Research Projects
Development and validation of a metabolic risk calculator (PsyMetRiC) for patients with first-episode psychosis


Programme(s) to which this project applies:
☑ MPhil/PhD ☑ MRes[Med] ☑ URIS

Introduction:
Metabolic syndrome (MetS) is a combination of cardiometabolic risk factors including central obesity, high blood pressure, low high-density lipoprotein (HDL) cholesterol, elevated triglycerides and hyperglycaemia. It is a key risk factor of long-term cardiometabolic morbidity and mortality. Meta-analyses found that the pooled prevalence of MetS in patients with SMI, including schizophrenia, was 32.6%, significantly higher than the general population. Even among younger individuals at the time of psychosis onset, the rate of MetS was found to be 13% and significantly increased over time. Local study found the rate of MS in first-episode patients was about 22%. Prognostic risk prediction algorithms developed with machine learning approaches are routinely used in the general population to identify individuals at higher cardiometabolic risk. However, so far there is only one Psychosis Metabolic Risk Calculator developed for patients with first-episode psychosis (FEP) aged 16-35 years in the UK (PsyMetRiC) to predict the risk of developing MetS up to six-years after FEP. In our local pilot study of validating the tool with FEP patients of one catchment area, The PsyMetRiC algorithm was found to have an adequate discrimination performance (full-model C statistics =0.76, 95% C.I., 0.69-0.81) with miscalibration. However, the prediction accuracy dropped in patients of aged >35. Furthermore, the risk threshold was only set based on assumption rather than well constructed consensus. 

Objective of the study:

  1. Externally validation of the psychosis metabolic risk calculator (PsyMetRiC-HK) for young people with FEP in Hong Kong
  2. To develop and externally validate a psychosis Metabolic risk calculator for older adults with FEP in Hong Kong (PsyMetRic-HK36)
  3. To determine the likely clinical usefulness of the algorithms developed with decision curve analysis and incorporatig views from multiple stakeholders. 

Methodology and study plan:
Baseline information relevant to PsyMetRic and culturally specific information as well as the metabolic syndrome outcomes of pateints with FEP between 1-6 years after the baseline will be obtained from the clinical records from four hospital centers. Delphi surveys will be conducted to establish a consensus on the risk threshold of interventions and interventional approaches according to recent suggested guideline. External validation of the PsyMetRiC-HK,  modification of PsyMetRiC for age >35 and synthesis of Delphi surveys will be conducted.

Expectation of students:
The student will be working with the team to collect data from the clinical records, learning about the risk calculator development, and conducting Delphi survey. 

Professor Sherry Kit Wa Chan, Department of Psychiatry

Prof Sherry Kit Wa Chan is a psychiatrist trained both in Hong Kong and the United Kingdom, who has obtained degree of Mphil from the University of Cambridge and MD from the University of Hong Kong. Prof Chan has published over 200 peer reviewed articles and has been ranked top 1% most cited scholar worldwide in the respective field by Clarivate Analytics since 2020.

Biography
HKU Scholars Hub
Laboratory Homepage
ORCID
kwsherry@hku.hk

For more information or to express interest for this project, please email the supervisor or the specified contact point in the project description.  Interested candidates are advised to enclose with your email:

  1. your CV,
  2. a brief description of your research interest and experience, and
  3. two reference letters (not required for HKUMed UG students seeking MRes[Med]/URIS projects).

Information on the research programme, funding support and admission documentations could be referenced online at the Research Postgraduate Admissions website. General admission enquiries should be directed to rpgmed@hku.hk.

HKUMed MBBS students interested in the Master of Research in Medicine (MRes[Med]) programme may visit the programme website for more information.  

HKUMed UG students interested in the Undergraduate Research Internship Scheme (URIS) may visit the scheme’s website for more information. 

Research @ Department of Psychiatry