Evaluating the utility of digital phenotyping to predict health outcomes in schizophrenia : protocol for the HOPE-S observational study

Introduction The course of schizophrenia illness is characterised by recurrent relapses which are associated with adverse clinical outcomes such as treatmentresistance, functional and cognitive decline. Early identification is essential and relapse prevention remains a primary treatment goal for long-term management of schizophrenia. With the ubiquity of devices such as smartphones, objective digital biomarkers can be harnessed and may offer alternative means for symptom monitoring and relapse prediction. The acceptability of digital sensors (smartphone and wrist-wearable device) and the association between the captured digital data with clinical and health outcomes in individuals with schizophrenia will be examined. Methods and analysis In this study, we aim to recruit 100 individuals with schizophrenia spectrum disorders who are recently discharged from the Institute of Mental Health (IMH), Singapore. Participants are followed up for 6 months, where digital, clinical, cognitive and functioning data are collected while health utilisation data are obtained at the 6month and 1 year timepoint from study enrolment. Associations between digital, clinical and health outcomes data will be examined. A data-driven machine learning approach will be used to develop prediction algorithms to detect clinically significant outcomes. Study findings will inform the design, data collection procedures and protocol of future interventional randomised controlled trial, testing the effectiveness of digital phenotyping in clinical management of individuals with schizophrenia spectrum disorders.Ministry of Health (MOH)National Medical Research Council (NMRC)Published versionThe study is supported by the Ministry of Health Office for Healthcare Transformation (grant no.: N/A) and the Ministry of Health National Medical Research Council Centre Grant (NMRC/CG/M002/2017_IMH). JL is supported by the Ministry of Health National Medical Research Council Clinician Scientist Award (NMRC/CSAINV17nov005)