https://onlinelibrary.wiley.com/doi/pdf/10.1002/wps.20882

The promise of machine learning in predicting treatment outcomes in psychiatry

Outcome measurement in the field of psychotherapy has developed considerably in the last decade. This review discusses key issues related to outcome measurement, modeling, and implementation of data-informed and measurement-based psychological therapy. First, an overview is provided, covering the rationale of outcome measurement by acknowledging some of the limitations of clinical judgment. Second, different models of outcome measurement are discussed, including pre-post, session-by-session, and higher-resolution intensive outcome assessments. Third, important concepts related to modeling patterns of change are addressed, including early response, dose-response, and nonlinear change. Furthermore, rational and empirical decision tools are discussed as the foundation for measurement-based therapy. Fourth, examples of clinical applications are presented, which show great promise to support the personalization of therapy and to prevent treatment failure. Finally, we build on continuous outcome measurement as the basis for a broader understanding of clinical concepts and data-driven clinical practice in the future. 

Measurement-Based and Data-Informed Psychological Therapy

OBJECTIVE Understanding the client perspective is important for the provision of psychotherapy. The significant events paradigm, within which clients report on the most significant events of a therapy session immediately after the session, represents a useful means to explore clients' in-session experience. METHOD The aim of this study was to investigate what types of client-identified impacts are reported in qualitative studies on helpful and hindering events in psychotherapy. Seventeen primary studies focusing on client-identified helpful and hindering events were identified through database searches and subsequent manual searches. The data were subjected to qualitative meta-analysis. RESULTS The descriptions of event impacts were classified into 12 helpful (e.g., gaining a new perspective on the self; feeling heard, understood, and accepted; and feeling engaged in the therapeutic process) and eight hindering (e.g., lacking guidance from the therapist and feeling emotionally overwhelmed) impact meta-categories. CONCLUSION The findings provide an update to a previous meta-analysis by identifying several new categories of helpful event impacts and by categorizing hindering event impacts.

Client-Identified Impacts of Helpful and Hindering Events in Psychotherapy: A Qualitative Meta-analysis.

Game-based learning (GBL) may address the unique characteristics of a single subject such as chemistry. Previous systematic reviews on the effects of GBL have yielded contradictory results concerning cognitive and motivational outcomes. This meta-analysis aims to: (a) estimate the overall effect size of GBL in chemistry education on cognitive, motivational, and emotional outcomes compared with non-GBL (i.e., media comparison); (b) examine possible moderators of the effects; and (c) identify the more effective game design and instructional design features (i.e., value-added comparison). We screened 842 articles and included 34 studies. This study is the first GBL meta-analysis that employed a three-level random-effects model for the overall effects. Moderator analysis used a mixed-effects meta-regression model. Results from the media comparison suggest chemistry GBL was more effective for cognition (g = 0.70, k = 30, N = 4155), retention (g = 0.59, k = 20, N = 2860), and motivation (g = 0.35, k = 7, N = 974) than non-GBL and the substantial heterogeneity (I2 = 86%) for cognitive outcomes. No study reported emotional outcomes, and studies considering value-added comparisons of GBL with versus without specific design features (k = 3) were too few to perform a meta-analysis. Moderator analyses implied that except for publication source and sample size, no other moderator was related to effect sizes. There may be the small-study effects, particularly publication bias. Although we conclude that GBL enhances chemistry learning more than non-GBL, the results also make clear that additional high-quality value-added research is needed to identify design guidelines that may further improve chemistry GBL. More GBL meta-analyses on subjects other than chemistry are also needed. As the first GBL meta-analysis that emphasizes emotion, we call for more research on emotion and on relationships between cognition, motivation, and emotion in GBL. 

Game‐based learning has good chemistry with chemistry education: A three‐level meta‐analysis

Cost-effectiveness of feedback-informed psychological treatment: Evidence from the IAPT-FIT trial

Using progress feedback to improve outcomes and reduce drop-out, treatment duration, and deterioration: A multilevel meta-analysis.

Background Deficits in error processing are reflected in an inability of people with externalizing problems to adjust their problem behaviour. The present study contains 2 meta-analyses, testing whether error processing - indexed by the event-related potentials error-related negativity (ERN) and error positivity (Pe) - is reduced in children and adults with externalizing problems and disorders compared to healthy controls. Methods We conducted a systematic search in PubMed (1980 to December 2018), PsycInfo (1980 to December 2018) and Scopus (1970 to December 2018), identifying 328 studies. We included studies that measured error processing using the Eriksen flanker task, the go/no-go task or the stop-signal task in healthy controls and in adults or children with clearly described externalizing behavioural problems (e.g., aggression) or a clinical diagnosis on the externalizing spectrum (e.g., addiction). Results Random-effect models (ERN: 23 studies, 1739 participants; Pe: 27 studies, 1456 participants) revealed a reduced ERN amplitude (Hedges' g = 0.44, 95% confidence interval [CI] 0.29 to 0.58) and a reduced Pe amplitude (Hedges' g = -0.27, 95% CI -0.44 to -0.09) during error processing in people with externalizing problems or disorders compared to healthy controls. Type of diagnosis, age and the presence of performance feedback or comorbidity did not moderate the results. The employed cognitive task was a moderator for Pe but not for ERN. The go/no-go task generated a greater amplitude difference in Pe than the Eriksen flanker task. Small-sample assessment revealed evidence of publication bias for both event-related potentials. However, a p curve analysis for ERN showed that evidential value was present; for Pe, the p curve analysis was inconclusive. Limitations The moderators did not explain the potential heterogeneity in most of the analysis, suggesting that other disorder- and patient-related factors affect error processing. Conclusion Our findings indicate the presence of compromised error processing in externalizing psychopathology, suggesting diminished activation of the prefrontal cortex during performance monitoring.

/pdf/diminished-error-related-negativity-and-error-positivity-in-1d823dcfn0.pdf

Diminished error-related negativity and error positivity in children and adults with externalizing problems and disorders: a meta-analysis on error processing.

Miranda C. Lutz

Papers

Using progress feedback to improve outcomes and reduce drop-out, treatment duration, and deterioration: A multilevel meta-analysis.

Diminished error-related negativity and error positivity in children and adults with externalizing problems and disorders: a meta-analysis on error processing.

Event-related potential (ERP) measures of error processing as biomarkers of externalizing disorders: A narrative review.