M3 Sensus

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How Sensus works

How Sensus organizes the picture of schizophrenia

Schizophrenia is not one symptom, and a single visit sees only one day of it. Sensus builds a picture over months, from the person, someone close to them and their clinician, and keeps that picture organized the same way every time. This page explains how it is laid out, and how it helps with the questions that matter: what is going on, whether the treatment is working, and what to talk about next.

What this adds up to

People stop treatment for reasons that can be measured. Sensus measures them every four weeks, in the person’s own words and a family member’s, and puts them in front of the clinician, so the conversation about a medicine can happen before the decision to stop it.

A picture built over time

This is what “phenotyping” means here.

A phenotype is the observable picture of a condition in one person: what they experience, how they are living, and how that changes.

Researchers use the term digital phenotyping for building that picture from repeated measurements taken in daily life, rather than from a single appointment. Sensus does this with short, validated questionnaires answered at home every four weeks, read alongside the clinician’s own assessment.

r = 0.80

How closely app-based mood reports tracked gold-standard clinical assessments in adults with schizophrenia. For anxiety the figure was 0.78. That supports tracking symptoms with reports made at home.

Ranjan et al., Schizophrenia Research 20221

At home

Mood, sleep and psychosis symptoms were reported as more severe when surveys were taken at home. Where a person answers from is part of the picture.

Ranjan et al., 20221

34.7%

The share of people with schizophrenia living with clinical pain, across 242,703 people in 14 studies. It is common, and easily missed.

Stubbs et al., Schizophrenia Research 20142

The same study found that differences between people accounted for more of the pattern than changes within a person.1 That is why Sensus compares each person with their own starting point, not with an average.

Seven parts of the picture

Every sitting fills in the same seven parts, so a change in any one of them can be seen against the rest.

1, Senses

Perception and thought

“What am I hearing, seeing or believing?”

Hearing or seeing things others do not, feeling watched or targeted, unusual thoughts. These are the symptoms most people associate with schizophrenia, and they are only one part of it.

Colorado Symptom Index and R-GPTS (paranoia), answered by the person.
Permission pending

2, Feelings

Mood, anxiety and safety

“How am I feeling, and am I safe?”

Depression, anxiety, the signs of bipolar disorder, and trauma, read together. Depression is common after a psychotic episode and it raises the risk of suicide, so this part runs at every sitting.

M3 Checklist, 27 items, answered by the person. Validated in 647 primary care patients.3
M3’s own

3, Awareness

Insight into the illness

“Do I see what is happening to me?”

How far the person recognizes their symptoms, sees them as part of an illness and sees a need for treatment. Insight shifts over time, and it shapes whether people stay with treatment.

VAGUS-SR, 10 items, answered by the person.
Licence pending (CAMH)

4, Function

How life is going

“Can I do the things my life needs?”

Looking after oneself, getting around, getting along with people, work, study and taking part in community life. This is where recovery is felt.

WHODAS 2.0, 12 items, answered by the person and by a family member.
Permission pending (WHO)

5, Body

Side-effects, pain and metabolism

“What is the treatment costing me?”

Sleepiness, stiffness, restlessness, weight, sexual and hormonal effects, and pain. These are the things people most often stop treatment over.

GASS (side-effects) Freely available (PhenX)
DVPRS (pain) Federal, free
Weight, blood pressure, glucose and lipids Clinician-entered

6, Treatment

The medication record

“What am I taking, and am I taking it?”

Each medicine, when it started, why it changed, and whether doses are being taken or injections given on time. No doses are ever shown.

Medication record and adherence questions.
M3’s own

7, Context

The circumstances of each reading

“Where am I, and what else is going on?”

Whether the person is answering from home or elsewhere, and substance use, especially cannabis. Context explains changes that would otherwise look like the illness or the medicine.

Home or elsewhere question M3’s own
TAPS substance-use screen Public domain (NIDA), planned

Not yet measured: thinking and memory. Problems with attention, memory and planning are a core part of schizophrenia and strongly affect everyday life. The validated test batteries are proprietary, and how Sensus will cover this part is still being decided. Until then, the function part is the best indirect reading.

Three voices, kept apart

Each part of the picture says whose account it is. The report never blends them.

The person

Answers about their own senses, feelings, awareness, body and treatment, at home, every four weeks. Theirs is the account that matters most, and it comes first on every report.

Someone close to them

A family member or partner answers about everyday function. Insight can come and go in schizophrenia, so a second view of how life is going is often the steadier one. They never see the person’s own answers.

The clinician

Adds what only an examination can give: their own symptom rating, lab results, weight and blood pressure. The definitions of remission and of treatment resistance rest on clinician ratings,45 so this voice anchors the rest.

What the picture is for

Four jobs, each with a clear limit on what Sensus does and what it leaves to the clinician.

Diagnosis — supporting it, never making it

A diagnosis of schizophrenia takes a clinician. What Sensus adds is a dated record the clinician would otherwise have to piece together from memory.

