Protocol Development of a digital biomarker and intervention for subclinical depression: study protocol for a longitudinal waitlist control study, 2023, Teepe

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Development of a digital biomarker and intervention for subclinical depression: study protocol for a longitudinal waitlist control study

Gisbert W. Teepe, Yanick X. Lukic, Birgit Kleim, Nicholas C. Jacobson, Fabian Schneider, Prabhakaran Santhanam, Elgar Fleisch & Tobias Kowatsch

Abstract
Background
Depression remains a global health problem, with its prevalence rising worldwide. Digital biomarkers are increasingly investigated to initiate and tailor scalable interventions targeting depression. Due to the steady influx of new cases, focusing on treatment alone will not suffice; academics and practitioners need to focus on the prevention of depression (i.e., addressing subclinical depression).

Aim
With our study, we aim to (i) develop digital biomarkers for subclinical symptoms of depression, (ii) develop digital biomarkers for severity of subclinical depression, and (iii) investigate the efficacy of a digital intervention in reducing symptoms and severity of subclinical depression.

Method
Participants will interact with the digital intervention BEDDA consisting of a scripted conversational agent, the slow-paced breathing training Breeze, and actionable advice for different symptoms. The intervention comprises 30 daily interactions to be completed in less than 45 days. We will collect self-reports regarding mood, agitation, anhedonia (proximal outcomes; first objective), self-reports regarding depression severity (primary distal outcome; second and third objective), anxiety severity (secondary distal outcome; second and third objective), stress (secondary distal outcome; second and third objective), voice, and breathing. A subsample of 25% of the participants will use smartwatches to record physiological data (e.g., heart-rate, heart-rate variability), which will be used in the analyses for all three objectives.

Discussion
Digital voice- and breathing-based biomarkers may improve diagnosis, prevention, and care by enabling an unobtrusive and either complementary or alternative assessment to self-reports. Furthermore, our results may advance our understanding of underlying psychophysiological changes in subclinical depression. Our study also provides further evidence regarding the efficacy of standalone digital health interventions to prevent depression.

Open: https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-023-01215-1
 
What on earth is subclinical depression? People are either depressed or they're not. If they are depressed then it can vary in severity.

If symptoms of depression are declared to be "subclinical" it is just the same as saying the doctor/therapist is making stuff up about the patient.
 
Development of a digital biomarker and intervention for subclinical depression: study protocol for a longitudinal waitlist control study
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Digital biomarker? Subclinical depression? waitlist control?

Is this an attempt to reach the lowest possible standards? A bit like a dive in the Mariana trench to see how low you can go.
 
More pseudoscience. Might as well be detecting ghosts.

In the end they are using the same old biased self-reported questionnaires so that whatever the evaluation may be, all it does is align with that the old questionnaires do. So the digital part is completely superfluous, this program could have been done exactly as is a century ago, and probably was done many, many times since it's completely generic anyway.

In the discussion, they're already describing it as effective:
Our study also provides further evidence regarding the efficacy of standalone digital health interventions to prevent depression.
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This all reminds of students in a computer science program. Always starting new side projects. Never finishing any. Only ever working on things that interest them but losing interest quickly once it becomes hard, and almost never on things that are actually useful to someone. It's the perfect toxic mix of tech broing with too much free money, where no one has any actual goal and they're not doing anything that hasn't been done millions of times before. Certainly nothing anyone would actually pay for, but they don't need to bother with that, their product is forced onto people, or at least their entire market is.

The "digital intervention" is just a dumb coaching program with gamified features:
To address these challenges and contribute to the efforts to develop speech- and breathing-based DBMs, we designed and implemented the digital intervention called “On a journey to feel a little better. Or BEDDA” (BEDDA). To improve daily reported symptoms and biweekly reported severity, we implemented intervention components observed to be effective in related work, namely the slow-paced breathing training Breeze [39, 48,49,50] and a conversational agent [51,52,53,54]. Additionally, participants will receive daily short, actionable advice [55,56,57]. We aim to use BEDDA in a 30-day waitlist control field study to collect different data to address three main objectives.
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Oh you BEDDA believe that the acronym game in this ideology is not FINE.
 
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