# mHealth Estimate-based Algorithms Signaling Upcoming Recurrence of Episodes in Bipolar Disorders (MEASURE-BD)

> **NIH VA I01** · MINNEAPOLIS VA  MEDICAL CENTER · 2024 · —

## Abstract

Veterans with bipolar disorders (BD) experience recurrent and seemingly unpredictable periods of severe
impairments in psychosocial functioning, such as participation in social roles and activities. Many effective
treatments for BD emphasize early detection of bipolar episodes, in order to make necessary treatment
adjustments and prevent psychosocial impairments associated with acute mood episodes. Unfortunately, acute
mood episodes in BD are also associated with a decrease in a patient’s insight into their own symptoms, which
can prevent one’s ability to self-report first signs of symptoms and functional declines. Moreover, routine care
visits for BD are typically too infrequent to capture and effectively monitor day-to-day changes in a patient’s mood
and functioning.
 Objective, low-effort, and continuous methods of tracking symptoms and social participation of Veterans
with BD in real-time and in-situ are needed to provide early (i.e., days in advance) warning signs of acute bipolar
episodes and functional declines, which in turn would enable well-timed interventions to prevent poor
psychosocial outcomes. mHealth refers to the use of mobile and wireless devices as part of patient care and
offers many potential opportunities for early detection of and intervention for acute mood states in this population.
However, these mHealth approaches have not been investigated in Veterans with BD. In a Small Projects in
Rehabilitation Research (SPiRE)-funded pilot study, our investigator team established high feasibility and
acceptability of one such innovative passive mHealth approach using a smartphone program, or an app, in a
small sample of Veterans with BD to track their smartphone’s GPS/location. The pilot study used a priori location
context ratings of visited places (e.g., a priori ratings on types of activities usually engaged in at a frequently
visited location) to derive unobtrusive measures of social participation (e.g., time spent at work-related locations).
The goal of this Merit Review proposal is to establish reliable and valid machine-learning algorithms using the
same types of mHealth data to prospectively (days in advance) detect declines in social participation and
prospective onset of mania and depression in Veterans with BD. This proposal has three aims:
 Aim 1. To establish a machine learning algorithm using GPS/location data for predicting prospective
declines in social participation in Veterans with BD.
 Aim 2. To establish machine learning algorithms using GPS/location data for predicting prospective acute
BD clinical states. We will explore whether adding more burdensome daily self-report and voice diaries’ speech
analysis features improves our models’ precision using statistical indices of prediction precision or accuracy.
 Aim 3. To explore clinical implementation of the mHealth-based algorithms in treatment of BD. Focus
groups of VA providers and administrators will assess feasibility of algorithms’ implementation in clinical ...

## Key facts

- **NIH application ID:** 10865394
- **Project number:** 1I01RX004800-01A1
- **Recipient organization:** MINNEAPOLIS VA  MEDICAL CENTER
- **Principal Investigator:** Snezana Urosevic
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-03-01 → 2028-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10865394

## Citation

> US National Institutes of Health, RePORTER application 10865394, mHealth Estimate-based Algorithms Signaling Upcoming Recurrence of Episodes in Bipolar Disorders (MEASURE-BD) (1I01RX004800-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10865394. Licensed CC0.

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