A predictor model of treatment resistance in schizophrenia using data from electronic health records

Giouliana Kadra-Scalzo, Daniela Fonseca de Freitas, Deborah Agbedjro, Emma Francis, Isobel Ridler, Megan Pritchard, Hitesh Shetty, Aviv Segev, Cecilia Casetta, Sophie E. Smart, Anna Morris, Johnny Downs, Søren Rahn Christensen, Nikolaj Bak, Bruce J. Kinon, Daniel Stahl, Richard D. Hayes, James H. MacCabe

Research output: Contribution to journalReview articlepeer-review

Abstract

OBJECTIVES: To develop a prognostic tool of treatment resistant schizophrenia (TRS) in a large and diverse clinical cohort, with comprehensive coverage of patients using mental health services in four London boroughs. METHODS: We used the Least Absolute Shrinkage and Selection Operator (LASSO) for time-to-event data, to develop a risk prediction model from the first antipsychotic prescription to the development of TRS, using data from electronic health records. RESULTS: We reviewed the clinical records of 1,515 patients with a schizophrenia spectrum disorder and observed that 253 (17%) developed TRS. The Cox LASSO survival model produced an internally validated Harrel's C index of 0.60. A Kaplan-Meier curve indicated that the hazard of developing TRS remained constant over the observation period. Predictors of TRS were: having more inpatient days in the three months before and after the first antipsychotic, more community face-to-face clinical contact in the three months before the first antipsychotic, minor cognitive problems, and younger age at the time of the first antipsychotic. CONCLUSIONS: Routinely collected information, readily available at the start of treatment, gives some indication of TRS but is unlikely to be adequate alone. These results provide further evidence that earlier onset is a risk factor for TRS.

Original languageEnglish
Pages (from-to)e0274864
JournalPLoS ONE
Volume17
Issue number9
DOIs
StatePublished - 2022

Fingerprint

Dive into the research topics of 'A predictor model of treatment resistance in schizophrenia using data from electronic health records'. Together they form a unique fingerprint.

Cite this