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000906465 1001_ $$0P:(DE-HGF)0$$aBarron, Daniel S.$$b0$$eCorresponding author
000906465 245__ $$aDecision Models and Technology Can Help Psychiatry Develop Biomarkers
000906465 260__ $$aLausanne$$bFrontiers Research Foundation$$c2021
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000906465 520__ $$aWhy is psychiatry unable to define clinically useful biomarkers? We explore this question from the vantage of data and decision science and consider biomarkers as a form of phenotypic data that resolves a well-defined clinical decision. We introduce a framework that systematizes different forms of phenotypic data and further introduce the concept of decision model to describe the strategies a clinician uses to seek out, combine, and act on clinical data. Though many medical specialties rely on quantitative clinical data and operationalized decision models, we observe that, in psychiatry, clinical data are gathered and used in idiosyncratic decision models that exist solely in the clinician's mind and therefore are outside empirical evaluation. This, we argue, is a fundamental reason why psychiatry is unable to define clinically useful biomarkers: because psychiatry does not currently quantify clinical data, decision models cannot be operationalized and, in the absence of an operationalized decision model, it is impossible to define how a biomarker might be of use. Here, psychiatry might benefit from digital technologies that have recently emerged specifically to quantify clinically relevant facets of human behavior. We propose that digital tools might help psychiatry in two ways: first, by quantifying data already present in the standard clinical interaction and by allowing decision models to be operationalized and evaluated; second, by testing whether new forms of data might have value within an operationalized decision model. We reference successes from other medical specialties to illustrate how quantitative data and operationalized decision models improve patient care.
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000906465 7001_ $$0P:(DE-HGF)0$$aBaker, Justin T.$$b1
000906465 7001_ $$0P:(DE-HGF)0$$aBudde, Kristin S.$$b2
000906465 7001_ $$0P:(DE-Juel1)136848$$aBzdok, Danilo$$b3
000906465 7001_ $$0P:(DE-Juel1)131678$$aEickhoff, Simon B.$$b4
000906465 7001_ $$0P:(DE-HGF)0$$aFriston, Karl J.$$b5
000906465 7001_ $$0P:(DE-HGF)0$$aFox, Peter T.$$b6
000906465 7001_ $$0P:(DE-HGF)0$$aGeha, Paul$$b7
000906465 7001_ $$0P:(DE-HGF)0$$aHeisig, Stephen$$b8
000906465 7001_ $$0P:(DE-HGF)0$$aHolmes, Avram$$b9
000906465 7001_ $$0P:(DE-HGF)0$$aOnnela, Jukka-Pekka$$b10
000906465 7001_ $$aPowers, Albert$$b11
000906465 7001_ $$aSilbersweig, David$$b12
000906465 7001_ $$aKrystal, John H.$$b13
000906465 773__ $$0PERI:(DE-600)2564218-2$$a10.3389/fpsyt.2021.706655$$gVol. 12, p. 706655$$p706655$$tFrontiers in psychiatry$$v12$$x1664-0640$$y2021
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