Background Validated clinical prediction models of short-term remission in psychosis are lacking. Our aim was to develop a clinical prediction model aimed at predicting 4−6-week remission following a first episode of psychosis. Method Baseline clinical data from the Athens First Episode Research Study was used to develop a Support Vector Machine prediction model of 4-week symptom remission in first-episode psychosis patients using repeated nested cross-validation. This model was further tested to predict 6-week remission in a sample of two independent, consecutive Danish first-episode cohorts. Results Of the 179 participants in Athens, 120 were male with an average age of 25.8 years and average duration of untreated psychosis of 32.8 weeks. 62.9% were antipsychotic-naïve. Fifty-seven percent attained remission after 4 weeks. In the Danish cohort, 31% attained remission. Eleven clinical scale items were selected in the Athens 4-week remission cohort. These included the Duration of Untreated Psychosis, Personal and Social Performance Scale, Global Assessment of Functioning and eight items from the Positive and Negative Syndrome Scale. This model significantly predicted 4-week remission status (area under the receiver operator characteristic curve (ROC-AUC) = 71.45, P < .0001). It also predicted 6-week remission status in the Danish cohort (ROC-AUC = 67.74, P < .0001), demonstrating reliability. Conclusions Using items from common and validated clinical scales, our model significantly predicted early remission in patients with first-episode psychosis. Although replicated in an independent cohort, forward testing between machine learning models and clinicians’ assessment should be undertaken to evaluate the possible utility as a routine clinical tool.

中文翻译：

---

使用机器学习预测首发精神病患者的两个独立样本的早期症状缓解

背景 缺乏经过验证的精神病短期缓解临床预测模型。我们的目标是开发一个临床预测模型，旨在预测第一次精神病发作后 4-6 周的缓解。方法 使用来自雅典第一集研究研究的基线临床数据，使用重复嵌套交叉验证，开发首发精神病患者 4 周症状缓解的支持向量机预测模型。进一步测试该模型以预测两个独立、连续的丹麦首集队列样本中的 6 周缓解。结果 在雅典的 179 名参与者中，120 名男性，平均年龄为 25.8 岁，未经治疗的精神病平均持续时间为 32.8 周。62.9% 未使用过抗精神病药物。57% 的患者在 4 周后得到缓解。在丹麦队列中，31% 获得缓解。在雅典 4 周缓解队列中选择了 11 个临床量表项目。其中包括未经治疗的精神病持续时间、个人和社会表现量表、全球功能评估以及阳性和阴性症状量表的八个项目。该模型显着预测了 4 周的缓解状态（受试者操作特征曲线下面积 (ROC-AUC) = 71.45，P < .0001）。它还预测了丹麦队列的 6 周缓解状态（ROC-AUC = 67.74，P < .0001），证明了可靠性。结论使用来自常见和经过验证的临床量表的项目，我们的模型显着预测首发精神病患者的早期缓解。虽然在一个独立的队列中重复，