Depression

Interprofessional George �鶹��Ƶ researchers awarded more than $1 million to improve outcomes for patients with depression

Jennifer Pocock — Tue, 10 Dec 2024 18:25:35 +0000

Interprofessional George �鶹��Ƶ researchers awarded more than $1 million to improve outcomes for patients with depression Jennifer Pocock Tue, 12/10/2024 - 13:25

Researchers Farrokh Alemi and Kevin Lybarger receive �鶹��Ƶ’s first Patient-Centered Outcomes Research Institute (PCORI) award to develop innovative Artificial Intelligence (AI) technology, including large language models, for improving antidepressant recommendations.

Farrokh Alemi and Kevin Lybarger

AI will soon receive a dose of empathy with the goal of helping to match people with depression to their best-fit medication. A team led by Farrokh Alemi, a professor in the College of Public Health (CPH), and Kevin Lybarger, an assistant professor in the College of Engineering and Computing (CEC), received $1,049,998 in research funding from the Patient-Centered Outcomes Research Institute (PCORI) to continue their work on developing an AI system that helps patients find the right depression medications.

With this funding support, Co-PIs Alemi and Lybarger will hone large language models (LLMs) to address known challenges in AI, including mitigating biases, reducing the potential for inaccurate information, and incorporating an empathetic tone, according to Alemi.

The new study will introduce an innovative way for AI to help patients make medication decisions. The AI system will engage patients in natural-language conversations to collect information about their medical history. The system will draw upon more than 10 million patient experiences with 15 different oral antidepressants and a National Institutes of Health All of Us database, which includes records from more than 80,000 participants with major depressive disorders, to help create a plan that is statistically likely to succeed. Alemi and Lybarger believe this will help alleviate the trial and error that can lead to negative patient outcomes.

The researchers will also introduce a first-of-its-kind patient simulator capable of mimicking various medical, linguistic, and behavioral characteristics. This simulator will be used to test and refine the AI system by simulating diverse patient scenarios, including infrequent but critical events such as suicidal ideation, to ensure the system’s recommendations are safe, culturally sensitive, and empathetic.

“This study was selected for its potential to address a high-priority methodological gap in patient-centered comparative clinical effectiveness research,” said PCORI Executive Director Nakela L. Cook. “We look forward to following the study’s progress and working with George �鶹��Ƶ to share the results.”

This is the first PCORI-funded study that George �鶹��Ƶ has received. “Depression is a major public health problem and we are excited to see the development of new AI-based decision tools, leveraging the multidisciplinary talents of our college to help tackle it,” said CPH Associate Dean of Research Alison Cuellar.

"This innovative study promises to generate methodologies for using AI for medical decision-support and for empowering patients to make critical health decisions beyond mental health,” says Özlem Uzuner, chair of CEC’s Department of Information Sciences and Technology.

This study is one of the latest funded by PCORI to examine which medical treatments work best, where and when treatment falls flat, and how to address the gaps. These studies deliver results that guide researchers in planning future studies and provide patients, their caregivers, and clinicians with the evidence-based information needed to make better-informed health and health care decisions.

In This Story

Farrokh Alemi, PhD

Kevin Lybarger

Alison Evans Cuellar, PhD, MBA

Özlem Uzuner

Research at George �鶹��Ƶ

Topics

grants

Depression

antidepressants

natural language processing

Artificial Intelligence

Strategic Direction

CEC faculty research

�鶹��Ƶ Momentum

Tech inefficiencies, piles of (electronic) paperwork, and increased patient volume contribute to burnout of primary care physicians, study finds

Mary Cunningham — Tue, 30 Jan 2024 18:11:13 +0000

Tech inefficiencies, piles of (electronic) paperwork, and increased patient volume contribute to burnout of primary care physicians, study finds Mary Cunningham Tue, 01/30/2024 - 13:11

In This Story

Debora Goetz Goldberg, PhD, MHA, MBA

Burnout is an occupational phenomenon that results from chronic workplace stress, according to the World Health Organization.

Burnout often includes emotional exhaustion, negative feelings or mental distance from one’s job, and a low sense of accomplishment at work. COVID-19 increased feelings of burnout in primary care physicians, and a new study, sought to understand primary care clinicians’ perspectives on burnout during the COVID-19 pandemic, the causes of burnout, and strategies to improve clinician well-being.

