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Calculating individualized risk components using a mobile app-based risk calculator for clinical high risk of psychosis: findings from ShangHai At Risk for Psychosis (SHARP) program

  • TianHong Zhang (a1), LiHua Xu (a1), HuiJun Li (a2), Kristen A. Woodberry (a3) (a4), Emily R. Kline (a3), Jian Jiang (a1), HuiRu Cui (a1), YingYing Tang (a1), XiaoChen Tang (a1), YanYan Wei (a1), Li Hui (a5), Zheng Lu (a6), LiPing Cao (a7), ChunBo Li (a1), Margaret A. Niznikiewicz (a8), Martha E. Shenton (a9), Matcheri S. Keshavan (a8), William S. Stone (a3) and JiJun Wang (a1) (a10) (a11)...

Abstract

Background

Only 30% or fewer of individuals at clinical high risk (CHR) convert to full psychosis within 2 years. Efforts are thus underway to refine risk identification strategies to increase their predictive power. Our objective was to develop and validate the predictive accuracy and individualized risk components of a mobile app-based psychosis risk calculator (RC) in a CHR sample from the SHARP (ShangHai At Risk for Psychosis) program.

Method

In total, 400 CHR individuals were identified by the Chinese version of the Structured Interview for Prodromal Syndromes. In the first phase of 300 CHR individuals, 196 subjects (65.3%) who completed neurocognitive assessments and had at least a 2-year follow-up assessment were included in the construction of an RC for psychosis. In the second phase of the SHARP sample of 100 subjects, 93 with data integrity were included to validate the performance of the SHARP-RC.

Results

The SHARP-RC showed good discrimination of subsequent transition to psychosis with an AUC of 0.78 (p < 0.001). The individualized risk generated by the SHARP-RC provided a solid estimation of conversion in the independent validation sample, with an AUC of 0.80 (p = 0.003). A risk estimate of 20% or higher had excellent sensitivity (84%) and moderate specificity (63%) for the prediction of psychosis. The relative contribution of individual risk components can be simultaneously generated. The mobile app-based SHARP-RC was developed as a convenient tool for individualized psychosis risk appraisal.

Conclusions

The SHARP-RC provides a practical tool not only for assessing the probability that an individual at CHR will develop full psychosis, but also personal risk components that might be targeted in early intervention.

Copyright

Corresponding author

Author for correspondence: JiJun Wang, E-mail: jijunwang27@163.com

Footnotes

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These authors contributed equally and share first authorship.

These authors contributed equally and share senior authorship.

Footnotes

References

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Calculating individualized risk components using a mobile app-based risk calculator for clinical high risk of psychosis: findings from ShangHai At Risk for Psychosis (SHARP) program

  • TianHong Zhang (a1), LiHua Xu (a1), HuiJun Li (a2), Kristen A. Woodberry (a3) (a4), Emily R. Kline (a3), Jian Jiang (a1), HuiRu Cui (a1), YingYing Tang (a1), XiaoChen Tang (a1), YanYan Wei (a1), Li Hui (a5), Zheng Lu (a6), LiPing Cao (a7), ChunBo Li (a1), Margaret A. Niznikiewicz (a8), Martha E. Shenton (a9), Matcheri S. Keshavan (a8), William S. Stone (a3) and JiJun Wang (a1) (a10) (a11)...

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