TY - JOUR
T1 - Personalized prediction of psychosis
T2 - External validation of the NAPLS-2 psychosis risk calculator with the EDIPPP project
AU - Carrión, Ricardo E.
AU - Cornblatt, Barbara A.
AU - Burton, Cynthia Z.
AU - Tso, Ivy F.
AU - Auther, Andrea M.
AU - Adelsheim, Steven
AU - Calkins, Roderick
AU - Carter, Cameron S.
AU - Niendam, Tara
AU - Sale, Tamara G.
AU - Taylor, Stephan F.
AU - McFarlane, William R.
N1 - Funding Information:
Supported by NIMH grants MH61523 and MH081857 (to Dr. Cornblatt); NIH grants 5KL2TR000434-08 (to Dr. Tso), 5R01MH059883-11 (to Dr.Carter), R21MH101676 (to Dr. Taylor), K23MH087708 (to Dr.Niendam), and MH074543 (to the Zucker Hillside Hospital NIMH Advanced Center for Intervention and Services Research for the Study of Schizophrenia; John M. Kane, principal investigator); grant 67525 from the Robert Wood Johnson Foundation; and additional institutional support from the Maine Medical Center Research Institute and the state of Maine. Dr. Carrión received funding from the Brain and Behavior Research Foundation (NARSAD):Young Investigator Grant 19740and Let the SunShineRun/Walk.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Objective: As part of the second phase of the North American Prodrome Longitudinal Study (NAPLS-2), Cannon and colleagues report, concurrently with the present article, on a risk calculator for the individualized prediction of a psychotic disorder in a 2-year period. The present study represents an external validation of the NAPLS-2 psychosis risk calculator using an independent sample of patients at clinical high risk for psychosis collected as part of the Early Detection, Intervention, and Prevention of Psychosis Program (EDIPPP). Method: Of the total EDIPPP sample of 210 subjects rated as being at clinical high risk basedonthe Structured Interview for Prodromal Syndromes, 176 had at least one follow-up assessment and were included in the construction of a new prediction model with six predictor variables in the NAPLS-2 psychosis risk calculator (unusual thoughts and suspiciousness, symbol coding test performance, verbal learning test performance, decline in social functioning, baseline age, and family history). Discrimination performance was assessed with the area under the receiver operating characteristic curve (AUC). The NAPLS-2 risk calculator was then used to generate a psychosis risk estimate for each case in the external validation sample. Results: The external validation model showed good discrimination, with an AUC of 0.790 (95% CI=0.644-0.937). In addition, the personalized risk generated by the risk calculator provided a solid estimation of the actual conversion outcome in the validation sample. Conclusions: Two independent samples of clinical high-risk patients converge to validate the NAPLS-2 psychosis risk calculator. This prediction calculator represents a meaningful step toward early intervention and the personalized treatment of psychotic disorders.
AB - Objective: As part of the second phase of the North American Prodrome Longitudinal Study (NAPLS-2), Cannon and colleagues report, concurrently with the present article, on a risk calculator for the individualized prediction of a psychotic disorder in a 2-year period. The present study represents an external validation of the NAPLS-2 psychosis risk calculator using an independent sample of patients at clinical high risk for psychosis collected as part of the Early Detection, Intervention, and Prevention of Psychosis Program (EDIPPP). Method: Of the total EDIPPP sample of 210 subjects rated as being at clinical high risk basedonthe Structured Interview for Prodromal Syndromes, 176 had at least one follow-up assessment and were included in the construction of a new prediction model with six predictor variables in the NAPLS-2 psychosis risk calculator (unusual thoughts and suspiciousness, symbol coding test performance, verbal learning test performance, decline in social functioning, baseline age, and family history). Discrimination performance was assessed with the area under the receiver operating characteristic curve (AUC). The NAPLS-2 risk calculator was then used to generate a psychosis risk estimate for each case in the external validation sample. Results: The external validation model showed good discrimination, with an AUC of 0.790 (95% CI=0.644-0.937). In addition, the personalized risk generated by the risk calculator provided a solid estimation of the actual conversion outcome in the validation sample. Conclusions: Two independent samples of clinical high-risk patients converge to validate the NAPLS-2 psychosis risk calculator. This prediction calculator represents a meaningful step toward early intervention and the personalized treatment of psychotic disorders.
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U2 - 10.1176/appi.ajp.2016.15121565
DO - 10.1176/appi.ajp.2016.15121565
M3 - Review article
C2 - 27363511
AN - SCOPUS:84988842527
SN - 0002-953X
VL - 173
SP - 989
EP - 996
JO - American Journal of Psychiatry
JF - American Journal of Psychiatry
IS - 10
ER -