of AI?

As companies and researchers propose the use of AI in healthcare, it will be essential to audit those systems for bias, AI experts say. Because machine learning systems are trained to recognize patterns, it's easy for biases that show up in the training data to trickle down, said Mark Sendak, a data scientist at the Duke Institute for Health Innovation (DIHI). .

Sendak is critical that the training data for AI models must reflect the population they are intended to serve.Dionysus says: The test was first tested in a cohort of primarily white patients at Johns Hopkins Hospital in Baltimore. The partnership with Emory University Hospital and the Department of Defense will help further validate the model with a more diverse group of patients, Min said.

Without recent advances in machine learning, Dionysus would never have been able to link specific genes to postpartum depression, Min said.Similar discoveries may soon follow for companies. Accelerate the application of AI for medical challenges.

But Suresh Bal, program director at DIHI, said progress can come with drawbacks. Existing disparities in health care access will be exacerbated if only those with disposable income can afford early screening and preventive care. Knowing you're at risk for a disease you may never contract can be anxiety-inducing, Ming said. Even people with a genetic predisposition to postpartum depression may not develop symptoms unless their genes are activated by environmental factors.

Min said Dionysus' ultimate goal is to sell postpartum depression tests directly to consumers, allowing people to assess their risk years before they become pregnant. She said the lives of mothers and children can change for the better if they have access to the care they need.