Medibio, an Australian medical technology company, has developed an evidence-based test for mental health disorders such as depression, chronic stress, schizophrenia, and bipolar disorder. Over 300 million people around the world have been estimated to suffer from depression, and depression is estimated to cost the US economy $210 billion a year. The company identified a series of circadian, sleep, and autonomic system biomarkers that can indicate certain mental health issues. The test is reported to be non-intrusive, rapid, and objective. One aspect of the test involves heart rate monitors to measure changes in heart rate during sleep. Some initial data collected by independent researchers validating the approach were announced at the recent “Sleep 2017” conference in Boston.
Medgadget had the opportunity to ask Jack Cosentino, CEO of Medibio, some questions about the technology.
Conn Hastings, Medgadget: Please tell us about yourself and how you got into this area.
Jack Cosentino, Medibio: I come from a deep medical device background and am motivated by developing solutions to address under-served patient communities. Mental health is the largest and most under-served community today. We have a real opportunity, in collaboration with our ecosystem of world-class corporate and academic partners, to significantly improve the current paradigm in mental health care. The challenge inspires me and the opportunity to make a difference motivates me and the team.
Medgadget: Is there a mental health crisis at the moment, or are we just getting better at diagnosing mental health issues?
Jack Cosentino: Mental health is an under-appreciated and grossly under-diagnosed condition. There are over 350 million people worldwide dealing with serious depression and the World Health Organization recognizes mental illness as the #1 issue in terms of disability adjusted life years. To compound the issue, there are simply not enough psychiatrists to serve the patient community. Access in the US is a real issue and there are ~8 psychiatrists per 100,000 people. In places like India, where mental health issues are exploding, it’s simply an intractable problem as there are just 0.3 psychiatrists per 100,000. As a result, care gets pushed down to the primary care level where diagnostic accuracy is at best 30–50%. Mental health is the clinical, economic and societal problem of our generation.
Medgadget: What problem does the technology solve? Is it currently difficult to diagnose mental health disorders accurately?
Jack Cosentino: The statistics are alarming. Less than 10% of patients are accurately diagnosed and prescribed the right therapy on the initial assessment. It usually takes many months and various treatment regimens to get it right. The essential issue underlying that statistic is that diagnoses of mental health disorders are completely subjective. A patient is asked a series of basic questions and a diagnosis is made. There are no objective tools or measurements available. In stark contrast, the cardiovascular area has a multitude of biomarkers and imaging measurement devices (ECG, ultrasound, CT, etc.) to mechanistically understand the core issue. We aim to bring objectivity to mental health care. By leveraging a panel of biomarkers related to the autonomic, circadian and sleep systems, Medibio has developed an objective way to diagnose and manage patients.
Medgadget: Please tell us in simple terms how the test works.
Jack Cosentino: The patient wears a clinical grade or consumer wearable device for a couple of days. Our system then processes the heart-rate and activity data with a proprietary set of algorithms to characterize the mental state of the individual. A comprehensive summary report is then provided to the doctor and/or user.
Medgadget: What mental health disorders can the system diagnose? Are the biomarkers for each disorder very different?
Jack Cosentino: Our approach is aimed at broad spectrum mental illness diagnosis and characterization. For generations, patients and doctors have empirically known that mental illness differentially effects the sleep and autonomic systems. Patients with anxiety disorders often talk about the difficulty in settling down and falling asleep while folks with depression often experience early rise. These phenomena are of course reflected in specific dynamics of the circadian, autonomic and sleep systems. Mental illnesses disrupt these systems in specific ways and our biomarker approach is able to characterize and accurately diagnose the underlying condition. We are now at a point where we can cost effectively capture longitudinal physiologic data on folks at scale and that provides us with the opportunity to apply our solution to a broad set of conditions.
Medgadget: How do you envisage the system being used in the future? Do you think that self-testing will be a phenomenon, or would the test be administered by healthcare professionals?
Jack Cosentino: Serious mental health issues should always be managed with a healthcare professional in the loop. However, I do see new models being deployed in the future in which physical visits are augmented with non-pharm therapies delivered via the mobile phone. I believe telepsychiatry will also play a key role in increasing access and extending the touch of healthcare professionals. I do see a self-management and consumer role in helping identify and manage conditions before they reach clinical severity levels. At the core of all these offerings will need to be an objective way of diagnosing and tracking patients and that is what Medibio will continuing building.
Link: Medibio homepage…