Digital Phenotyping of Psychological Distress in Skin Cancer Patients: A Transformer-Based Analysis of Chinese Social Media Content
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 500
- 试验地点
- 1
- 主要终点
- Incidence of Suicide Ideation Risk Assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS)
研究概览
简要总结
This prospective observational study enrolls 500 skin cancer patients across five Chinese tertiary care centers. The investigators use natural language processing and a hierarchical transformer model to analyse 1.2 million social media posts (Weibo, Douyin, Xiaohongshu, WeChat) for psychological distress and suicide ideation, with prospective validation of an AI Early Warning System.
详细描述
Skin cancer patients experience high rates of anxiety and depression, yet routine screening is inconsistent. This study collects social media content from 500 patients over 24 months (12 months retrospective + 12 months prospective). Linguistic markers are identified using a custom Skin Cancer Linguistic Inquiry and Word Count (SC-LIWC) dictionary developed through expert consensus. A hierarchical transformer network with multi-head self-attention is built, comprising word-level (RoBERTa-wwm-ext), post-level (BiGRU+attention), and user-level (8-head self-attention) encoders with platform embeddings to address cross-platform heterogeneity. The model predicts suicide ideation risk (C-SSRS score ≥2) within 12 months, achieving AUC=0.91 in validation. An AI Early Warning System (EWS) is prospectively tested: alerts are triggered at threshold 0.38, reviewed by psychologists (12.4 min/alert), and interventions (crisis hotline, online counselling, psychoeducational materials) are automatically delivered. All data collection complies with China's Personal Information Protection Law (PIPL) and uses a 5-layer de-identification protocol (direct identifier removal, SHA-256 hashing, NER redaction, timestamp shifting, role-based access control). The study also examines cross-platform performance, optimal observation windows, and false-positive patterns to guide refinement
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥ 18 years
- •Histologically confirmed skin cancer within the preceding 60 months
- •Active user of at least one target social media platform (Weibo, Douyin, Xiaohongshu, or WeChat Channels)
- •Willingness to provide informed consent for social media data collection
- •Ability to read and write in Chinese
排除标准
- •Pre-existing major psychiatric disorder diagnosed prior to cancer diagnosis
- •Cognitive impairment preventing informed consent
- •Inability to access social media accounts
- •Concurrent participation in other digital mental health interventions
结局指标
主要结局
Incidence of Suicide Ideation Risk Assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS)
时间窗: 24 months
Proportion of participants with C-SSRS score ≥ 2 (active suicidal ideation with some intent to act, without specific plan) at any follow-up assessment. The C-SSRS is a clinician-administered instrument with a severity subscale ranging from 0 (no suicidal ideation) to 5 (active suicidal ideation with specific plan and intent). Higher scores indicate greater suicide risk.
次要结局
- Depression Severity Assessed by the Patient Health Questionnaire-9 (PHQ-9)(24 months)
- Anxiety Severity Assessed by the Generalized Anxiety Disorder-7 (GAD-7)(24 months)
- Psychological Distress Assessed by the Hospital Anxiety and Depression Scale (HADS)(24 months)
- Rate of Psychological Resource Utilization Following AI Early Warning System Alerts(24 months)
研究者
Zhigang Lan
Professor
West China Hospital