Toshi A. Furukawa

David Benrimoh, Akiva Kleinerman, Toshi A. Furukawa et al.

Major depressive disorder (MDD) is a heterogeneous condition; multiple underlying neurobiological substrates could be associated with treatment response variability. Understanding the sources of this variability and predicting outcomes has been elusive. Machine learning has shown promise in predicting treatment response in MDD, but one limitation has been the lack of clinical interpretability of machine learning models. We analyzed data from six clinical trials of pharmacological treatment for depression (total n = 5438) using the Differential Prototypes Neural Network (DPNN), a neural network model that derives patient prototypes which can be used to derive treatment-relevant patient clusters while learning to generate probabilities for differential treatment response. A model classifying remission and outputting individual remission probabilities for five first-line monotherapies and three combination treatments was trained using clinical and demographic data. Model validity and clinical utility were measured based on area under the curve (AUC) and expected improvement in sample remission rate with model-guided treatment, respectively. Post-hoc analyses yielded clusters (subgroups) based on patient prototypes learned during training. Prototypes were evaluated for interpretability by assessing differences in feature distributions and treatment-specific outcomes. A 3-prototype model achieved an AUC of 0.66 and an expected absolute improvement in population remission rate compared to the sample remission rate. We identified three treatment-relevant patient clusters which were clinically interpretable. It is possible to produce novel treatment-relevant patient profiles using machine learning models; doing so may improve precision medicine for depression. Note: This model is not currently the subject of any active clinical trials and is not intended for clinical use.

Yuki Kataoka, Masahiro Banno, Michihito Kyo et al.

Background: Server-based screening tools impose subscription costs, while open-source alternatives require coding skills. Objectives: We developed a browser extension that provides no-code, serverless artificial intelligence (AI)-assisted title and abstract screening and examined its functionality. Methods: TiAb Review Plugin is an open-source Chrome browser extension (available at https://chromewebstore.google.com/detail/tiab-review-plugin/alejlnlfflogpnabpbplmnojgoeeabij). It uses Google Sheets as a shared database, requiring no dedicated server and enabling multi-reviewer collaboration. Users supply their own Gemini API key, stored locally and encrypted. The tool offers three screening modes: manual review, large language model (LLM) batch screening, and machine learning (ML) active learning. For ML evaluation, we re-implemented the default ASReview active learning algorithm (TF-IDF with Naive Bayes) in TypeScript to enable in-browser execution, and verified equivalence against the original Python implementation using 10-fold cross-validation on six datasets. For LLM evaluation, we compared 16 parameter configurations across two model families on a benchmark dataset, then validated the optimal configuration (Gemini 3.0 Flash, low thinking budget, TopP=0.95) with a sensitivity-oriented prompt on five public datasets (1,038 to 5,628 records, 0.5 to 2.0 percent prevalence). Results: The TypeScript classifier produced top-100 rankings 100 percent identical to the original ASReview across all six datasets. For LLM screening, recall was 94 to 100 percent with precision of 2 to 15 percent, and Work Saved over Sampling at 95 percent recall (WSS@95) ranged from 48.7 to 87.3 percent. Conclusions: We developed a functional browser extension that integrates LLM screening and ML active learning into a no-code, serverless environment, ready for practical use in systematic review screening.