Debora Goldberg

Inefficiencies of electronic health records systems and high levels of documentation contribute to burnout, according to clinicians participating in a recent study led by Debora Goldberg, associate professor in �鶹��Ƶ’s College of Public Health. Other contributors to burnout included high patient volume, staffing shortages, and expectations for responding to patient emails and telephone calls. Most participants also described the need to work after clinic hours to complete documentation.

“The results of this study provide an in-depth view of participating clinicians’ experiences and perceptions of burnout and other mental health challenges. These viewpoints can improve awareness of the issues and strategies to improve the health and well-being of our clinician workforce,” said Goldberg, the principal investigator.

Most of the suggested strategies to improve clinician well-being were changes at the organizational level and included increasing efforts to improve work-life balance, enhancing the use of team-based care models, optimizing electronic health record functions, providing accessible mental health services, granting additional administrative time to complete documentation, and increasing institutional awareness and recognition of the issues surrounding burnout.

Additionally, clinicians reported experiencing traumatic events during the pandemic and in some cases reported both burnout and depression. The study findings align with previous research that reported primary care physicians indicated dramatic increases in their workload since the beginning of the pandemic and an escalation in staffing issues, both contributing to an increase in burnout and stress among clinicians.

This research was funded by the Health Resources and Services Administration, Health and Public Safety Workforce Resiliency Training Program (1 U3NHP45404-01-00), and �鶹��Ƶ College of Public Health Intramural Pilot Study Funding.

“Anxiety, COVID, Burnout and Now Depression”: a Qualitative Study of Primary Care Clinicians’ Perceptions of Burnout” was published in the Journal of General Internal Medicine in November 2023. Tulay Soylu from Temple University; Carolyn Faith Hoffman, a �鶹��Ƶ doctoral student; and Rachel E. Kishton and Peter F. Cronholm from the University of Pennsylvania are co-authors.

Topics

coronavirus; covid-19

Research

�鶹��Ƶ Momentum

Verywell Health: Dr. Farrokh Alemi comments on antidepressants and a new website that predicts which antidepressant will work best for a patient.

eander6 — Thu, 18 Nov 2021 16:29:16 +0000

Verywell Health: Dr. Farrokh Alemi comments on antidepressants and a new website that predicts which antidepressant will work best for a patient. eander6 Thu, 11/18/2021 - 11:29

In This Story

Farrokh Alemi, PhD

This Website Could Help You Find the Right Antidepressant on Your First Try.

Topics

College of Health and Human Services

College of Health and Human Services Department of Health Administration and Policy

Medical Press: Research from Dr. Alemi on the effectiveness of certain antidepressants is cited.

eander6 — Tue, 26 Oct 2021 15:47:02 +0000

Medical Press: Research from Dr. Alemi on the effectiveness of certain antidepressants is cited. eander6 Tue, 10/26/2021 - 11:47

In This Story

Farrokh Alemi, PhD

New study helps those with depression pick antidepressant based on health history.

Topics

College of Health and Human Services

College of Health and Human Services Department of Health Administration and Policy

New Study Helps Those With Depression Pick Antidepressant Based on Health History

mthomp7 — Sat, 23 Oct 2021 13:12:32 +0000

New Study Helps Those With Depression Pick Antidepressant Based on Health History mthomp7 Sat, 10/23/2021 - 09:12

In This Story

Farrokh Alemi, PhD

The study, by Farrokh Alemi, PhD and collaborators, analyzed data from more than 3.6 million patients with major depression who had more than 10 million antidepressant treatments.

Web site developed based on the study can help alleviate depression symptoms more effectively.

Although antidepressants are one of the most frequently taken medications in the United States (11% of the population takes antidepressants)[i] [ii], 60% of depressed patients do not benefit from their first antidepressant.[iii] The sales of antidepressants exceed several billion dollars annually.[iv]

According to a new study published today from �鶹��Ƶ, a person’s existing medical conditions can have an influence on which antidepressant may work best. The data from the study can help millions alleviate depression symptoms more effectively and is now available to clinicians and patients in an online database.

“Effectiveness of Common Antidepressants: A Post Market Release Study,” released today in EClinical Medicine (published by The Lancet), summarizes the experiences of patients who have multiple comorbidities, or medical conditions, with using 15 different antidepressants. The study, by Farrokh Alemi, PhD, professor in �鶹��Ƶ College of Health and Human Services Department of Health Administration and Policy and collaborators, analyzed data from more than 3.6 million patients with major depression who had more than 10 million antidepressant treatments. Patients were broken into more than 16,000 subgroups based on conditions, demographic information, and prescribed medications to analyze their experiences using antidepressants.

