Predicting Onset of Visual Hallucinations Using Pareidolias: A Qualitative Exploration of the Ethics of a Digital App to Detect a Possible Biomarker

This study aimed to assess ethical considerations for using digital biomarkers in predicting the onset of neuropsychiatric disease. The study employed semi-structured interviews with 21 people ( N = 16 people at-risk for hallucinations and N = 5 current patients who experience visual hallucinations). The interview questions were grounded in the Consolidated Framework for Implementation Research (CFIR). The Rapid and Rigorous Qualitative Data Analysis (RADar) method was used to generate results. Emerging themes included prior knowledge, care partner resources, perception of outcomes, accessibility, interest in the tool, essential safety, organizational capacity, and monetary considerations. Understanding how to address these concerns from a participant’s experience may promote engagement and positive attitudes surrounding prodromal biomarker metrics adapted for digital health. Participants mentioned the potential of the digital biomarker to increase access to health care in areas with remote access to in-person health care and offset the trajectory of disease. Participants endorsed coordination with health care providers to provide next steps for modifying the trajectory of disease. Future research should promote team science among researchers, physicians, and individuals with lived experience of mental illness to improve telemedicine practices in accordance with population needs. With the increasing use of telemedicine and other remote health care practices, it is vital to consider the ethics of a stand-alone remote technology to diagnose pre-clinical neuropsychiatric disorders.