Sequential diagnosis with language models - Science | AAAS

MainDespite substantial efforts, treatment for major depressive disorder (MDD) remains imprecise and, for many, ineffective, and still involves trial and error to determine the most effective approach. Findings from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial revealed that only ~50% of individuals with MDD responded (that is, showed ≥50% reduction in symptoms) to the selective serotonin reuptake inhibitor (SSRI) citalopram1, with even lower response rates in primary care (~30%), and over one-third failed to respond to two or more antidepressants2. To exacerbate these issues, it takes at least 4 weeks to evaluate the efficacy of an antidepressant. This can lead to lengthy treatment that is insufficient and unnecessary, thereby increasing patient morbidity, drop-outs and suicide risk. Despite a large number of treatment options, no biomarker-based guidance for antidepressant medication assignment is currently available, which is especially problematic in light of the substantial clinical and biological heterogeneity of MDD3,4. Some individuals with MDD may benefit from SSRIs, while others might benefit from medications with different mechanisms of action

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