The performance and accuracy of depression screening tools capable of self-administration in primary care: A systematic review and meta-analysis

2021 ◽  
Vol 35 (1) ◽  
pp. 1-18
Author(s):  
Peter Miller ◽  
David Newby ◽  
Emily Walkom ◽  
Jenny Schneider ◽  
Shu Chuen Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Meta Analysis ◽  
Screening Tools ◽  
Depression Screening ◽  
Self Administration

scholarly journals Technology-assisted depression screening tools for patients with cancer: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041878
Author(s):  
Maria Isabel Lazaro-Escudero ◽  
Camila Alanna Burgos-Cardona ◽  
Karina Acevedo-Fernández ◽  
Eida Maria Castro-Figueroa
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Screening Tools ◽  
Depression Screening ◽  
Published Data ◽  
Final Decision ◽  
Patients With Cancer ◽  
Use Of Technology ◽  
Registration Number

IntroductionAmong patients with cancer, depression is still under-detected. The use of technology-assisted screening tools is rising; however, little is known about the uptake of these devices as depression screening tools among patients with cancer.Methods and analysisA systematic review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). The review is registered with PROSPERO and any adjustments to the protocol will be traced. The aims of this systematic review are to (1) identify the most common and feasible depression screening information technology (IT) delivery models among patients with cancer, (2) identify the most common depression screening instrument used in IT devices and (3) describe the published technology-assisted depression screening tools for patients with cancer. PubMed, EBSCOhost and Google Scholar databases will be used. PICO (Patient/Population, Intervention, Comparison, Outcomes) guidelines will inform the inclusion criteria. Two researchers will independently review titles and abstracts, followed by full article review and data extraction. In the case of a disagreement, a third reviewer will make the final decision. Title/abstract screening will be conducted using a screening tool prepared by the researchers. Articles will be included for review if: (1) the study includes patients with cancer, cancer survivors and/or patients on remission, (2) depression is screened using technology and (3) technology-assisted depression screening effectiveness, efficacy, feasibility and/or acceptance is addressed. The quality of the articles will be assessed using the Methodological Index For Non-Randomised Studies (MINORS, maximum score 24) through independent coding of reviewers.Ethics and disseminationThis research is exempt from ethics approval given that this is a protocol for a systematic review, which uses published data. Findings from this review will be disseminated through peer-reviewed publications and scientific conferences.Systematic review registrationPROSPERO registration number CRD42019121048.

Diagnostic Accuracy of the Screening Instruments Used to Identify Postpartum Depression in the Primary Care Setting: Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Russy Novita Andriani ◽  
Siti Solichatul Makkiyyah ◽  
Amanda Safira Dea Hertika ◽  
Wahyudi Istiono ◽  
Mohammad Hakimi
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Postpartum Depression ◽  
Diagnostic Accuracy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Meta Analysis ◽  
Depression Screening ◽  
Screening Instruments ◽  
Meta Analyses

Abstract Background Postpartum depression (PPD) is a prevalent complication of pregnancy, this condition affects maternal and child well-being and functioning. Results from a meta-analysis showed an incidence of 13% PPD cases in the first 12 weeks after labor. Primary care is the first gate and continuing point of care for patients. Despite the controversy of screening and early identification in primary care settings, many PPD cases remain undetected. Given the uncertainty about this issue, screening instruments must be effective in identifying the cases. This systematic review and meta-analyses aim to identify the most suitable postpartum depression screening instrument for use in primary care. Methods PubMed, ScienceDirect, and ProQuest databases were used to search using relevant keywords or MeSH, with limitation of publication from January 1st, 2010 through December 31st, 2020. We will include screening studies on postpartum women using validated screening tools followed by validated structured or semi-structured interview for Diagnostic and Statistical Manual of Mental Disorders (DSM) as the reference standard in the primary care setting. Study designs included in the review are cross-sectional and randomized controlled trial without no screening arm on the diagnostic study. We will use a liberal accelerated method on the title and abstract review stage, then perform full-text article reviews on selected studies. Methodological quality will be assessed independently by two authors according to QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2). Extraction of the study data will be undertaken by one reviewer and checked by a second reviewer. Disagreements will be resolved by consensus and including a third investigator as necessary. The test characteristics will be extracted into 2x2 tables for all included studies. Study-specific estimates of sensitivity and specificity with 95% confidence intervals will be displayed in forest plots. Discussion The proposed systematic review and meta-analyses will allow us to obtain the most suitable postpartum depression screening instrument for use in primary care. Systematic review registration: PROSPERO CRD42020216067

scholarly journals Under detection of depression in primary care settings in low and middle-income countries: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Abebaw Fekadu ◽  
Mekdes Demissie ◽  
Rahel Berhane ◽  
Girmay Medhin ◽  
Teserra Bitew ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Sample Size ◽  
Meta Analysis ◽  
Screening Tools ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Care Clinicians ◽  
Detection Of Depression ◽  
Low And Middle Income

