Quantifying the Association Between Psychotherapy Content and Clinical Outcomes Using Deep Learning (2019) Ewbank et al.

Sly Saint · Aug 28, 2019

Psychosocial research: still not acknowledging failings (unless you look beyond the abstract) - (original title of thread)

August 22, 2019
Quantifying the Association Between Psychotherapy Content and Clinical Outcomes Using Deep Learning

Question What aspects of psychotherapy content are significantly associated with clinical outcomes?
Findings In this quality improvement study, a deep learning model was trained to automatically categorize therapist utterances from approximately 90 000 hours of internet-enabled cognitive behavior therapy (CBT). Increased quantities of CBT change methods were positively associated with reliable improvement in patient symptoms, and the quantity of nontherapy-related content showed a negative association.

Meaning The findings support the key principles underlying CBT as a treatment and demonstrate that applying deep learning to large clinical data sets can provide valuable insights into the effectiveness of psychotherapy.
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Really?

the lack of systematic methods for measuring the delivery of psychotherapy.1 As with any evidence-based intervention, to be effective, treatment needs to be delivered as intended (also known as treatment integrity),4,5 which requires accurate measurement of treatment delivered.6
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Despite its widespread use, the Improving Access to Psychological Therapies (IAPT) program in England includes no objective measure of treatment integrity for CBT, and it has been proposed that only 3.5% of psychotherapy randomized clinical trials use adequate treatment integrity procedures.9
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The information captured through IAPT’s minimum data set is intended to support monitoring of implementation and effectiveness of national policy/legislation, performance analysis and benchmarking, and national audit of IAPT services.

As determined by the National Health Service, and per The National Institute of Health and Care Excellence principles,20 clinical audit studies within the IAPT framework do not require additional patient consent or ethical approval.20 When registering to use the Ieso service, patients provide written informed consent as part of a privacy policy agreement, allowing the service to use their anonymized data for audit purposes and to support research, including academic publications.
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Clinical outcomes were defined according to IAPT guidelines19 and were measured in terms of reliable improvement and IAPT engagement and included as binary measures (ie, 0 or 1). A patient was classed as engaged if they attended 2 or more treatment sessions. Reliable improvement was calculated based on 2 severity measures: Patient Health Questionnaire (PHQ-9)21 and Generalized Anxiety Disorder 7-item scale (GAD-7),22 corresponding to depressive and anxiety symptoms respectively, completed by the patient at initial assessment and before every therapy session
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still only questionnaires, subjective outcome measures.

If the outcome measures are unreliable then the rest is irrelevant; which they later sort of acknowledge.

Given the limited outcomes measures available, we are also unable to address the association between therapy content and long-term improvements in symptoms. In addition, other patient factors not included are likely to play a role in determining outcomes.
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full article here
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2748757

alktipping · Aug 28, 2019

now if all these long term sick people where really suffering from serious mental health problems as comorbidities do you think some one with only 6 weeks training is going to be any use to them since obviously the so called professionals in mental health have failed to provide any useful treatments in a timely fashion .

rvallee · Aug 28, 2019

GIGO

Snow Leopard · Aug 29, 2019

Quantifying the circular reasoning Between Psychotherapy Content and Clinical Outcomes Using Deep Learning.

Skycloud · Aug 29, 2019

What clinical outcomes would those be? They don’t know what the true picture of clinical outcomes is because they can’t be bothered using objective measures to find out, or follow up patients longer term.

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Quantifying the Association Between Psychotherapy Content and Clinical Outcomes Using Deep Learning (2019) Ewbank et al.

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