Comparison of Different Machine Learning Methodologies for Predicting the Non‐Specific Treatment Response in Placebo Controlled Major Depressive Disorder Clinical Trials

ABSTRACT Placebo effect represents a serious confounder for the assessment of treatment effect to the extent that it has become increasingly difficult to develop antidepressant medications appropriate for outperforming placebo. Treatment effect in randomized, placebo‐controlled trials, is usually es...

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Main Authors: Roberto Gomeni, Françoise Bressolle‐Gomeni
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Clinical and Translational Science
Subjects:
Online Access:https://doi.org/10.1111/cts.70128
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author Roberto Gomeni
Françoise Bressolle‐Gomeni
author_facet Roberto Gomeni
Françoise Bressolle‐Gomeni
author_sort Roberto Gomeni
collection DOAJ
description ABSTRACT Placebo effect represents a serious confounder for the assessment of treatment effect to the extent that it has become increasingly difficult to develop antidepressant medications appropriate for outperforming placebo. Treatment effect in randomized, placebo‐controlled trials, is usually estimated by the mean baseline adjusted difference of treatment response in active and placebo arms and is function of treatment‐specific and non‐specific effects. The non‐specific treatment effect varies subject by subject conditional to the individual propensity to respond to placebo. This effect is not estimable at an individual level using the conventional parallel‐group study design, since each subject enrolled in the trial is assigned to receive either active treatment or placebo, but not both. The objective of this study was to conduct a comparative analysis of the machine learning methodologies to estimate the individual probability of a non‐specific treatment effect. The estimated probability is expected to support novel methodological approaches for better controlling effect of excessively high placebo response. At this purpose, six machine learning methodologies (gradient boosting machine, lasso regression, logistic regression, support vector machines, k‐nearest neighbors, and random forests) were compared to the multilayer perceptrons artificial neural network (ANN) methodology for predicting the probability of individual non‐specific treatment response. ANN achieved the highest overall accuracy among all methods tested. A fivefold cross‐validation was used to assess performances and risks of overfitting of the ANN model. The analysis conducted without subjects with non‐specific effect indicated a significant increase of signal detection with significant increase in effect size.
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spelling doaj-art-99ae84f51ce7438583addc160bc2ea312025-01-24T08:17:46ZengWileyClinical and Translational Science1752-80541752-80622025-01-01181n/an/a10.1111/cts.70128Comparison of Different Machine Learning Methodologies for Predicting the Non‐Specific Treatment Response in Placebo Controlled Major Depressive Disorder Clinical TrialsRoberto Gomeni0Françoise Bressolle‐Gomeni1Pharmacometrica La Fouillade FrancePharmacometrica La Fouillade FranceABSTRACT Placebo effect represents a serious confounder for the assessment of treatment effect to the extent that it has become increasingly difficult to develop antidepressant medications appropriate for outperforming placebo. Treatment effect in randomized, placebo‐controlled trials, is usually estimated by the mean baseline adjusted difference of treatment response in active and placebo arms and is function of treatment‐specific and non‐specific effects. The non‐specific treatment effect varies subject by subject conditional to the individual propensity to respond to placebo. This effect is not estimable at an individual level using the conventional parallel‐group study design, since each subject enrolled in the trial is assigned to receive either active treatment or placebo, but not both. The objective of this study was to conduct a comparative analysis of the machine learning methodologies to estimate the individual probability of a non‐specific treatment effect. The estimated probability is expected to support novel methodological approaches for better controlling effect of excessively high placebo response. At this purpose, six machine learning methodologies (gradient boosting machine, lasso regression, logistic regression, support vector machines, k‐nearest neighbors, and random forests) were compared to the multilayer perceptrons artificial neural network (ANN) methodology for predicting the probability of individual non‐specific treatment response. ANN achieved the highest overall accuracy among all methods tested. A fivefold cross‐validation was used to assess performances and risks of overfitting of the ANN model. The analysis conducted without subjects with non‐specific effect indicated a significant increase of signal detection with significant increase in effect size.https://doi.org/10.1111/cts.70128artificial intelligenceclinical trialsmachine learningnon‐specific treatment responseplacebo effect
spellingShingle Roberto Gomeni
Françoise Bressolle‐Gomeni
Comparison of Different Machine Learning Methodologies for Predicting the Non‐Specific Treatment Response in Placebo Controlled Major Depressive Disorder Clinical Trials
Clinical and Translational Science
artificial intelligence
clinical trials
machine learning
non‐specific treatment response
placebo effect
title Comparison of Different Machine Learning Methodologies for Predicting the Non‐Specific Treatment Response in Placebo Controlled Major Depressive Disorder Clinical Trials
title_full Comparison of Different Machine Learning Methodologies for Predicting the Non‐Specific Treatment Response in Placebo Controlled Major Depressive Disorder Clinical Trials
title_fullStr Comparison of Different Machine Learning Methodologies for Predicting the Non‐Specific Treatment Response in Placebo Controlled Major Depressive Disorder Clinical Trials
title_full_unstemmed Comparison of Different Machine Learning Methodologies for Predicting the Non‐Specific Treatment Response in Placebo Controlled Major Depressive Disorder Clinical Trials
title_short Comparison of Different Machine Learning Methodologies for Predicting the Non‐Specific Treatment Response in Placebo Controlled Major Depressive Disorder Clinical Trials
title_sort comparison of different machine learning methodologies for predicting the non specific treatment response in placebo controlled major depressive disorder clinical trials
topic artificial intelligence
clinical trials
machine learning
non‐specific treatment response
placebo effect
url https://doi.org/10.1111/cts.70128
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AT francoisebressollegomeni comparisonofdifferentmachinelearningmethodologiesforpredictingthenonspecifictreatmentresponseinplacebocontrolledmajordepressivedisorderclinicaltrials