AURORA: Adaptive Understanding through Real-time Observation, Reporting, and Assistance

Depression acuity can rapidly shift, yet weekly assessments detect change slowly and often unreliably, delaying treatment personalization and compounding disability. AURORA (Adaptive Understanding through Real-time Observation, Reporting, and Assistance) pairs passive sensing with voice-native, conversational GenAI check-ins to capture rich context plus objective multimodal signals. This enables sensitive, safe, and equitable measurement—the foundation for just-in-time adaptive interventions that address stakeholder concerns about privacy, context, and the risk of dehumanizing, metric-driven care. AURORA’s passive triggers launch brief, adaptive audio-visual assessments of depressive symptoms and provide psychoeducation and CBT-inspired engagement prompts/cues, while collecting high-quality audio–visual signals and lived context. The result is an actionable, valid depressive symptom measurement that can individualize treatment. Following development and refinement, we will evaluate AURORA in a pragmatic cluster-randomized trial of 1,000 patients through 100 clinician dyads across 4 continents. With an international team of researchers and lived experience experts, we leverage our strengths in GenAI, digital phenotyping, global clinical studies, ethics, and advanced analytical methods. We aim to: (1) Develop AURORA; (2) Validate AURORA as a psychometrically robust, responsive, and fair measurement system for depression; (3) Demonstrate engagement, acceptability, and clinical utility; and (4) Explore AURORA’s impact on clinical outcomes relative to treatment-as-usual.