An AI-based mobile sensing approach to optimize clinical monitoring of anxiety among youth patients

Anxiety is the most common mental health problem among youth. About 11% of youth in Canada suffer annually from an anxiety disorder and even more so during the recent pandemic. Youth with anxiety disorders do worse at school, have poorer health outcomes and are more likely to die by suicide. Cognitive behavioural therapy is the most effective treatment for anxiety disorders in youth. But many patients do not respond well enough. To decide if cognitive behavioural therapy is working well for their patient or other treatment options should be considered clinicians often rely on subjective data. But clinical decision-making based on such subjective data is difficult, as changes in symptoms might be sub-threshold, varying over time, or too small for patients to recognize. Hence, there is a real need to identify better and more objective markers of clinical response. The recent advances in mobile sensing technologies provide new ways to find such markers by objectively recording behaviours of patients. We thus aim to: (a) test if mobile sensing data predict daily anxiety symptoms over time, (b) assess if combining these data with subjective data can improve clinical prediction accuracy, and (c) develop actionable feedback loops. We will recruit 420 youth (aged 12-21) who are seeking care for anxiety. Youth will rate their symptoms in brief surveys and install a mobile sensing app on their phones to objectively record their behaviours from the start to end of their cognitive behavioural therapy. Analyses will combine complex modelling and machine learning to identify objective predictors of clinical response. With youth patients and their clinicians we will then discuss what they would like to do when the mobile sensing data predict poor clinical response. Based on their ideas we will add feedback loops to the app suggesting next steps. Such an actionable clinical monitoring tool will be of major clinical benefit and empower youth to get actively involved in their care.