scholarly journals Validity and diagnostic accuracy of the Luganda version of the 9-item and 2-item Patient Health Questionnaire for detecting major depressive disorder in rural Uganda

2016 ◽  
Vol 3 ◽  
Author(s):  
J. E. M. Nakku ◽  
S. D. Rathod ◽  
D. Kizza ◽  
E. Breuer ◽  
K. Mutyaba ◽  
...  
Keyword(s):  
Primary Care ◽  
Diagnostic Accuracy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Characteristic Curve ◽  
Screening Tools ◽  
Idioms Of Distress ◽  
Future Research ◽  
Predictive Values ◽  
Patient Health

Background.The prevalence of depression in rural Ugandan communities is high and yet detection and treatment of depression in the primary care setting is suboptimal. Short valid depression screening measures may improve detection of depression. We describe the validation of the Luganda translated nine- and two-item Patient Health Questionnaires (PHQ-9 and PHQ-2) as screening tools for depression in two rural primary care facilities in Eastern Uganda.Methods.A total of 1407 adult respondents were screened consecutively using the nine-item Luganda PHQ. Of these 212 were randomly selected to respond to the Mini International Neuropsychiatric Interview diagnostic questionnaire. Descriptive statistics for respondents’ demographic characteristics and PHQ scores were generated. The sensitivity, specificity and positive predictive values (PPVs), and area under the ROC curve were determined for both the PHQ-9 and PHQ-2.Results.The optimum trade-off between sensitivity and PPV was at a cut-off of ≧5. The weighted area under the receiver Operating Characteristic curve was 0.74 (95% CI 0.60–0.89) and 0.68 (95% CI 0.54–0.82) for PHQ-9 and PHQ-2, respectively.Conclusion.The Luganda translation of the PHQ-9 was found to be modestly useful in detecting depression. The PHQ-9 performed only slightly better than the PHQ-2 in this rural Ugandan Primary care setting. Future research could improve on diagnostic accuracy by considering the idioms of distress among Luganda speakers, and revising the PHQ-9 accordingly. The usefulness of the PHQ-2 in this rural population should be viewed with caution.

scholarly journals A Pilot Study on Using the Patient Health Questionnaire in the Primary Care Setting in Japan

2005 ◽  
Vol 6 (1) ◽  
pp. 9-16
Author(s):  
Kazuhiro Waza ◽  
Graham Antonnette ◽  
Zyzanski Stephen ◽  
Kazuo Inoue ◽  
Masato Sasaki ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Patient Health

Diagnostic accuracy of transient elastography (FibroScan) versus the aspartate transaminase to platelet ratio index in assessing liver fibrosis in chronic hepatitis B: The role in primary care setting

2011 ◽  
Vol 64 (10) ◽  
pp. 916-920 ◽  
Author(s):  
C Rinaldi A Lesmana ◽  
Simon Salim ◽  
Irsan Hasan ◽  
Andri S Sulaiman ◽  
Rino A Gani ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Diagnostic Accuracy ◽  
Chronic Hepatitis B ◽  
Care Setting ◽  
Primary Care Setting ◽  
Transient Elastography ◽  
Liver Stiffness

BackgroundA non-invasive method to assess liver fibrosis by measuring liver stiffness with transient elastography (TE) has been recently introduced. The role of TE among chronic hepatitis B (CHB) patients in starting antiviral therapy in the primary care setting is still controversial because of its high cost. The AST to platelet ratio index (APRI) could be a much cheaper alternative.ObjectivesThis study compares the diagnostic accuracy of TE and APRI in assessing liver fibrosis in CHB patients.Patients and MethodsA cross-sectional study in CHB patients intending to start antiviral treatment. Liver fibrosis was staged according to the METAVIR scoring system. Liver stiffness was measured by TE performed on the same day with liver biopsy, while APRI was calculated as follows: APRI=(AST/upper limit of normal)×100/platelet count (109/l). Cutoff levels of liver stiffness and APRI were calculated by using the receiver operating characteristic curve to detect significant liver fibrosis, defined as fibrosis stage F2 or more.Results117 patients were enrolled in the study; their mean age was 40.6±10.97 years. The median liver stiffness was 5.9 kPa (2.5–48 kPa) and the median APRI was 0.239 (0.09–2.73). The cutoff level of liver stiffness was 5.85 kPa for ≥F2 with an AUC of 0.614, 60.3% sensitivity, 63.6% specificity, 73.3% PPV, 49.1% NPV and a LR+ of 1.66. The APRI cutoff level was 0.235 for F≥2 with an AUC of 0.693, 64.4% sensitivity, 70.5% specificity, 78.3% PPV, 54.4% NPV and a LR+ of 2.18. Both methods gave comparable diagnostic accuracy.ConclusionAPRI is a useful marker to screen liver fibrosis in the primary care setting when TE is not available.

