Researchers develop virtual reality-based system to improve psychiatric diagnosis

 

Researchers have developed a virtual reality-based system that shows promise in improving the differentiation between common mental health conditions, potentially paving the way for earlier and more personalised treatment. The work is published in the March edition of the peer-reviewed journal European Neuropsychopharmacology, with a subsequent (31 March) comment also being published in the same journal.

Accurate diagnosis remains one of the biggest challenges in psychiatry, with more than half of psychiatric patients changing their diagnosis within 10 years. Most psychiatric diagnoses rely on patients reporting their symptoms, but many mental health conditions share overlapping features. For example, apathy, hallucinations, and cognitive problems may be present in both schizophrenia and bipolar disorder, making it difficult to distinguish between the two. Misdiagnosis can lead to suboptimal treatment and poorer outcomes.

 Now, a group of Danish scientists have combined virtual reality with physiological measurements (such as skin conductivity) to explore a more objective method for identifying different mental health conditions.

 Lead researcher Professor Kamilla Miskowiak (University of Copenhagen) said, “This is an important step forward. Until now, diagnosis has largely depended on self-reporting of symptoms, but our findings suggest that virtual reality scenarios combined with physiological measures may help differentiate between similar conditions. This is an area where psychiatry has long faced difficulties.”

 The researchers recruited 100 participants, including individuals with bipolar disorder, borderline personality disorder, schizophrenia, and healthy controls. Participants were exposed to various immersive virtual reality scenarios designed to elicit emotional and physiological responses, such as a video of a crying baby, a discussion in a canteen, and a cramped elevator scenario. The researchers measured emotional responses and skin conductivity during these scenarios.

 Their results indicate that these responses differed systematically between diagnostic groups, suggesting that this approach has the potential to enhance diagnostic accuracy. However, larger studies are needed to confirm these findings and to explore how such methods might be used in clinical practice.

Professor Miskowiak said, “This study is part of the VIRDIS project, which aims to develop objective tools to support psychiatric diagnosis. Our initial findings are promising, but further large-scale research is needed to validate this approach and develop it into a practical clinical tool. We are now launching a follow-up study with 300 participants and implementing machine learning methods to improve individual-level diagnostic predictions. Our long-term goal is to improve early and personalised treatment for patients with mental health disorders.”

The European Neuropsychopharmacology paper has attracted attention since it was placed online, including a published commentary from Dr Sijia Liu at the Liaoning University of Traditional Chinese Medicine, Shenyang, China, stating:
 
“This study offers a groundbreaking approach to addressing the persistent challenges in psychiatric diagnosis and treatment by leveraging virtual reality (VR) technology. I suggest that future research should consider integrating artificial intelligence algorithms to analyse the extensive data generated from these VR scenarios. I believe this work holds significant promise for advancing our understanding and clinical practices in mental health care”.  
 
This project is a collaboration between the Copenhagen Mental Health Centre, Khora Virtual Reality and EXP360. This study was supported by the Ivan Nielsen Foundation. 

New Survey Findings Show Patients and Carers Want to Better Understand the Science Behind Cancer Diagnosis and Treatments

New survey findings indicate a significant need for scientific information that is accessible to, and understood by, people living with (and affected by) cancer. The majority of patient/carer organisations responding to the survey recognise that cancer science is complex and fast changing. As cancer science improves, and new discoveries occur, people who are living with cancer wish to learn more about the science of their cancer diagnosis and treatments. Nearly all (99%) of the patient/carer organisations surveyed “Agree” or “Somewhat agree” that patients want to know how their treatments work, and 91% of the respondent patient/carer organisations say that patients need to understand relevant scientific concepts about cancer to better manage their cancer.

The patient/carer organisations responding to the survey, however, also say that cancer science is hard to navigate for newly-diagnosed and experienced patients alike, and that currently-available patient information about cancer is difficult to understand, and confusing to people who are living with cancer [60% of respondent patient/carer organisations believe that cancer science is not well explained to patients and the public].

