@article{6cbac50eafb1486bac91b9ede9051eb9,
title = "Classification and Prediction of Post-Trauma Outcomes Related to PTSD Using Circadian Rhythm Changes Measured via Wrist-Worn Research Watch in a Large Longitudinal Cohort",
abstract = "Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition resulting from threatening or horrifying events. We hypothesized that circadian rhythm changes, measured by a wrist-worn research watch are predictive of post-trauma outcomes. Approach: 1618 post-trauma patients were enrolled after admission to emergency departments (ED). Three standardized questionnaires were administered at week eight to measure post-trauma outcomes related to PTSD, sleep disturbance, and pain interference with daily life. Pulse activity and movement data were captured from a research watch for eight weeks. Standard and novel movement and cardiovascular metrics that reflect circadian rhythms were derived using this data. These features were used to train different classifiers to predict the three outcomes derived from week-eight surveys. Clinical surveys administered at ED were also used as features in the baseline models. Results: The highest cross-validated performance of research watch-based features was achieved for classifying participants with pain interference by a logistic regression model, with an area under the receiver operating characteristic curve (AUC) of 0.70. The ED survey-based model achieved an AUC of 0.77, and the fusion of research watch and ED survey metrics improved the AUC to 0.79. Significance: This work represents the first attempt to predict and classify post-trauma symptoms from passive wearable data using machine learning approaches that leverage the circadian desynchrony in a potential PTSD population.",
keywords = "Actigraphy, Circadian rhythms, Photoplethysmography, Post-traumatic stress disorder, Wearables, mHealth",
author = "Cakmak, {Ayse S.} and Alday, {Erick A.Perez} and {Da Poian}, Giulia and Rad, {Ali Bahrami} and Metzler, {Thomas J.} and Neylan, {Thomas C.} and House, {Stacey L.} and Beaudoin, {Francesca L.} and Xinming An and Stevens, {Jennifer S.} and Donglin Zeng and Linnstaedt, {Sarah D.} and Tanja Jovanovic and Germine, {Laura T.} and Bollen, {Kenneth A.} and Rauch, {Scott L.} and Lewandowski, {Christopher A.} and Hendry, {Phyllis L.} and Sophia Sheikh and Storrow, {Alan B.} and Musey, {Paul I.} and Haran, {John P.} and Jones, {Christopher W.} and Punches, {Brittany E.} and Swor, {Robert A.} and Gentile, {Nina T.} and McGrath, {Meghan E.} and Seamon, {Mark J.} and Kamran Mohiuddin and Chang, {Anna M.} and Claire Pearson and Domeier, {Robert M.} and Bruce, {Steven E.} and O'Neil, {Brian J.} and Rathlev, {Niels K.} and Sanchez, {Leon D.} and Pietrzak, {Robert H.} and Jutta Joormann and Barch, {Deanna M.} and Pizzagalli, {Diego A.} and Harte, {Steven E.} and Elliott, {James M.} and Kessler, {Ronald C.} and Koenen, {Karestan C.} and Ressler, {Kerry J.} and McLean, {Samuel A.} and Qiao Li and Clifford, {Gari D.}",
note = "Funding Information: Disclosure: In the past three years Dr. Clifford has received research support from Otsuka and unrestricted donations from AliveCor Inc. Dr. Clifford is CTO of Mindchild Medical Inc and has financial interest in the company. He is also Chief Scientific Officer of LifeBell AI Inc. and has financial interest in the company. Dr. Clifford is a consultant to AliveCor Inc and has financial interest in the company. No funding, technology owned or licensed by these companies was used in this research. Over the past three years, Dr. Pizzagalli has received consulting fees from Akili Interactive Labs, BlackThorn Therapeutics, Boehringer Ingelheim, Compass Pathway, Otsuka Pharmaceuticals, and Takeda Pharmaceuticals; one honorarium from Alkermes, and research funding from NIMH, Dana Foundation, Brain and Behavior Research Foundation, Millennium Pharmaceuticals. In addition, he has received stock options from BlackThorn Therapeutics. No funding from these entities was used to support the current work, and all views expressed are solely those of the authors. In the past three years, Dr. Kessler received support for his epidemiological studies from Sanofi Aventis; was a consultant for Datastat, Inc., Sage Pharmaceuticals, and Takeda. Dr. Jones reports no direct conflicts related to this paper, and no ongoing conflicts. Dr. Jones has been an investigator on studies funded by Roche Diagnostics, AstraZeneca, Janssen, and Hologic Inc. Dr. Sheikh has received funding from the Florida Medical Malpractice Joint Underwriter{\textquoteright}s Association. Funding Information: Manuscript received July 21, 2020; revised November 24, 2020 and January 7, 2021; accepted January 18, 2021. Date of publication January 22, 2021; date of current version August 5, 2021. This work was supported in part by the National Institute of Mental Health (NIMH) U01MH110925, in part by U.S. Army Medical Research and Material Command, One Mind Foundation, and Mayday Fund. (Corresponding author: Ayse S. Cakmak.) Author affiliations are presented at the end of the article. Digital Object Identifier 10.1109/JBHI.2021.3053909 Publisher Copyright: {\textcopyright} 2013 IEEE.",
year = "2021",
month = aug,
doi = "10.1109/JBHI.2021.3053909",
language = "English",
volume = "25",
pages = "2866--2876",
journal = "IEEE Journal of Biomedical and Health Informatics",
issn = "2168-2194",
number = "8",
}