Predicting Premature Treatment Termination in Inpatient Psychotherapy: A Machine Learning Approach

The study aims to develop a prediction model of premature treatment termination in psychosomatic hospitals using a machine learning approach.

Study Overview

• Status: Completed
• Conditions: Machine Learning; Inpatient Psychotherapy; Premature Treatment Termination; Dropout Prediction
• Intervention / Treatment: Behavioral: Psychotherapy

Detailed Description

The aim of the study is to identify risk factors that lead to or predict premature treatment termination in psychosomatic hospitals. In the long-term, the study shall help to develop more precise prediction models that can enhance communication between therapists and patients about potential dropout and- if necessary- adaption of treatment in using a feedback loop.

Since it is still not clear which variables play a major role in predicting treatment termination in psychosomatic hospitals, the study design is exploratory and includes a broad range of intake patient characteristics. The purpose of this study is hereby, to develop a prediction model based on the information that are routinely assessed at intake. Therefore, three kind of variables are planned to be included: (1) demographic and other clinical variables (e.g. age, gender, ICD-10 diagnoses), (2) psychological questionnaire data (e.g. PHQ, SF-12, EB-45, IIP-32, OPD-SFK), and (3) physiological data (e.g. routine laboratory data, blood pressure). For the study, all patients that started inpatient psychotherapy at the medical centre Heidelberg between 2015 and January 2022 will be included, resulting in a sample size of approximately N = 2000. As the average dropout rate based on meta analytical results is around 20%, one can assume that up to 400 patients prematurely dropped out of treatment.

To calculate the prediction model, it is planned to use a machine learning approach which is highly functional in big data sets. Using a Random Forest Model for binary outcomes (regular treatment length vs. premature treatment termination) it is envisioned to identify variables that contribute to the prediction of premature treatment termination at intake. Additionally, waiting list effects will be considered by taking into account the waiting duration between the initial intake interview and the moment of the hospital admission. Therefore, the study will, for the first time, investigate a prediction model for premature treatment termination in inpatient psychotherapy including clinically relevant physiological data as well as waiting time effects in preparation of the psychosomatic treatment.

• Study Type: Observational
• Enrollment (Actual): 2023

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of patients being treated at the inpatient unit of University Hospital Heidelberg, department for psychosomatic medicine.

Description

Inclusion Criteria:

• patients of at least 18 years of age
• included in inpatient psychotherapy treatment program in a hospital for psychosomatic medicine
• provided information about admission and discharge date

Exclusion Criteria:

• bipolar, acute psychotic or substance abuse disorder

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Premature treatment termination (vs. treatment completion)	Premature treatment termination will be classified based on the treatment duration. Classification will be made retrospectively for each patient based on the duration of the inpatient treatment and if applicable (duration < 49 days) on the hospital discharge letter to screen for reasons of the shorter treatment duration.	Premature treatment termination will be operationalized as a dummy variable. Regular treatment duration is 8 weeks of inpatient psychotherapy. Data will be reported for 7 years of continuous study enrolment (01/2015 - 01/2022).

Collaborators and Investigators

• Sponsor: University Hospital Heidelberg
• Investigators: Study Director: Ulrike Dinger-Ehrenthal, Prof. Dr., Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2015
• Primary Completion (Actual): January 1, 2022
• Study Completion (Actual): January 1, 2022

Study Registration Dates

• First Submitted: August 11, 2023
• First Submitted That Met QC Criteria: September 15, 2023
• First Posted (Actual): September 18, 2023

Study Record Updates

• Last Update Posted (Actual): September 18, 2023
• Last Update Submitted That Met QC Criteria: September 15, 2023
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pregnancy Complications; Obstetric Labor Complications; Obstetric Labor, Premature; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Premature Birth
• Other Study ID Numbers: Dropout-Prediction-2023

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared because study data is provided by mental health patients and is therefore subject to strict protection.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No