The course over time. A diagnosis depends on how long signs have lasted and how they have changed, not only on how someone presents on one day. A run of sittings shows that.
The mood picture beside the psychosis. Whether mood episodes come with the psychotic symptoms matters for telling schizophrenia from schizoaffective disorder or bipolar disorder with psychotic features. The M3 Checklist reads depression, anxiety, bipolar signs and trauma at every sitting.
What else could explain it. Substance use and physical causes can produce or worsen psychotic symptoms. The context part keeps them in view.

The limit. Sensus never gives a diagnosis, and no score on this platform is a diagnosis. The record is information for the person’s conversation with their clinician.

Treatment understanding — what this medicine is doing for this person

Antipsychotics differ less in how well they work than in what they cost the person.

The evidence. The largest comparison to date covered 32 oral antipsychotics in 402 trials and 53,463 participants. Differences in effect between medicines were modest apart from clozapine, and differences in side-effects were “more marked.”6
So the person’s own record matters. Which side-effects they have, how much pain they are in, and whether they are taking the medicine are what the conversation about a change rests on.
Taking it comes first. No conclusion about whether a medicine works can be drawn from a medicine that is not being taken, so the report shows adherence before anything else.
Treatment resistance. When the record shows two or more medicines tried for at least six weeks each, mostly taken, with symptoms not easing, it notes that the consensus criteria for treatment-resistant schizophrenia may be worth assessing.5

The limit. Sensus does not recommend starting, changing or stopping any medicine, and shows no doses. The prescriber decides. The clinician view of this material is off unless the practice has switched it on.

Monitoring — is it working, and is it still working?

A sitting every four weeks, read against the person’s own starting point.

Every medication change starts a new window with its own baseline, so one medicine can be compared with the next.
A trial of a medicine is judged over at least six weeks,5 so every window holds a baseline and at least one reading inside it.
The body is checked on the national timetable: weight and blood pressure at 4, 8 and 12 weeks after a start or change, glucose and lipids at 12 weeks, then at set intervals.7

An illustration of one person’s first 32 weeks. The timetable for the body checks follows the ADA/APA consensus for second-generation antipsychotics.7

Safety — at every sitting, before anything else

If a person’s answers show they may be at risk, the sitting stops and shows help straight away.

Call or text 988, the Suicide & Crisis Lifeline, and call 911 in an emergency. This appears whatever every other score says.
The person can carry on or stop, and their answers are kept either way.
A family member is told a sitting raised a concern, and is shown where to find help. They are not shown the person’s answers.

Every part at a glance

Part	What it reads	Instrument	Answered by	Status
Senses	Hallucinations, paranoia, unusual thoughts	Colorado Symptom Index; R-GPTS	The person	Permission pending
Feelings	Depression, anxiety, bipolar signs, trauma, safety	M3 Checklist	The person	M3’s own
Awareness	Insight into symptoms, illness and treatment	VAGUS-SR	The person	Licence pending
Function	Self-care, mobility, getting along, life activities, participation	WHODAS 2.0, 12-item	The person and a family member	Permission pending
Body	Side-effects; pain; weight, blood pressure, glucose, lipids	GASS; DVPRS; clinician entries	The person; the clinician	GASS pending; DVPRS free
Treatment	Medicines, changes, adherence, injection dates	Medication record; adherence questions	The person; the practice	M3’s own
Context	Where the person answers; substance use	Home-or-elsewhere question; TAPS	The person	Ours; TAPS public domain, planned
Clinician rating	The clinician’s own symptom score	Entered by the clinician	The clinician	To be confirmed

References

Ranjan T, Melcher J, Keshavan M, Smith M, Torous J. Longitudinal symptom changes and association with home time in people with schizophrenia: an observational digital phenotyping study. Schizophrenia Research 2022. PMID 35245703. doi:10.1016/j.schres.2022.02.031
Stubbs B, Mitchell AJ, De Hert M, Correll CU, et al. The prevalence and moderators of clinical pain in people with schizophrenia: a systematic review and large scale meta-analysis. Schizophrenia Research 2014. sciencedirect.com
Gaynes BN, et al. Feasibility and diagnostic validity of the M-3 checklist: a brief, self-rated screen for depressive, bipolar, anxiety, and post-traumatic stress disorders in primary care. Annals of Family Medicine 2010.
Andreasen NC, et al. Remission in schizophrenia: proposed criteria and rationale for consensus. American Journal of Psychiatry 2005.
Howes OD, et al. Treatment-resistant schizophrenia: Treatment Response and Resistance in Psychosis (TRRIP) Working Group consensus guidelines on diagnosis and terminology. American Journal of Psychiatry 2017. psychiatryonline.org
Huhn M, et al. Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. The Lancet 2019. thelancet.com
American Diabetes Association, American Psychiatric Association, et al. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care 2004;27(2):596–601. diabetesjournals.org

Where this page comes from. This page is written by M3 Information. The figures are taken from the published studies listed above, and nothing here should be read as an endorsement of this platform by their authors or publishers. Instruments marked pending are not yet in use on the platform and will not be until written permission is in hand.

If you or someone you know is in danger right now, do not wait for the next sitting. Call or text 988 (Suicide & Crisis Lifeline), or call 911 in an emergency.