Mental health
AI-related maternal healthcare software improves odds of good care by 69%, research finds
Women are more likely to receive good care during pregnancy where AI and other clinical software tools are used, a large review of research has found.
In a paper published in eClinicalMedicine researchers have conducted a review of over 12,000 papers and 87 articles for different AI and related software tools, investigating the impact of their use in maternity settings.
A meta-analysis of 35 included studies found the odds of improved outcomes was 1.69 times higher in women cared for using CDSS, with data from over 5.2 million pregnancies in both High-Income and Low-and-Middle-Income Countries.
Neil Cockburn is Health Informatics Research Fellow, Department of Applied Health Sciences at the University of Birmingham.
He said: “The government has made digital transformation of the NHS a top priority to improve quality of care and reduce costs, and Clinical Decision Support Systems will be a key technology in delivering these improvements.
“However, there needs to be systematic, rigorous, and rapid evaluation of the tools being used in order to ensure they are doing what is expected while keeping up with the pace of change in technology.”
In a bid to encourage safer maternity services, academics from the University of Birmingham, Birmingham Health Partners, Keele University, Warwick University and the Shrewsbury and Telford Hospitals NHS Trust evaluated almost 50 different types of CDSS across 49 High-Income and 38 Low-and-Middle-Income Countries.
The findings revealed that although there were variations in each situation and implementation of CDSS that they reviewed, most showed improvements in outcomes for the pregnancies.
Cockburn said: “Maternity services are under huge pressure in the UK and internationally, and that makes it challenging to offer safe services.
“We can see this in the huge rise in hospitals receiving support from the Maternity Safety Support Programme.”
“One solution is the use of AI and related software tools called ‘Clinical Decision Support Systems’ to help expecting families and healthcare workers to make safe decisions, so we looked at every evaluation of these kinds of software ever published in academic literature.”
In a study led by the Bristol University that was reviewed, a software program trialled was designed to help women decide if they wanted a vaginal birth after previously having a c-section.
This CDSS supported women in feeling more confident about their decisions by providing them with useful information about risks and benefits, while reducing the rate of c-section overall.
Another study supported by the Tommy’s National Centre for Miscarriage Research trialled a risk-prediction model to accurately triage women as at low risk of having an ectopic pregnancy, which can be life-threatening in some cases.
These examples highlighted the possibility for CDSS to support both clinical and individual decision-making concerning maternity care; an important step for supporting safe pregnancies in the future.
The team note that while substantial contributions can be made to maternity care with CDSS, it relies on appropriateness to each unique situation.
As the first systematic review of CDSS, it is hoped that this will encourage evaluations of different CDSS to continue aiding clinicians, developers, and researchers in maternity care.
Insight
Scaling startups risk increasing gender gaps, study finds
Rapidly scaling startups often make rushed hiring choices that disadvantage women, a recent study has found.
The findings draw on more than 31,000 new ventures founded in Sweden between 2004 and 2018.
Researchers at the Stockholm School of Economics report that in male-led startups, scaling reduces the odds of hiring a woman by about 18 per cent, and the odds of appointing a woman to a managerial post by 22 per cent.
Mohamed Genedy is co-author and postdoctoral fellow at the House of Innovation, Stockholm School of Economics.
Genedy said: “During those moments of rapid growth, even well-intentioned leaders can fall back on familiar stereotypes when assessing who they believe is best suited for the role.”
The patterns emerge even in Sweden, regarded as a highly gender-equal national context.
Founders with human resources-related education counteract these challenges.
In ventures led by founders with HR training, the odds of hiring a woman increase by more than 30 per cent, and the odds of appointing a woman to a managerial role increase by 14 per cent for the same level of growth.
Genedy said: “When founders have experience with structured hiring practices, the gender gaps shrink, and in some cases even reverse.
“This shows that getting the basics of HR right early on really pays off.
“When things start moving fast, founders with HR knowledge are less likely to rely on biased instincts and more likely to hire from a broader talent pool.”
Prior experience in companies with established HR practices also helps, though to a lesser degree.
It raises the likelihood of hiring women as ventures scale, but does not significantly affect managerial appointments.
