Within medicine, psychiatry is unique for its reliance on subjective measurements. Psychiatric assessments, for instance, rely heavily on the clinician’s observations and the patient’s self-reports. For Dr Bechara Saab, CEO and chief scientist of Mobio Interactive, this comes at odds with his training and background in academia. “As a scientist, I had to provide objective data to convince the scientific community of my studies’ conclusions,” he shares. “And yet, psychiatrists at the hospital I was working at were making life-altering decisions for their patients without access to truly objective data on measures that we really care about in mental health – how people feel.”
Dr Saab believes that metrics which are objectively measurable, such as hormone levels and neural activity, do not provide the data that give insights into a patient’s sense of wellbeing. He calls this “the hard problem of psychiatry” – which Mobio Interactive is working to solve with its AmDTx platform.
AmDTx is best understood as a theragnostic platform that provides remote patient monitoring and clinical decision support for doctors, while delivering on-demand, treatment for patients. Through 30-second smartphone video selfies, the AmDTx app collects biometric data from the user that its AI then analyses to quantify their stress level, before delivering personalised therapies.
Amidst the slew of mental health and wellness apps that are available, AmDTx stands out with its rapid and objective measurement of stress that, in turn, enables the delivery of personalised, clinically-validated therapies. As it is app-based, the platform is also able to achieve precision psychiatry (i.e. personalised, measurement-based care) at scale. This makes it a viable solution to the global shortage of mental health professionals.
Mobio Interactive is already generating revenue with four sales contracts representing some 500,000 patients in North America and Asia. For Dr Saab, quantifying stress through objective measurements is just the beginning. The team at Mobio Interactive is also working to do the same for valence (how positive/negative one feels) and arousal (how intense one’s feelings are). The end goal? A triple-axis measurement of a person’s mental state to finally, in Dr Saab’s words, “quantify these ephemeral senses of wellbeing”. He shares more in the following interview.
How did all this start?
During my PhD, I discovered that mental illness in humans correlates with reduced exploratory activities, either because the brain doesn’t get the same rewards, or because the patient is too anxious. It’s often both. As a principal investigator at the Psychiatric University Hospital of Zurich some time later, my lab built on this finding and successfully alleviated symptoms reminiscent of mental illness in animals by stimulating specific brain circuitries. The next step was to apply this to humans, so we developed the concept of training people’s brains via mental exercises to reinforce specific neural circuits, ideally achieving similar effects. Mobio Interactive is built to apply this preclinical research to clinical use.
As a neuroscientist who’s navigating the field of psychiatry, have you ever felt the need to recruit a psychiatrist or a psychologist to your core team?
We work with about 70 different psychiatrists, clinical psychologists, and healthcare professionals to develop the content and interventions that we provide to patients. This works out pretty well, because at the end of the day we create the medical solutions, similar to how a chemist creates a drug that is then delivered by a doctor. It makes sense to have the neuroscientist create the tools and interventions for the psychiatrist to use.
So how have psychologists and psychiatrists – your end users – responded to AmDTx so far?
Psychiatrists whom I meet for the first time fall into two groups: those who get what we are doing right away, and those who think that the entire concept just doesn’t make sense. The latter are usually practitioners who think that it isn’t possible to objectively measure the brain, or those who believe in mind-body dualism. I’ll ask, “Wouldn’t it be great if you could have information that saves you from second-guessing whether your patient is being honest with you and with themselves?” And as soon as I mention that second point about patients being honest with themselves, they get it.
I think one of the most difficult things in psychiatry is just getting people to be honest with themselves. Assessments are heavily reliant on self-reporting, so it’s very difficult to accurately assess somebody’s wellbeing by asking them – it’s just a very, very bad way to do it. I really think that 50 years from now, the psychological scales that currently define medical standards and determine treatments will go the way of phrenology [a pseudoscience that predicts mental traits from bumps on the skull].
That sounds like a fundamental change to the field of psychiatry.
Absolutely, because for the first time in history, we can objectively assess which therapies each specific patient is responding to within just a few weeks. You cannot do this with the current tools that are used to measure wellbeing, like psychological scales – these assessments are just too noisy, biased, and infrequently administered. With the shift towards objectivity, we will see a number of current treatments fall off the market, because the data will show that they are just not working. Simultaneously, we will see a new set of therapies in the market because there are finally tools that are sensitive enough to identify their benefits to patients.
AmDTx’s modules currently focus on mindfulness and Cognitive Behavioural Therapy (CBT). Is there potential to incorporate other therapeutic frameworks?
There are many different types of neuroplasticity-inducing techniques that are available to us, and anything that we can deliver at scale is on the table. One of the 12 interventions that we currently have in the pipeline, for example, is focused on addressing chronic pain through self-hypnosis.
To train AmDTx’s AI, you used a huge, proprietary dataset of more than 3 million digital biomarker datapoints that continues to grow. Has this data yielded any unexpected findings?
What’s by far the most exciting stuff we’ve discovered is that the objective measurement of stress that we’ve developed can disagree with what users feel. When our users first learn to meditate on the AmDTx app, the initial few sessions are usually difficult. Their minds may wander during meditation, for example, or they may find it difficult to sit still. But these users will still report that their stress levels have fallen after their meditation sessions – because this is what they expect meditation to do.
According to our system’s measurements, however, these users’ stress levels actually increase after their first few meditation sessions, presumably due to the initial difficulties. With further practice they then get the hang of things, and their stress levels – according to our measurements – start lowering. This trend may initiatlly appear counterintuitive, but it’s backed by data collected across the entire world. What it suggests is that objective measurements are better than subjective, self-reported ones. These sorts of observations are important because is helps convince myself and the field that you can find support for superior accuracy without referring back to self-reports.
A second example is how the objective data may be better than subjective data when attempting to personalise therapy. We are completing a study exploring this presently.
What would you say to a potential investor who’s weighing the option of joining your Series Pre-A?
I’m in a very privileged position of being not just Mobio Interactive’s CEO, but also its chief scientist. I know just how powerful and incredible our technology is, so much so that I have taken on the risk to fund the company’s operations myself more than once, just because it was faster than securing external funding. From my perspective, this company is going somewhere, so if you back us financially, you will be rewarded. I will also say to a potential investor that you could be worth much more than the money you invest, so do not hesitate to reach out to me or anyone else on my team if you have an idea. I’m happy to take a call to see how you can best help. Most important thing is that all our investors are aligned. We are all striving towards phenomenal impact and exceptional returns.