Janusz Wojtusiak, PhD, associate professor, used the data to build a Web site designed to help individuals with depression find what will work best for them. By entering a patient’s medical history into the site, users can find similar cases in the data and receive recommendations for antidepressants based on the experience of symptom remission in other patients. Patients can share those recommendations with their clinicians to ensure their appropriateness for their individual case.

“Unlike with previously published randomized studies, the remission rates in the study differed significantly based on the subgroup’s medical history,” says Alemi. “The choice of the optimal antidepressant depended on the subgroup matched to the patient’s medical history.”

As an example, Alemi says, in the age and gender subgroups, the best antidepressant had an average remission rate of 50.78 percent, 1.5 times higher than the average antidepressant, which has a 30.3 percent remission rate. This was 20 times higher than the worst antidepressant used in the age and gender subgroup.

Alemi’s �鶹��Ƶ colleagues in the study included Hua Min, PhD, associate professor, and Janusz Wojtusiak, PhD, associate professor in the Department of Health Administration and Policy; Melanie Yousefi, DNP, assistant professions in the School of Nursing. Laura Becker, MS, Christopher Hane, PhD, and Vijay Nori, PhD, from OptumLabs also collaborated. Alemi was also a visiting fellow at OptumLabs.

The researchers received a grant from the Robert Wood Johnson Foundation for the study. Virginia’s Commonwealth Health Research Board provided additional funds for the related website.

[i] Urquhart L. Top companies and drugs by sales in 2019. Nat Rev Drug Discov. 2020 Apr; 19(4): 228.

[ii] Piek E, van der Meer K, Nolen WA. Guideline recommendations for long-term treatment of depression with antidepressants in primary care--a critical review. Eur J Gen Pract. 2010 Jun;16(2):106-12.

[iii] Cheung AH, Zuckerbrot RA, Jensen PS, Ghalib K, Laraque D, Stein RE; GLAD-PC Steering Group. Guidelines for Adolescent Depression in Primary Care (GLAD-PC): II. Treatment and ongoing management. Pediatrics. 2007 Nov;120(5):e1313-26.

[iv] Gautam S, Jain A, Gautam M, Vahia VN, Grover S. Clinical Practice Guidelines for the management of Depression. Indian J Psychiatry. 2017 Jan;59(Suppl 1):S34-S50.

Topics

Depression

antidepressants

Health Informatics

College of Health and Human Services

College of Health and Human Services Department of Health Administration and Policy

CHHS News

faculty spotlight

Center for Health Equity

Miki Goerdt, MSW, LCSW, ATR-BC

admin_alpha — Fri, 10 Nov 2017 04:52:01 +0000

Miki Goerdt, MSW, LCSW, ATR-BC admin_alpha Thu, 11/09/2017 - 23:52

Adjunct Faculty, Social Work

Biography

Miki Goerdt is a Licensed Clinical Social Worker and a board-certified art therapist. She has been an adjunct faculty in the Department of Social Work since 2018. Miki has spent over 14 years in the field of geriatric social work, providing mental health treatment and case management for older adults in nursing homes, assisted livings, hospice, and outpatient geriatric mental health teams. She has a private practice in Arlington, VA, and specializes in treating adults and older adults with depression and anxiety. Miki utilizes cognitive behavioral therapy and creative strategies to address clients’ clinical symptoms.

Degrees

MSW, Social Work, Marywood University
Advanced Graduate Certification, Art Therapy, Marywood University

Depression

Interprofessional George �鶹��Ƶ researchers awarded more than $1 million to improve outcomes for patients with depression

In This Story

Research at George �鶹��Ƶ

Related Stories

Topics

Tech inefficiencies, piles of (electronic) paperwork, and increased patient volume contribute to burnout of primary care physicians, study finds

In This Story

Topics

Verywell Health: Dr. Farrokh Alemi comments on antidepressants and a new website that predicts which antidepressant will work best for a patient.

In This Story

Topics

Medical Press: Research from Dr. Alemi on the effectiveness of certain antidepressants is cited.

In This Story

Topics

New Study Helps Those With Depression Pick Antidepressant Based on Health History

In This Story

Web site developed based on the study can help alleviate depression symptoms more effectively.

Topics

Miki Goerdt, MSW, LCSW, ATR-BC

Biography

Degrees