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| Format: | Artículo Open Access |
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Wiley
2025
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| Online Access: | https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.14131 |
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| author | Bo Wang Yi‐Han Sheu Hyunjoon Lee Robert G. Mealer Victor M. Castro Jordan W. Smoller |
| author_facet | Bo Wang Yi‐Han Sheu Hyunjoon Lee Robert G. Mealer Victor M. Castro Jordan W. Smoller Bo Wang Yi‐Han Sheu Hyunjoon Lee Robert G. Mealer Victor M. Castro Jordan W. Smoller |
| collection | Wiley Open Access |
| contents | Prediction of early‐onset bipolar using electronic health records Bo Wang Yi‐Han Sheu Hyunjoon Lee Robert G. Mealer Victor M. Castro Jordan W. Smoller Journal of Child Psychology and Psychiatry Background Early identification of bipolar disorder (BD) provides an important opportunity for timely intervention. In this study, we aimed to develop machine learning models using large‐scale electronic health record (EHR) data including clinical notes for predicting early‐onset BD. Methods Structured and unstructured data were extracted from the longitudinal EHR of the Mass General Brigham health system. We defined three cohorts aged 10–25 years: (1) the full youth cohort ( N = 300,398); (2) a subcohort defined by having a mental health visit ( N = 105,461); and (3) a subcohort defined by having a diagnosis of mood disorder or ADHD ( N = 35,213). By adopting a prospective landmark modeling approach that aligns with clinical practice, we developed and validated a range of machine learning models, across different cohorts and prediction windows. Results We found the two tree‐based models, random forests (RF) and light gradient‐boosting machine (LGBM), achieving good discriminative performance across different clinical settings (area under the receiver operating characteristic curve 0.76–0.88 for RF and 0.74–0.89 for LGBM). In addition, we showed comparable performance can be achieved with a greatly reduced set of features, demonstrating computational efficiency can be attained without significant compromise of model accuracy. Conclusions Good discriminative performance for models predicting early‐onset BD can be achieved utilizing large‐scale EHR data. Our study offers a scalable and accurate method for identifying youth at risk for BD that could help inform clinical decision‐making and facilitate early intervention. Future work includes evaluating the portability of our approach to other healthcare systems and exploring considerations regarding possible implementation. 10.1111/jcpp.14131 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/jcpp.14131 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_jcpp_14131 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Prediction of early‐onset bipolar using electronic health records Bo Wang Yi‐Han Sheu Hyunjoon Lee Robert G. Mealer Victor M. Castro Jordan W. Smoller Journal of Child Psychology and Psychiatry Prediction of early‐onset bipolar using electronic health records Bo Wang Yi‐Han Sheu Hyunjoon Lee Robert G. Mealer Victor M. Castro Jordan W. Smoller Journal of Child Psychology and Psychiatry Background Early identification of bipolar disorder (BD) provides an important opportunity for timely intervention. In this study, we aimed to develop machine learning models using large‐scale electronic health record (EHR) data including clinical notes for predicting early‐onset BD. Methods Structured and unstructured data were extracted from the longitudinal EHR of the Mass General Brigham health system. We defined three cohorts aged 10–25 years: (1) the full youth cohort ( N = 300,398); (2) a subcohort defined by having a mental health visit ( N = 105,461); and (3) a subcohort defined by having a diagnosis of mood disorder or ADHD ( N = 35,213). By adopting a prospective landmark modeling approach that aligns with clinical practice, we developed and validated a range of machine learning models, across different cohorts and prediction windows. Results We found the two tree‐based models, random forests (RF) and light gradient‐boosting machine (LGBM), achieving good discriminative performance across different clinical settings (area under the receiver operating characteristic curve 0.76–0.88 for RF and 0.74–0.89 for LGBM). In addition, we showed comparable performance can be achieved with a greatly reduced set of features, demonstrating computational efficiency can be attained without significant compromise of model accuracy. Conclusions Good discriminative performance for models predicting early‐onset BD can be achieved utilizing large‐scale EHR data. Our study offers a scalable and accurate method for identifying youth at risk for BD that could help inform clinical decision‐making and facilitate early intervention. Future work includes evaluating the portability of our approach to other healthcare systems and exploring considerations regarding possible implementation. 10.1111/jcpp.14131 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Prediction of early‐onset bipolar using electronic health records |
| topic | Journal of Child Psychology and Psychiatry |
| url | https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.14131 |