The study additionally shows these patterns are not driven by founder gender alone.
Even solo female-led ventures display similar tendencies when growing rapidly, though to a somewhat lesser degree.
In female-dominated industries, rapid growth increases the hiring of women for regular roles but still reduces the likelihood that women are appointed to managerial positions.
“When scaling accelerates, cognitive bias kicks in for everyone. Female founders are not immune to these patterns,” said Genedy.
Mental health
Study reveals why women more likely to develop PTSD
High brain oestrogen may raise women’s PTSD risk if severe stress strikes during high oestrogen phases, causing memory problems and stronger fear responses, new research has revealed.
The study found that exposure to several simultaneous stressors can lead to persistent memory problems, difficulty recalling events and stronger reactions to trauma reminders.
Tallie Baram is distinguished professor of paediatrics, anatomy and neurobiology, and neurology at UC Irvine’s School of Medicine, and led the research.
Baram said: “High oestrogen is essential for learning, memory and overall brain health.
“But when severe stress hits, the same mechanisms that normally help the brain adapt can backfire, locking in long-lasting memory problems.”
Oestrogen, which usually supports learning and memory, can increase vulnerability when levels are high in the hippocampus, a brain region central to memory formation and retrieval.
Researchers reported that female mice stressed during cycle phases with high oestrogen developed enduring memory loss and heightened fear of reminders, while lower levels were protective. Males, who also have high hippocampal oestrogen, were susceptible more mildly and through different receptor pathways.
High oestrogen loosens the packaging of DNA in brain cells, known as permissive chromatin.
This normally helps learning, but under extreme stress it can allow harmful, lasting changes in memory circuits.
Memory problems were driven by different oestrogen receptors in men and women, alpha in men and beta in women.
Blocking the relevant receptor prevented stress-related memory issues even when oestrogen stayed high. Vulnerability depended on hormone levels at the time of stress, not afterwards.
Co-author Elizabeth Heller is associate professor of pharmacology at the University of Pennsylvania Perelman School of Medicine.
She said: “A lot of what determines vulnerability is the state your brain is already in.
“If a traumatic event hits during a period when oestrogen is already unusually high, the biology can amplify the impact in lasting ways.
“This study shows that a state of high oestrogen in a specific brain region promotes vulnerability to stress in both male and female subjects.”
Mental health
Wysa awarded £5.3m to address girls’ mental health in rural India
Wysa has secured £5.3m to adapt a digital mental health programme for adolescent girls in rural India.
The funding comes from Wellcome and will support a scale-up study to tailor a clinically validated digital intervention for girls facing limited autonomy, restricted access to technology, lower literacy, stigma and family gatekeeping.
Digital interventions are app-based programmes that deliver guided tools to manage anxiety and low mood, and are tested to show clinical benefit.
The study will map cultural and practical barriers to access, adapt Wysa’s content and delivery to those realities, and then test effectiveness in real-world low-to-middle-income settings.
Wysa is a global platform that combines artificial intelligence and human support to provide psychological wellbeing services.
It is used by more than seven million users across 105 countries and works with healthcare providers, employers and governments including the UK’s NHS, the Ministry of Health in Singapore, and programmes in India.
“This funding allows us to go far beyond simple translation,” said Chaitali Sinha, chief clinical and research and development officer at Wysa and the study’s principal investigator.
“By working closely with academic and community partners, we aim to co-design a digital intervention that is not only clinically effective, but genuinely usable and relevant for adolescent girls living in rural India.”
India has more than 253 million adolescents, the largest such population globally.
Around half of mental health conditions begin before age 14, and suicide is among the leading causes of death for young people.
The study team includes Aparna Joshi from Tata Institute of Social Sciences, Ceire Costelloe and Patrick Kierkegaard from Imperial College London, Dhirendra Pratap Singh from Milaan Foundation, and Becky Inkster from the University of Cambridge.
Miranda Wolpert is director of mental health at Wellcome.
She said: “We are delighted to support Wysa in their work to adapt and scale up this evidence-based digital intervention to address anxiety and depression in adolescent girls across rural India.
“This funding was awarded as part of our call to find the best ways to develop and scale digital innovations for early intervention.”
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