PsyMetRiC: A New Web Tool to Forecast Cardiometabolic Risk in Young People with Psychosis
A new web-based risk prediction tool, PsyMetRiC, is now available to forecast the risk of cardiometabolic disorders in young people with psychosis. These disorders include obesity, metabolic syndrome, and diabetes. The tool's algorithms are tailored for this population and predict clinically significant weight gain within one year, metabolic syndrome within six years, and type 2 diabetes within 10 years.
Development and Validation
The algorithms were developed and tested using anonymized health data from over 25,000 young people with psychosis in the UK, followed for more than 20 years. The research findings have been published in The Lancet Psychiatry.
Individuals with severe mental illness often experience a shorter lifespan compared to the general population, largely attributed to preventable physical health conditions.
Existing prediction tools designed for general populations do not accurately assess risk in younger individuals or those with psychosis.
Purpose and Functionality
Dr. Benjamin Perry from the University of Birmingham, who led PsyMetRiC's development, noted that psychotic disorders typically manifest in late teens and early twenties. Factors contributing to the early onset of obesity, diabetes, and heart disease in this group include lifestyle impacts, potential side effects of antipsychotic medications, and healthcare inequalities.
PsyMetRiC aims to facilitate discussions between patients and health professionals, encouraging shared decision-making regarding preventative measures and lifestyle adjustments. The web application provides risk assessments for metabolic syndrome within six years and type 2 diabetes within ten years from the onset of psychosis.
PsyMetRiC2 is an updated version of the original PsyMetRiC1 model, which was validated in 2021 and tested internationally across various countries. The refinement of PsyMetRiC2 utilized larger UK population datasets to enhance its predictive accuracy.
Design and Fairness
Feedback from clinicians, carers, and young people with lived experience of psychosis, including collaboration with The McPin Foundation, shaped the tool's design to ensure clinical relevance and patient-desired outcomes. PsyMetRiC requires simple, routinely recorded information for predictions.
During its validation, researchers took steps to ensure the tool operates fairly across diverse and underserved populations, addressing potential biases within health datasets.
Clinical Integration and Future
PsyMetRiC is designed to inform, rather than dictate, clinical decisions, focusing on outcomes meaningful to both medical professionals and patients. Input from a lived experience panel was crucial for developing accessible and motivating risk communication guides.
The tool presents risk information through various graphical and numeric formats, including an adaptation of the 'heart age' score approach, to promote deeper clinician-patient health-risk conversations.
PsyMetRiC is certified as a Class 1 Medical Device by the UK's Medicines & Healthcare products Regulatory Agency (MHRA), marking it as one of the first prediction tools in psychiatry to achieve clinical practice status.
Health professionals can sign up for a free account. The application is planned to receive iterative updates and future international extensions.