Prevalence of psychotic symptoms: comparation of immigrants and native- born primary care service users

2011 ◽  
Vol 26 (S2) ◽  
pp. 467-467
Author(s):  
P. Martinena-Palacio ◽  
F. Eiroa ◽  
A. Qureshi ◽  
F. Collazos ◽  
H.W. Revollo ◽  
...  
Keyword(s):  
Primary Care ◽  
Life Span ◽  
Care Setting ◽  
Psychotic Disorders ◽  
Primary Care Setting ◽  
Economic Status ◽  
Demographic Characteristics ◽  
Psychotic Symptoms ◽  
Future Research ◽  
Socio Economic Status

IntroductionEpidemiological studies reveal higher rates of psychotic disorders among immigrants of ethnic minorities. However, the variation in prevalence of psychosis differs, and the proposed explanations and risk factors vary across the literature.Objectives1) to examine the prevalence of psychotic symptoms in a sample of immigrants and native-born in a primary care setting context2) to explore the effect that certain socio-demographic characteristics have in the difference in prevalence.AimsIt is expected that the presence of psychotic symptoms will be greater for the immigrant population than for the native-born population. Low educational level, a low socio-economic status and the presence of a physical illness will partly explain these differences.Methods3000 patients (1500 immigrants and 1500 native-born outpatients paired in age and gender) were interviewed in a primary care setting. They completed the Mini International Neuropsychiatric Interview, including the psychotic disorders sections, and a questionnaire that probed demographic characteristics and physical health status.ResultsImmigrants showed significantly higher rates of psychotic symptoms than native-born patients in both sections of diagnosis: life-span psychotic symptoms only (9.8% in immigrants and 5.3% in native-born) and life span with current psychotic symptoms (7% of the immigrants and 4.8% of the native-born). Immigrants also showed a lower education level, and a lower socio-economic status. When controlling for these factors, a relationship between these factors and the symptoms was found.ConclusionsFindings are discussed in the context of culture and etiology of psychotic symptoms, and suggestions with regard to future research are made.

Women and Substance Abuse: Health Considerations and Recommendations

CNS Spectrums ◽  
2011 ◽  
Vol 16 (2) ◽  
pp. 37-47 ◽  
Author(s):  
Nassima Ait-Daoud ◽  
Mudhasir Bashir
Keyword(s):  
Primary Care ◽  
Substance Abuse ◽  
Care Setting ◽  
Primary Care Setting ◽  
Screening Tools ◽  
Psychological Interventions ◽  
Health Consequences ◽  
Seeking Help ◽  
Gender Specific ◽  
Specific Health

AbstractThere has been growing evidence in recent years of the importance of gender specific issues in the addiction field. This paper explores specific problems and including specific health consequences faced by women who drink or use drugs. We describe helpful screening tools that can be used in the primary care setting and offer an understanding of some of the barriers preventing women from seeking help. This article also provides guidance on the best pharmacotherapy and psychological interventions that can be used to help women recover from their addiction.

Detection, assessment and management of eating disorders; how involved are GPs?

2006 ◽  
Vol 23 (3) ◽  
pp. 96-99 ◽  
Author(s):  
Claire Flahavan
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Eating Disorders ◽  
General Practitioners ◽  
Care Setting ◽  
Primary Care Setting ◽  
Screening Tools ◽  
Current Evidence ◽  
Eating Disordered ◽  
Screening Assessment

AbstractObjectives: To determine the extent to which general practitioners are currently active in the screening, assessment, diagnosis and management of eating disorders. To identify current deficits in service delivery for eating disordered patients, as identified by general practitioners.Method: A postal questionnaire was circulated to 360 general practitioners within the greater Dublin area and North Eastern Health Service Executive.Results: Response rate was 25%. Respondents had lower case-loads of eating disordered patients than would be expected given the epidemiology of anorexia and bulimia nervosa. Most do not routinely screen for eating disorders, even in at-risk populations and are unaware of the current evidence-based data for guidance. GPs do not feel confident at managing eating disorders within the primary care setting and see their chief role as that of referral to psychiatric services. Treatment outcomes are typically poor. Concern was expressed at the lack of access to specialist treatment in the public sector. Specific deficits in service provision were highlighted including delays in assessment, lack of services appropriate to the adolescent population, poor service transition, and poor availability of psychotherapy at primary care level.Conclusions: Eating disorders are currently underdiagnosed in the primary care setting. Use of simple screening tools might aid detection of pathological eating patterns, particularly in at-risk groups. General practitioners feel under-equipped to manage these complex disorders, given that the resources required to provide high quality care are not widely available. Better integration of primary and secondary services, coupled with training for GPs in the area of screening, assessment and diagnosis, may lead to earlier intervention and improved outcomes.

scholarly journals Diagnostic Accuracy of a Device for the Automated Detection of Diabetic Retinopathy in a Primary Care Setting

Diabetes Care ◽  
2019 ◽  
Vol 42 (4) ◽  
pp. 651-656 ◽  
Author(s):  
Frank D. Verbraak ◽  
Michael D. Abramoff ◽  
Gonny C.F. Bausch ◽  
Caroline Klaver ◽  
Giel Nijpels ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Diagnostic Accuracy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Automated Detection