ABSTRACTObjectiveDepression is the commonest mental disorder in primary care but is poor identified. The objective of this review was to determine the level of detection of depression by primary care clinicians and its determinants in studies from low-and middle-income countries (LMICs).MethodsDesignSystematic review and meta-analysis. Review protocol was registered in the PROSPERO database (CRD42016039704).DatabasesPubMed, PsycINFO, Medline, EMBASE, LILAC and AJOL.Quality assessmentRisk of bias within studies evaluated with the Effective Public Health Practice Project (EPHPP).Synthesis“Gold standard” diagnosis for the purposes of this review were based on the 9-item Patient Health Questionnaire (PHQ-9; cutoff scores of 5 and 10), structured interview or expert diagnosis. Meta-analysis was conducted excluding studies on special populations. Analysis of pooled data were stratified by diagnostic approaches.ResultsA total of 2223 non-duplicate publications were screened. Ten publications, from two multi-country studies and eight single country studies, making 18 country level reports, were included. One of the multi-country studies used an enriched sample of screen positive participants. Overall methodological quality of the studies was good. Depression detection was 0.0% in five reports and <12% in another five. The pooled detection for two reports that used PHQ-9 at a cutoff point of 5 (combined sample size = 1426) was 3.9% (95% CI = 2.3%, 5.5%); in the four reports that used PHQ-9 cutoff score of 10 (combined sample size =5481), the pooled detection was 7.0% (95% CI = 3.9%, 10.2%). For the enriched sample, the pooled detection was 43.5 % (95% CI: 25.7%, 61.0%). Severity of depression and suicidality were significantly associated with detection.ConclusionsThe extremely low detection of depression by primary care clinicians poses a serious threat to scaling up mental healthcare in LMICs. Interventions to improve detection should be prioritized.Strength and limitation of study▸This is the first review of detection of depression in LMIC settings▸The review was comprehensive in terms of databases searched▸Screening tools were used as gold standards, which may lead to overestimation of prevalence and underestimation of detection▸The small number of studies and the use of different instruments and cutoff▸points precluded exploration of sources of heterogeneity▸The review does not include studies on distress or sub-threshold depression

scholarly journals Approaches for combining primary care electronic health record data from multiple sources: a systematic review of observational studies

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037405
Author(s):  
Daniel Dedman ◽  
Melissa Cabecinha ◽  
Rachael Williams ◽  
Stephen J W Evans ◽  
Krishnan Bhaskaran ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Electronic Health Record ◽  
Observational Studies ◽  
Meta Analysis ◽  
Data Sources ◽  
Health Record ◽  
Two Stage ◽  
One Stage ◽  
Electronic Health

ObjectiveTo identify observational studies which used data from more than one primary care electronic health record (EHR) database, and summarise key characteristics including: objective and rationale for using multiple data sources; methods used to manage, analyse and (where applicable) combine data; and approaches used to assess and report heterogeneity between data sources.DesignA systematic review of published studies.Data sourcesPubmed and Embase databases were searched using list of named primary care EHR databases; supplementary hand searches of reference list of studies were retained after initial screening.Study selectionObservational studies published between January 2000 and May 2018 were selected, which included at least two different primary care EHR databases.Results6054 studies were identified from database and hand searches, and 109 were included in the final review, the majority published between 2014 and 2018. Included studies used 38 different primary care EHR data sources. Forty-seven studies (44%) were descriptive or methodological. Of 62 analytical studies, 22 (36%) presented separate results from each database, with no attempt to combine them; 29 (48%) combined individual patient data in a one-stage meta-analysis and 21 (34%) combined estimates from each database using two-stage meta-analysis. Discussion and exploration of heterogeneity was inconsistent across studies.ConclusionsComparing patterns and trends in different populations, or in different primary care EHR databases from the same populations, is important and a common objective for multi-database studies. When combining results from several databases using meta-analysis, provision of separate results from each database is helpful for interpretation. We found that these were often missing, particularly for studies using one-stage approaches, which also often lacked details of any statistical adjustment for heterogeneity and/or clustering. For two-stage meta-analysis, a clear rationale should be provided for choice of fixed effect and/or random effects or other models.

