The use of the Psychiatric Electroencephalography Evaluation Registry (PEER) to personalize pharmacotherapy
Dan V Iosifescu,1 Robert J Neborsky,2–4 Robert J Valuck5–7 1Adult Psychopharmacology Program, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 2School of Medicine, University of California, San Diego, CA, USA; 3University of Califor...
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Dove Medical Press
2016-08-01
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| Series: | Neuropsychiatric Disease and Treatment |
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| author | Iosifescu D Neborsky R Valuck R |
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| description | Dan V Iosifescu,1 Robert J Neborsky,2–4 Robert J Valuck5–7 1Adult Psychopharmacology Program, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 2School of Medicine, University of California, San Diego, CA, USA; 3University of California, Los Angeles, CA, USA; 4Medical Corps, US Navy, USA; 5Pharmacy, Epidemiology, and Family Medicine, University of Colorado, Denver, CO, USA; 6Center for Pharmaceutical Outcomes Research, University of Colorado, Denver, CO, USA; 7Colorado Consortium for Prescription Drug Abuse Prevention, Denver, CO, USA Purpose: This study aims to determine whether Psychiatric Electroencephalography Evaluation Registry (PEER) Interactive (an objective, adjunctive tool based on a comparison of a quantitative electroencephalogram to an existing registry of patient outcomes) is more effective than the current standard of care in treatment of subjects suffering from depression. Patients and methods: This is an interim report of an ongoing, 2-year prospective, randomized, double blind, controlled study to evaluate PEER Interactive in guiding medication selection in subjects with a primary diagnosis of depression vs standard treatment. Subjects in treatment at two military hospitals were blinded as to study group assignment and their self-report symptom ratings were also blinded. Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR16) depression scores were the primary efficacy endpoint. One hundred and fifty subjects received a quantitative electroencephalography exam and were randomized to either treatment as usual or PEER-informed pharmacotherapy. Subjects in the control group were treated according to Veterans Administration/Department of Defense Guidelines, the current standard of care. In the experimental group, the attending physician received a PEER report ranking the subject’s likely clinical response to on-label medications. Results: In this post hoc interim analysis subjects were separated into Report Followed and Report Not Followed groups – based on the concordance between their subsequent treatment and PEER medication guidance. We thus evaluated the predictive validity of PEER recommendations. We found significantly greater improvements in depression scores (QIDS-SR16 P<0.03), reduction in suicidal ideation (Concise Health Risk Tracking Scale-SR7 P<0.002), and post-traumatic stress disorder (PTSD) score improvement (PTSD Checklist Military/Civilian P<0.04) for subjects treated with PEER-recommended medications compared to those who did not follow PEER recommendations. Conclusion: This interim analysis suggests that an objective tool such as PEER Interactive can help improve medication selection. Consistent with results of earlier studies, it supports the hypothesis that PEER-guided treatment offers distinct advantages over the current standard of care. Keywords: EEG, depression, antidepressant, suicide, predictive analyticsA Letter to the Editor has been received and published for this article.  |
| format | Article |
| id | doaj-art-d57d31be79bc4789bbeda7392a8e3554 |
| institution | Kabale University |
| issn | 1178-2021 |
| language | English |
| publishDate | 2016-08-01 |
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| spelling | doaj-art-d57d31be79bc4789bbeda7392a8e35542025-08-20T03:30:03ZengDove Medical PressNeuropsychiatric Disease and Treatment1178-20212016-08-01Volume 12Issue 12131214228554The use of the Psychiatric Electroencephalography Evaluation Registry (PEER) to personalize pharmacotherapyIosifescu D0Neborsky RValuck RPsychiatry and NeuroscienceDan V Iosifescu,1 Robert J Neborsky,2–4 Robert J Valuck5–7 1Adult Psychopharmacology Program, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 2School of Medicine, University of California, San Diego, CA, USA; 3University of California, Los Angeles, CA, USA; 4Medical Corps, US Navy, USA; 5Pharmacy, Epidemiology, and Family Medicine, University of Colorado, Denver, CO, USA; 6Center for Pharmaceutical Outcomes Research, University of Colorado, Denver, CO, USA; 7Colorado Consortium for Prescription Drug Abuse Prevention, Denver, CO, USA Purpose: This study aims to determine whether Psychiatric Electroencephalography Evaluation Registry (PEER) Interactive (an objective, adjunctive tool based on a comparison of a quantitative electroencephalogram to an existing registry of patient outcomes) is more effective than the current standard of care in treatment of subjects suffering from depression. Patients and methods: This is an interim report of an ongoing, 2-year prospective, randomized, double blind, controlled study to evaluate PEER Interactive in guiding medication selection in subjects with a primary diagnosis of depression vs standard treatment. Subjects in treatment at two military hospitals were blinded as to study group assignment and their self-report symptom ratings were also blinded. Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR16) depression scores were the primary efficacy endpoint. One hundred and fifty subjects received a quantitative electroencephalography exam and were randomized to either treatment as usual or PEER-informed pharmacotherapy. Subjects in the control group were treated according to Veterans Administration/Department of Defense Guidelines, the current standard of care. In the experimental group, the attending physician received a PEER report ranking the subject’s likely clinical response to on-label medications. Results: In this post hoc interim analysis subjects were separated into Report Followed and Report Not Followed groups – based on the concordance between their subsequent treatment and PEER medication guidance. We thus evaluated the predictive validity of PEER recommendations. We found significantly greater improvements in depression scores (QIDS-SR16 P<0.03), reduction in suicidal ideation (Concise Health Risk Tracking Scale-SR7 P<0.002), and post-traumatic stress disorder (PTSD) score improvement (PTSD Checklist Military/Civilian P<0.04) for subjects treated with PEER-recommended medications compared to those who did not follow PEER recommendations. Conclusion: This interim analysis suggests that an objective tool such as PEER Interactive can help improve medication selection. Consistent with results of earlier studies, it supports the hypothesis that PEER-guided treatment offers distinct advantages over the current standard of care. Keywords: EEG, depression, antidepressant, suicide, predictive analyticsA Letter to the Editor has been received and published for this article. https://www.dovepress.com/the-use-of-the-psychiatric-electroencephalography-evaluation-registry--peer-reviewed-fulltext-article-NDTEEGDepressionAntidepressantSuicidePredictive Analytics |
| spellingShingle | Iosifescu D Neborsky R Valuck R The use of the Psychiatric Electroencephalography Evaluation Registry (PEER) to personalize pharmacotherapy Neuropsychiatric Disease and Treatment EEG Depression Antidepressant Suicide Predictive Analytics |
| title | The use of the Psychiatric Electroencephalography Evaluation Registry (PEER) to personalize pharmacotherapy |
| title_full | The use of the Psychiatric Electroencephalography Evaluation Registry (PEER) to personalize pharmacotherapy |
| title_fullStr | The use of the Psychiatric Electroencephalography Evaluation Registry (PEER) to personalize pharmacotherapy |
| title_full_unstemmed | The use of the Psychiatric Electroencephalography Evaluation Registry (PEER) to personalize pharmacotherapy |
| title_short | The use of the Psychiatric Electroencephalography Evaluation Registry (PEER) to personalize pharmacotherapy |
| title_sort | use of the psychiatric electroencephalography evaluation registry peer to personalize pharmacotherapy |
| topic | EEG Depression Antidepressant Suicide Predictive Analytics |
| url | https://www.dovepress.com/the-use-of-the-psychiatric-electroencephalography-evaluation-registry--peer-reviewed-fulltext-article-NDT |
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