“An exciting new wave of cancer treatments is emerging out of the rapidly-advancing scientific concepts about cancer,” says Alex Wyke, founder and CEO of PatientView. “Yet, in the face of the advance, cancer patient information remains stubbornly hard for ordinary people to digest. The results from this 2016 survey show that over 90% of respondent patient/carer organisations believe that people living with cancer (and their families and carers) will be better equipped to manage the disease if they have a fundamental understanding of basic cancer science. Arming the cancer patient community with intelligible knowledge about cancer will allow people with cancer to understand more about the disease and its numerous diagnostic procedures and treatments. Such knowledge will empower people with cancer to communicate more effectively with doctors, nurses, and all the other health professionals who help them to fight cancer. In short, information about cancer science—carefully tailored to the needs of patients—will ultimately permit people with cancer to make truly informed decisions about their health.”

 

KEY FINDINGS FROM THE SURVEY INCLUDE:

• 99% of respondent patient/carer organisations “Agree” or “Somewhat agree” that people living with cancer want to know how their cancer treatments work.
• Over 90% of respondent patient/carer organisations “Agree” or “Somewhat agree” that patients must understand scientific concepts about cancer if they are to better manage their cancer.
• 57% of respondents indicate that increasing the awareness of cancer treatment options among patients and the public is a top priority of their organisation.
• 61% of respondents say that the public is unfamiliar with basic scientific concepts about cancer.
• 83% of patient/carer organisations have been asked by patients/carers about immuno-oncology. However, only 48.2 % of those same organisations are themselves familiar with the topic of immunotherapies in oncology.
• 67% of patient/carer organisations have been asked by patients/carers about gene mutations associated with cancer and biomarkers. Again, though, only 52 % of the organisations themselves claim familiarity with the concepts of genetic testing and precision medicine.

 

Full survey results can be accessed by clicking on this button

 

ESE publishes new recommendations for the diagnosis and treatment of Adrenal Incidentalomas

 The appropriate clinical response to adrenal incidentaloma should depend on the likelihood of malignancy, according to new guidelines published today by the European Society of Endocrinology (ESE), in collaboration with the European Network for the Study of Adrenal Tumours (ENSAT) and first presented at ESE’s annual European Congress of Endocrinology in May 2016.

An adrenal incidentaloma is a tumour of the adrenal glands discovered through imaging performed for reasons other than a suspected adrenal tumour. These incidentally discovered adrenal masses may be malignant or benign as well as functionally active (releasing hormones), or inactive. The majority found are benign, non-functioning masses.

Due to a rise in the number of imaging procedures available, the frequency of diagnosis of these tumours is increasing. Despite this, no international guidelines exist on the topic. In response, an interdisciplinary guideline working group made up of 10 international experts and led byProfessors Martin Fassnacht (Germany) and Olaf Dekkers (The Netherlands) determined to establish the best response to adrenal incidentaloma.

The working group used GRADE (Grading of Recommendations, Assessment, Development and Evaluations) to define key clinical questions surrounding the disease. They then carried out extensive literature research to address these questions, providing recommendations based on quality of evidence as well as outcomes, patient preferences and feasibility of implementation.

“These guidelines are an important step in the handling of adrenal incidentaloma” says Martin Fassnacht. “We provide for the first time evidence-based recommendations to avoid over-diagnostics and over-treatment, without missing relevant disease, such as adrenocortical carcinomas.”

Focusing on the assessment of malignancy, surgical intervention, follow-up recommendations and the definition and management of low-level autosomal cortisol secretion, the guidelines provide a comprehensive overview of disease assessment, treatment and follow-up. They state that the appropriateness of surgical intervention depends on the likelihood of malignancy, the presence and degree of hormone over-production as well as the age, general health and preference of the patient.

“The guidelines also provide recommendations on how to address bilateral incidentalomas (both adrenal glands) and tumours in patients with extra-adrenal malignancy (outside of the adrenal glands). They also clearly define that benign, non-functioning masses less than 4cm in size do not require follow-up imaging. Identification of this group is a major change to prior expert opinions.”

The full guidelines can be downloaded free of charge from the European Journal of Endocrinology, the official journal of the European Society of Endocrinology.