scholarly journals Gambling problems in primary care: a systematic review and meta-analysis

2021 ◽  
pp. 1-15
Author(s):  
Amanda Roberts ◽  
Jim Rogers ◽  
Stephen Sharman ◽  
G. J. Melendez-Torres ◽  
Sean Cowlishaw
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Meta Analysis ◽  
Gambling Problems

scholarly journals Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (7) ◽  
pp. 3471
Author(s):  
Hyeon-Ju Lee ◽  
Youn-Jung Son
Keyword(s):  
Systematic Review ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Associated Factors ◽  
Meta Analysis ◽  
Screening Tools ◽  
Cochrane Library ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Hemodialysis is the most common type of treatment for end-stage renal disease (ESRD). Frailty is associated with poor outcomes such as higher mortality. ESRD patients have a higher prevalence of frailty. This systematic review and meta-analysis aimed to identify the prevalence and associated factors of frailty and examine whether it is a predictor of mortality among ESRD patients undergoing hemodialysis. Five electronic databases including PubMed, Embase, CINAHL, Web of Science, and Cochrane Library were searched for relevant studies up to 30 November 2020. A total of 752 articles were found, and seven studies with 2604 participants in total were included in the final analysis. The pooled prevalence of frailty in patients with ESRD undergoing hemodialysis was 46% (95% Confidence interval (CI) 34.2−58.3%). Advanced age, female sex, and the presence of diabetes mellitus increased the risk of frailty in ESRD patients undergoing hemodialysis. Our main finding showed that patients with frailty had a greater risk of all-cause mortality compared with those without (hazard ratio (HR): 2.02, 95% CI: 1.65−2.48). To improve ESRD patient outcomes, healthcare professionals need to assess the frailty of older ESRD patients, particularly by considering gender and comorbidities. Comprehensive frailty screening tools for ESRD patients on hemodialysis need to be developed.

scholarly journals Prevalence, aetiologies and prognosis of the symptom cough in primary care: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Milena Bergmann ◽  
Jörg Haasenritter ◽  
Dominik Beidatsch ◽  
Sonja Schwarm ◽  
Kaja Hörner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Respiratory Tract ◽  
Chronic Cough ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Current Guideline ◽  
Acute Cough ◽  
Reason For Encounter ◽  
Tract Infections

Abstract Background Cough is a relevant reason for encounter in primary care. For evidence-based decision making, general practitioners need setting-specific knowledge about prevalences, pre-test probabilities, and prognosis. Accordingly, we performed a systematic review of symptom-evaluating studies evaluating cough as reason for encounter in primary care. Methods We conducted a search in MEDLINE and EMBASE. Eligibility criteria and methodological quality were assessed independently by two reviewers. We extracted data on prevalence, aetiologies and prognosis, and estimated the variation across studies. If justifiable in terms of heterogeneity, we performed a meta-analysis. Results We identified 21 eligible studies on prevalence, 12 on aetiology, and four on prognosis. Prevalence/incidence estimates were 3.8–4.2%/12.5% (Western primary care) and 10.3–13.8%/6.3–6.5% in Africa, Asia and South America. In Western countries the underlying diagnoses for acute cough or cough of all durations were respiratory tract infections (73–91.9%), influenza (6–15.2%), asthma (3.2–15%), laryngitis/tracheitis (3.6–9%), pneumonia (4.0–4.2%), COPD (0.5–3.3%), heart failure (0.3%), and suspected malignancy (0.2–1.8%). Median time for recovery was 9 to 11 days. Complete recovery was reported by 40.2- 67% of patients after two weeks, and by 79% after four weeks. About 21.1–35% of patients re-consulted; 0–1.3% of acute cough patients were hospitalized, none died. Evidence is missing concerning subacute and chronic cough. Conclusion Prevalences and incidences of cough are high and show regional variation. Acute cough, mainly caused by respiratory tract infections, is usually self-limiting (supporting a “wait-and-see” strategy). We have no setting-specific evidence to support current guideline recommendations concerning subacute or chronic cough in Western primary care. Our study presents epidemiological data under non non-pandemic conditions. It will be interesting to compare these data to future research results of the post-pandemic era.

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