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 Evaluation of the Mini Nutritional Assessment short-form among the elderly population from Ethiopia

2021 ◽  
Author(s):  
Megersso Urgessa
Keyword(s):  
Diagnostic Accuracy ◽  
Nutritional Assessment ◽  
Short Form ◽  
Characteristic Curve ◽  
Strong Association ◽  
Mini Nutritional Assessment ◽  
Screening Tools ◽  
Roc Curve Analysis ◽  
Predictive Values ◽  
Long Form

Abstract Background Different tools have been used to perform a nutritional screening and assessment, and MNA is one of the widely used and recommended tools in the geriatrics population. MNA has two forms, long and short. However, MNA short-forms have not been evaluated in Ethiopia. Therefore, this study was aimed to evaluate MNA short form against MNA long-form tool among Ethiopian elders.Methods One hundred and seventy-six randomly selected elders entered into the community-based cross-sectional validation study. Amputated, bedridden, those with visible deformity were excluded. Original MNA questionnaires were translated to Afan Oromo and Amharic languages. All translated and pretested MNA questionnaires were administered to each participant. The anthropometrics were measured. Reliability, validity, sensitivity, specificity, positive and negative predictive values were calculated. Receiver-operating characteristic curve (ROC-curve) analysis was plotted for MNA, to identify the area under the curve (AUC) and optimal cut-off value for prediction of malnutrition.Result Strong association between MNA-long form score and MNA-short form score indicated by spearman’s rank correlation coefficients of BMI-MNA-SF 0.771,p < 0.05 and CC-MNA-SF 0.759, P < 0.05. Similar the agreement between the long and short form of MNA was found to be a weighted kappa 0.396(0.318, 0.474) for BMI-MNA-SF and 0.546(0.422, 0.669) for CC-MNA-SF at 95% CI. These values indicate moderate agreement with the MNA-long form. There is very good agreement between the BMI-MNA-SF and CC-MNA-SF 0.400(0.322, 0.478). Also, high power to identify two categories using MNA long-form as golden standard with AUC for BMI –MNA-SF 0.908 (0.865–0.951) and 0.880 (0.831–0.929) for CC-MNA-SF at 95% CI. Diagnostic accuracy of both versions of MNA-SF showed that 34.2% sensitivity, 100.0% specificity, 100.0% PPV, and 41.5% NPV for BMI-MNA-SF. Similar sensitivity 75.8%, specificity 83.9%, PPV 91.0%, and 61.8% NPV for CC-MNA-SF. Total Diagnostic accuracy for BMI-MNA-SF 55.12%, and 78.41% for CC-MNA-SFConclusion Both versions of MNA-SF were found to be valid screening tools in the Ethiopian elders against Long-form MNA.

scholarly journals Validity of the COPD-6® Device for COPD Screening in the Primary Care Setting of China

2020 ◽  
Author(s):  
Shuyun Chen ◽  
Xiaochen Li ◽  
Zihui Wang ◽  
Yumin Zhou ◽  
Dongxing Zhao ◽  
...  
Keyword(s):  
Primary Care ◽  
Characteristic Curve ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Screening Tools ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Predictive Values ◽  
Primary Care Settings ◽  
Significant Difference

Abstract Background: The use of simple and affordable screening tools for chronic obstructive pulmonary disease (COPD) is limited. We aimed to assess the validity of a handheld expiratory flow meter (COPD-6®, Vitalograph Ltd., Ireland) for COPD screening in Chinese primary care settings.Methods: In our cross-sectional study, subjects were randomly selected in eight primary care settings. Testing with the Vitalograph-COPD-6® and conventional spirometry were sequentially performed on subjects. The correlation between COPD-6® and conventional spirometry was determined. Validity was analyzed by the area under the receiver operator characteristic curve (AUC) of the forced expiratory volume in one second (FEV1) / forced expiratory volume in six seconds (FEV6) that used to detect airway obstruction. The sensitivity, specificity, predictive values, and likelihood ratio were calculated according to different FEV1/FEV6 cut-off points.Results: 229 subjects (15.4%) were diagnosed with airflow limitation by standard spirometry. FEV1, FEV6, and FEV1/FEV6 measured by COPD-6® were correlated with FEV1, FVC, and FEV1/FVC measured by spirometry (r=0.889, 0.835and 0.647, p<0.001), respectively. AUC of the FEV1/FEV6 to determine airflow obstruction was 0.857 (95%CI: 0.826 to 0.888). No significant difference of AUC was observed between the symptomatic group and the asymptomatic population (AUC=0.869 vs. 0.843, P=0.425). A similar phenomenon was found in the AUC of smokers and never-smokers (AUC=0.862 vs.0.840; P=0.515). The value of AUC was largest (i.e., 0.80) when the cut-off point for FEV1/FEV6 was 0.77.Conclusions: The handheld COPD-6® could be used as a pre-screening device on early diagnosis of COPD in Chinese primary care settings.

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