Last September, we visited the 6th European Society for the Research on Internet Interventions (ESRII). The ESRII is organized every other year and this years’ host was Copenhagen. Researchers in the field of e-health and internet interventions gathered in Copenhagen to share their newest insights and research developments. Dr. Mieke Schulte and Dr. Julia Henrich from the Digital Society Health & Well-being programme line attended the conference and presented a poster that outlines the challenges and goals of digitalization in the health care sector.
Does iCBT work?
The program contained some excellent keynote presentations. Gerhard Andersson, professor of Clinical Psychology, delivered the first keynote presentation that focused on the effects of internet-based CBT (iCBT) interventions at treating a variety of clinical problems. Andersson presented findings from his recent umbrella review (a review of several reviews and/or meta-analyses on a specific topic) and concluded that iCBT works for a variety of mental health problems such as panic disorder and major depression.
Could digital phenotyping play a role in the treatment of depression?
Turning toward the future, Digital Society Professor Heleen Riper introduced the audience to the role that digitomics and digital phenotyping could play in the treatment of depression. Riper explained that experts in the field agree that personalized medicine and a personalized treatment approach is needed to effectively help people with depression. Objective markers developed in the fields of genomics, epigenomics and pharmagenomics could improve diagnostic procedure and hence personalize the treatment pathway. However, she pointed out that we might be missing out on important and informative data points based on an individual’s digital phenotype – i.e. geographical data, speech or online social media behavior. For example, changes in digital behavioral patterns could indicate the onset or relapse into depression. These data points together with the person’s biomarkers could help to develop signatures of depression. However, such an approach requires the willingness and trust of patients and care providers – and as such stakeholder engagement in all development phases of such diagnostics would be necessary. Obviously, this approach touches upon a variety of data privacy issues that need to be weighed against the benefits of personalized treatments based on digital phenotypes.
Click here to read about the conference on privacy and legal matters in e-health we recently organized.
User Experience is key in digital interventions for psychosis
Weeks prior to the conference, everyone who registered to attend the conference could vote for one early career researcher to be awarded the ‘superspot’ plenary presentation. Stephanie Allan, PhD student at the University of Glasgow, was nominated to present her work on digital interventions for psychosis. She described a small series of case studies embedded within clinical trials that use both quantitative and qualitative data to theorize complexities that underpin intervention (dis)engagement. In her presentation, she underlined the importance of understanding user experience on an individual level and pointed out that there is a difference between what the researcher thinks and what the user experiences.
The negative effects of internet-based interventions
Although internet-based interventions are very promising for a variety of treatments, negative effects also need to be considered. In his keynote, Alexander Rozental, postdoctoral researcher at the Karolinska Institute and honorary associate professor at University College London, showed us the importance of measuring and reporting deterioration, non-response, and adverse and unwanted events in iCBT. The importance of explicitly asking participants about these experiences was underlined by the fact that patients do not report these events unless they are specifically asked about them. In addition to showing the use of a questionnaire to measure these events, he also gave several recommendations on how to handle adverse events.
Delivering digital mental health services: lessons learned
The last keynote at ESRII was by Nick Titov, Professor in the Department of Psychology, Macquarie University, Australia, who presented lessons in delivering digital mental health services that he and his team had learned the hard way. The lessons contained tips on how to work with consumers and therapists, operate digital mental health services (DMHS) and work within healthcare systems. For example, in addition to skills required for conducting RCTs, successful delivery of DMHS requires commercial expertise in management, IT, finance and related business processes. Cooperating with people at different stages of the development and implementation of DMHS requires to operate at different levels. In order to communicate their vision effectively, researchers need to “wear a finance, IT or management hat” when necessary and speak the ‘languages’ of each branch. He concluded that all these challenges of developing and delivering DMHS are outweighed by the benefit of such services to the broader community.
Mieke and Julia received a lot of positive feedback from senior researchers in the field about the aims of the Health & Well-being group. Many researchers recognized the need for collaboration to create and implement innovative digital projects responsibly and sustainably. The Digital Society Health & Well-being team aims to address the biggest challenges in the Netherlands – involving all stakeholders in the development of e-health interventions, bridging the implementation gap (interventions that are developed are never implemented in the health care system), and responsibly integrating privacy and legal matters. Our approach aims to build collaborative research projects that develop, evaluate and implement integrated and personalized digital health(care) solutions. We use a multidisciplinary perspective to understand and consider the related societal challenges.
There were many interesting and informative (poster) presentations at ESRII2019, that provided a good insight into all the work that is going on in the field of internet interventions. To the organizers we would like to say: Tak!
We already look forward to ESRII 2021, which will take place in Amsterdam from 25-26 March.