Background: Digital technologies have the potential to provide objective and precise tools to detect depression-related symptoms. Deployment of digital technologies in clinical research can enable collection of large volumes of clinically relevant data that may not be captured using conventional psychometric questionnaires and patient-reported outcomes. Rigorous methodology studies to develop novel digital endpoints in depression are warranted.Objective: We conducted an exploratory, cross-sectional study to evaluate several digital technologies in subjects with major depressive disorder (MDD) and persistent depressive disorder (PDD), and healthy controls. The study aimed at assessing utility and accuracy of the digital technologies as potential diagnostic tools for unipolar depression, as well as correlating digital biomarkers to clinically validated psychometric questionnaires in depression.Methods: A cross-sectional, non-interventional study of 20 participants with unipolar depression (MDD and PDD/dysthymia) and 20 healthy controls was conducted at the Centre for Human Drug Research (CHDR), the Netherlands. Eligible participants attended three in-clinic visits (days 1, 7, and 14), at which they underwent a series of assessments, including conventional clinical psychometric questionnaires and digital technologies. Between the visits, there was at-home collection of data through mobile applications. In all, seven digital technologies were evaluated in this study. Three technologies were administered via mobile applications: an interactive tool for the self-assessment of mood, and a cognitive test; a passive behavioral monitor to assess social interactions and global mobility; and a platform to perform voice recordings and obtain vocal biomarkers. Four technologies were evaluated in the clinic: a neuropsychological test battery; an eye motor tracking system; a standard high-density electroencephalogram (EEG)-based technology to analyze the brain network activity during cognitive testing; and a task quantifying bias in emotion perception.Results: Our data analysis was organized by technology – to better understand individual features of various technologies. In many cases, we obtained simple, parsimonious models that have reasonably high diagnostic accuracy and potential to predict standard clinical outcome in depression.Conclusion: This study generated many useful insights for future methodology studies of digital technologies and proof-of-concept clinical trials in depression and possibly other indications.

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Currently, there is an increasing global need for COVID-19 screening to help reduce the rate of infection and at-risk patient workload at hospitals. Smartphone-based screening for COVID-19 along with other respiratory illnesses offers excellent potential due to its rapid-rollout remote platform, user convenience, symptom tracking, comparatively low cost, and prompt result processing timeframe. In particular, speech-based analysis embedded in smartphone app technology can measure physiological effects relevant to COVID-19 screening that are not yet digitally available at scale in the healthcare field. Using a selection of the Sonde Health COVID-19 2020 dataset, this study examines the speech of COVID-19-negative participants exhibiting mild and moderate COVID-19-like symptoms as well as that of COVID-19-positive participants with mild to moderate symptoms. Our study investigates the classification potential of acoustic features (e.g., glottal, prosodic, spectral) from short-duration speech segments (e.g., held vowel, pataka phrase, nasal phrase) for automatic COVID-19 classification using machine learning. Experimental results indicate that certain feature-task combinations can produce COVID-19 classification accuracy of up to 80% as compared with using the all-acoustic feature baseline (68%). Further, with brute-forced n -best feature selection and speech task fusion, automatic COVID-19 classification accuracy of upwards of 82–86% was achieved, depending on whether the COVID-19-negative participant had mild or moderate COVID-19-like symptom severity.

Depression is a leading cause of disease burden worldwide, however there is an unmet need for screening and diagnostic measures that can be widely deployed in real-world environments. Voice-based diagnostic methods are convenient, non-invasive to elicit, and can be collected and processed in near real-time using modern smartphones, smart speakers, and other devices. Studies in voice-based depression detection to date have primarily focused on laboratory-collected voice samples, which are not representative of typical user environments or devices. This paper conducts the first investigation of voice-based depression assessment techniques on real-world data from 887 speakers, recorded using a variety of different smartphones. Evaluations on 16 hours of speech show that conservative segment selection strategies using highly thresholded voice activity detection, coupled with tailored normalization approaches are effective for mitigating smartphone channel variability and background environmental noise. Together, these strategies can achieve F1 scores comparable with or better than those from a combination of clean recordings, a single recording environment and long utterances. The scalability of speech elicitation via smartphone allows detailed models dependent on gender, smartphone manufacturer and/or elicitation task. Interestingly, results herein suggest that normalization based on these criteria may be more effective than tailored models for detecting depressed speech.

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