Ignacio de Ramón: "AI will help us to be better therapists"

Times change, and thanks to the irruption of the Internet, first, and Artificial Intelligence, later, we have new ways of issuing and receiving information in real time, many times without the mediation of a real person bone. And this is something that can be used to create forms of therapy that would have been inconceivable just a few short years ago.

We will talk about it in this interview with Ignacio de Ramón, CEO of SincroLab and enthusiast of the possibilities that arise by combining AI with the development of psychotherapeutic intervention resources useful in the face of problems of mental health.

• Related article: "Neuropsychology: what is it and what is its object of study?"

Interview with Ignacio de Ramón: digital prescription therapies in mental health

Ignacio de Ramón Burgos is the co-founder and CEO of SincroLab, a company that develops a platform from which psychologists and neuropsychologists can apply digital therapies as a resource for training cognitive skills, something that has proven to be useful and effective in the face of alterations such as ADHD. In this interview he talks to us about the potential of digital therapies in the age of Artificial Intelligence (AI).

What is the main need that a technology like SincroLab's satisfies?

Mainly, access to scientifically validated cognitive stimulation in a manner adapted to the patient and at an amount that families can afford. Face-to-face sessions with specialized therapists is the ideal treatment, but according to our data, more than 50% of children, for example with ADHD, do not receive a combined drug and therapy treatment due to lack of resources or time and logistical complications. This means that the vast majority of children with ADHD (53%) either only receive a pharmacological regimen or have no treatment at all.

We want to reverse this situation as far as possible, bringing personalized digital treatment to patients' homes, validated and supervised by professionals. And we not only want to do it in patients with ADHD, but in many others who are also in this situation.

Could you mention some limitations that digital therapies do not have compared to “traditional” forms of psychological and neuropsychological intervention?

Of course, many. Face-to-face interaction with a therapist cannot be replaced for now with any technology, the transfer emotional, non-verbal communication with the body, including the responsibility of attending a scheduled appointment is therapeutic etc All that cannot be compared, but digital therapies are designed to complement face-to-face sessions.

What happens when your patient leaves the office until the next session? Is he following your recommendations or not? Can you remotely help them implement your recommendations? These are some of the many issues that digital therapies can help with. In fact, there is already evidence showing that online therapies have the same or better efficacy in some cases than face-to-face therapies.

Can digital therapies be undervalued for their “entertainment” video game appearance?

Well, that's always been the case. I, as a Child Neuropsychologist, have often heard parents say that "the child only comes to consult, play with Nacho" and it had to be explained that each game was "prescribed" for the stimulation of a cognitive process concrete. In the case of children, their natural language is play, especially in the case of children under 10 years of age. For this reason, I believe that children's treatments should be as playful as possible.

However, digital therapies are slowly showing that if they are well designed and built they can be very serious and help therapists to achieve the objectives of the treatments, getting our sector to technify.

At SincroLab you use the term “neurogame”. Can digital therapies be seen as a way to gamify the therapeutic process, or do they not always have to follow this model that is inspired by video games?

One of the most important problems that the therapeutic process has, and it gives me the feeling that it is not given enough emphasis, is the adherence to treatment. Treatments are often unsuccessful due to lack of adherence to it, but we do not ask ourselves too much how we can do so that patients finish their therapeutic processes.

But as you say, it is not valid for all cases or pathologies and, on the other hand, gamifying with meaning requires a lot of work and analysis and sometimes it is difficult to establish the itinerary of beginning and end of treatment. But, despite all this, I believe that gamification is an excellent ally to achieve greater adherence to treatments.

How does the customization system for the games offered by SincroLab work? What characteristics of the patient and her behavior are taken into account?

SincroLab is built on an Artificial Intelligence that adapts each stimulus, each game modality, each neurogame to the cognitive profile of the patient with one objective: to maximize the performance of the processes that are affected. It does this by learning from the daily performance of these patients, and from our database of over 6 million data points. What our AI does is prescribe the best possible treatment for that patient to improve her performance in the shortest possible time.

In the context of digital therapies, do therapists have an easy time monitoring the patient's progress, or do they have to devise a plan to collect data on their own?

Digital therapies are all about saving time, so ideally they don't have to collect a lot of data. In our case, the professional can take around 7 minutes to register a patient on the platform and from then on they do not have to do anything else. You can monitor progress through our reports and pass the information on to patients as you see fit.

Digital therapies are designed to intuitively display relevant data for the professional and the patient. Another thing is that some do not succeed, and that is the challenge and the differentiation between those that add value and those that do not. That is where I think regulation and quality standards such as ISO and markings should come in. CE and FDA to guarantee the quality of the design and manufacture of these therapies for professionals and patients.

From your point of view, what are the next achievements that digital therapies will achieve due to new technological advances in Artificial Intelligence?

I am a great defender of Artificial Intelligence as an ally for the understanding of the brain and the conduct. The computing power and the possibilities that AI can offer in diseases such as schizophrenia, ADHD, depression, anxiety disorders or Alzheimer's are enormous.

Through responsible and ethical use (Rafael Yuste's team is already working on the neurorights) AI can show us new therapeutic paths, new approaches that we don't have contemplated. I believe that AI will help us to be better therapists and offer more effective treatments to our patients.

Would it have been possible to create SincroLab as it is today 15 years ago?

Impossible. In 2007 the first iPhone was released. We believe that all our lives we have had enormous computing power in our pockets, but no. It's been a while since we've had this ability. Mobility and data processing capacity is what allows algorithms to be properly trained. In fact, the vast majority of AI algorithms in use today have been designed for a long time. several decades, but we did not have an "iPhone" type technology to collect so much data and train it in a way adequate. Now yes.

When in 2015 we talked about digital therapies based on Artificial Intelligence, few people understood what we were talking about. Today it is already a reality, but in 2008 it would be unthinkable.