A multidisciplinary research team made up of health and computer engineering professionals has devised a digital tool to facilitate shared decision-making for patients with attention deficit hyperactivity disorder (ADHD). The tool, called TDApp, is based on artificial intelligence to automatically generate up-to-date, participatory and personalised therapeutic recommendations that are tailored to the characteristics and preferences of each patient.
The scientific team is led by Xavier Castells and Beatriz López (University of Girona) and Domènec Serrano, a professional at the Institute of Health Care and a researcher in the Mental Health and Addictions research group at IDIBGI. Specifically, researchers from the UdG research groups TransLab, eXiT, GRECS and Health and Healthcare and specialists in psychiatry and psychology from the Mental Health and Addictions Network of the Healthcare Institute who, in turn, are researchers at the Girona Biomedical Research Institute (IDIBGI). The project has benefited from the collaboration of the Parc Sanitari Sanitari Sant Joan de Déu, the Cochrane Ibero-American Centre and the Open University of Catalonia (UOC). The results of the research project were presented on Thursday evening at a public event at the Espai Fundació "la Caixa" in Girona.
TDApp is aimed at health professionals who care for people with ADHD. The tool will allow them to select the most appropriate treatment for each patient according to their characteristics, values and preferences, offering the best options as it will evaluate the risk and benefit of each intervention. TDApp also offers the possibility for patients themselves, as well as their families, to participate in treatment decision-making.
TDApp has already been tested with a sample of 33 people. The results are positive and show that the digital tool "has proposed more satisfactory treatment recommendations than those offered so far by the standard sources of therapeutic information, the clinical guidelines".
The best treatment
"All patients want to receive the best treatment and all professionals want to administer the best treatment to their patients, but the reality is that when the same person is visited by different professionals, they receive different treatments," explains researcher Xavier Castells. This situation "happens especially in cases of people with ADHD", he adds. According to the researcher, the main reason for this variability is the "failure" of current medical information systems.
"As scientific information is growing rapidly, it is not possible for doctors to update it adequately," says IAS psychiatrist Domènec Serrano. "Clinical practice guidelines have tried to solve this problem, but they have not entirely succeeded, as indicated by the low adherence to their therapeutic recommendations," he points out. The most likely explanations for the poor implementation of clinical practice guideline proposals are obsolescence, as they should be updated every 3-5 years and this is not always the case; the recommendations are too general; they do not take into account the views of patients; and they are perceived as an instrument that undermines the autonomy of the clinician when it comes to making decisions.
Faced with this problem, the authors of the research wanted to respond to it by developing the TDApp tool. To go on the market, the project must obtain European certification as a medical device and is expected to be available to health professionals and patients in 2024.
The project has been financed with funds from the Ministry of Health and thanks to the e-health COMG grant from the Official College of Doctors of Girona, endowed with 12,000 euros and awarded in 2018 jointly with the Campus Salut of the University of Girona. The e-health COMG is an annual grant for research and innovation projects in health technologies.
The researchers who have taken part in the project are Xavier Castells (Faculty of Medicine - UdG), Beatriz López (Higher Polytechnic School - UdG), Domènec Serrano (Mental Health Network - IAS/IDIBGI), Marc Sáez (Faculty of Economics and Environmental Sciences - UdG), Sacramento Mayoral (Mental Health Network - IAS/IDIBGI), Evgenia Baykova (Mental Health Network - IAS/IDIBGI), Dolors Capellà (Faculty of Medicine - UdG), Lídia Blanco (Department of Health - Generalitat de Catalunya), Carme Carrion (eHealth Center - UOC/UdG Health Sciences Studies) and David Rigau (Iberoamerican Cochrane Centre).
Photo credit: Aida Fuentes