Schizophrenia affects a staggering 21 million people worldwide, with 80% of these citizens suffering from a relapsing disease, putting their health and safety at enormous risk. Timely detection of these psychotic relapses would require very frequent contact with clinicians, which is neither desirable nor feasible. An accurate online relapse predictor could alert clinicians of subtle deterioration, which enables timely intervention and allow safe discontinuation of long-term medication, which so many affected citizens desire. Our Consortium demonstrated that subtle alterations in speech carry a predictive signal for psychosis onset. This project will develop an AI monitoring system that leverages spoken language processing (SLP) and natural language processing (NLP) of speech recorded at home to calculate the relapse risk. The monitoring tool we develop will be validated retrospectively in a longitudinal cohort, cross-sectionally, across six languages, after which it will be tested prospectively in a multicenter randomized trial, with the end goal of improving functional and clinical outcomes of those affected by schizophrenia. Developing such a system for exceptionally vulnerable people requires ‘buy-in’ from clinicians and mental health care service users, namely trust. A lack of trust is the biggest obstacle to the real-world implementation of a speech-based monitoring system. TRUSTING will develop a framework that systematically ensures addressing all the criteria for trustworthy AI put forward by the EU. This will ensure an empirically based and validated tool that can reliably detect pending relapse. As the core philosophy of trustworthiness is part of every aspect of the project, it will be a system more likely to be welcomed and embraced by service users and their carers. TRUSTING generates the scientific and social foundation for disruptive technology to deliver the unmet promise of an equitable and just form of healthcare for people at risk of relapse.

SYNCHROS (SYNergies for Cohorts in Health: integrating the ROle of all Stakeholders) coordination and support action aims to establish a sustainable European strategy for the development of the next generation of integrated population, patient and clinical trial cohorts, thereby contributing to an international strategic agenda for enhanced coordination of cohorts globally. This will address the practical, ethical and legal, and the methodological challenge to optimising the exploitation of current and future cohort data, towards the development of stratified and personalised medicine as well as facilitating health policy. In order to achieve this objective, SYNCHROS will map the cohort landscape in Europe and large international initiatives, identify the best methods for integrating cohort data, identify solutions for addressing practical, ethical and legal challenges in integrating data across patient, clinical trial and population cohorts, and evaluate the use of emerging and new data collection technologies and types of data. Together with intensive stakeholder involvement (researchers, patients, funding bodies, clinicians, coordinators of previous harmonization and integration exercises), strategy briefs will be written and used to conduct stakeholder dialogues to generate consensus following a deliberative process and implementation science methods. We aim to make sustainable recommendations on standards to improve future sample, data collection and data sharing methods and disseminate this information so as to contribute to defining an international strategic agenda for better coordination of cohorts globally. SYNCHROS partners include a large range of expertise from epidemiology and clinical research to legal/ethical issues and anthropology, international organizations such as WHO and European infrastructures such as ECRIN.

Due to the chronic relapsing nature of mental disorders and increased life expectancy, the societal burden of these non-communicable diseases will increase even further. Treatments for mental disorders are available, but their effect is limited due to patients’ (genetic) heterogeneity, low treatment compliance and frequent side effects. Only one-third of the patients respond to treatment. Today, medication selection in psychiatry relies on a trial-and-error approach based mainly on physicians’ experience. Pharmacogenetic testing enables assessing person-specific genetic factors that predict clinical response and side effects. Recent studies show that genotyping of drug-metabolizing enzymes can increase the effectiveness of treatment, which could benefit millions of patients. PSY-PGx is the first initiative to propose a large-scale non-industry sponsored clinical study that demonstrates the clinical benefits and potential of implementing pharmacogenetics for psychiatric patients in existing medical settings. To this end 1) available biobank data (www.biobankki.fi, www.ukbiobank.ac.uk), with the aid of AI, will be searched for pharmacogenetics that influence medication response. This information is used to 2) perform a clinical trial that will be the first large international, multicenter clinical trial on using pharmacogenetic-based treatment personalization in real-life psychiatric care for depressed, anxiety or psychotic disorder patients. All data is combined with AI to set-up an algorithm for personalizing medication prescription for psychiatric patients that reduces side effects and increases effectiveness of pharmacotherapy. PSY-PGx will thus deliver a new model of care for sustainable healthcare systems and reduce the suffering of psychiatric patients.