The internal and external validity of the Major Depression Inventory in measuring severity of depressive states

2003 ◽  
Vol 33 (2) ◽  
pp. 351-356 ◽  
Author(s):  
L. R. OLSEN ◽  
D. V. JENSEN ◽  
V. NOERHOLM ◽  
K. MARTINY ◽  
P. BECH
Keyword(s):  
Major Depression ◽  
External Validity ◽  
Depression Scale ◽  
Internal Validity ◽  
Depressive Illness ◽  
Hamilton Depression Scale ◽  
Major Depression Inventory ◽  
Icd 10 ◽  
Internal And External Validity ◽  
Depressive States

Background. We have developed the Major Depression Inventory (MDI), consisting of 10 items, covering the DSM-IV as well as the ICD-10 symptoms of depressive illness. We aimed to evaluate this as a scale measuring severity of depressive states with reference to both internal and external validity.Method. Patients representing the score range from no depression to marked depression on the Hamilton Depression Scale (HAM-D) completed the MDI. Both classical and modern psychometric methods were applied for the evaluation of validity, including the Rasch analysis.Results. In total, 91 patients were included. The results showed that the MDI had an adequate internal validity in being a unidimensional scale (the total score an appropriate or sufficient statistic). The external validity of the MDI was also confirmed as the total score of the MDI correlated significantly with the HAM-D (Pearson's coefficient 0·86, P[les ]0·01, Spearman 0·80, P[les ]0·01).Conclusion. When used in a sample of patients with different states of depression the MDI has an adequate internal and external validity.

scholarly journals A novel preference-informed complementary trial (PICT) design for clinical trial research influenced by strong patient preferences

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Samina Ali ◽  
◽  
Gareth Hopkin ◽  
Naveen Poonai ◽  
Lawrence Richer ◽  
...  
Keyword(s):  
External Validity ◽  
Treatment Options ◽  
Internal Validity ◽  
Clinical Effectiveness ◽  
Drop Out ◽  
Innovative Design ◽  
Clinical Trial Research ◽  
Research Questions ◽  
Internal And External Validity ◽  
Treatment Population

Abstract Background Patients and their families often have preferences for medical care that relate to wider considerations beyond the clinical effectiveness of the proposed interventions. Traditionally, these preferences have not been adequately considered in research. Research questions where patients and families have strong preferences may not be appropriate for traditional randomized controlled trials (RCTs) due to threats to internal and external validity, as there may be high levels of drop-out and non-adherence or recruitment of a sample that is not representative of the treatment population. Several preference-informed designs have been developed to address problems with traditional RCTs, but these designs have their own limitations and may not be suitable for many research questions where strong preferences and opinions are present. Methods In this paper, we propose a novel and innovative preference-informed complementary trial (PICT) design which addresses key weaknesses with both traditional RCTs and available preference-informed designs. In the PICT design, complementary trials would be operated within a single study, and patients and/or families would be given the opportunity to choose between a trial with all treatment options available and a trial with treatment options that exclude the option which is subject to strong preferences. This approach would allow those with strong preferences to take part in research and would improve external validity through recruiting more representative populations and internal validity. Here we discuss the strengths and limitations of the PICT design and considerations for analysis and present a motivating example for the design based on the use of opioids for pain management for children with musculoskeletal injuries. Conclusions PICTs provide a novel and innovative design for clinical trials with more than two arms, which can address problems with existing preference-informed trial designs and enhance the ability of researchers to reflect shared decision-making in research as well as improving the validity of trials of topics with strong preferences.

scholarly journals High Fidelity Microsurgical Simulation: The Thiel Model and Evaluation Instrument

2018 ◽  
Vol 27 (2) ◽  
pp. 118-124 ◽  
Author(s):  
Andrei Odobescu ◽  
Isak Goodwin ◽  
Djamal Berbiche ◽  
Joseph BouMerhi ◽  
Patrick G. Harris ◽  
...  
Keyword(s):  
External Validity ◽  
Internal Validity ◽  
High Fidelity ◽  
Evaluation Instrument ◽  
Intra Class Correlation ◽  
Validity Measures ◽  
The Difference ◽  
Fidelity Model ◽  
Junior Residents ◽  
Internal And External Validity

Background: The Thiel embalmment method has recently been used in a number of medical simulation fields. The authors investigate the use of Thiel vessels as a high fidelity model for microvascular simulation and propose a new checklist-based evaluation instrument for microsurgical training. Methods: Thirteen residents and 2 attending microsurgeons performed video recorded microvascular anastomoses on Thiel embalmed arteries that were evaluated using a new evaluation instrument (Microvascular Evaluation Scale) by 4 fellowship trained microsurgeons. The internal validity was assessed using the Cronbach coefficient. The external validity was verified using regression models. Results: The reliability assessment revealed an excellent intra-class correlation of 0.89. When comparing scores obtained by participants from different levels of training, attending surgeons and senior residents (Post Graduate Year [PGY] 4-5) scored significantly better than junior residents (PGY 1-3). The difference between senior residents and attending surgeons was not significant. When considering microsurgical experience, the differences were significant between the advanced group and the minimal and moderate experience groups. The differences between minimal and moderate experience groups were not significant. Based on the data obtained, a score of 8 would translate into a level of microsurgical competence appropriate for clinical microsurgery. Conclusions: Thiel cadaveric vessels are a high fidelity model for microsurgical simulation. Excellent internal and external validity measures were obtained using the Microvascular Evaluation Scale (MVES).

scholarly journals Using the RE-AIM framework to evaluate internal and external validity of mobile phone–based interventions in diabetes self-management education and support

2020 ◽  
Vol 27 (6) ◽  
pp. 946-956 ◽  
Author(s):  
Yilin Yoshida ◽  
Sonal J Patil ◽  
Ross C Brownson ◽  
Suzanne A Boren ◽  
Min Kim ◽  
...  
Keyword(s):  
External Validity ◽  
Management Education ◽  
Data Extraction ◽  
Internal Validity ◽  
Self Management ◽  
Future Research ◽  
Limited Information ◽  
Quality Of Reporting ◽  
Screening Process ◽  
Internal And External Validity

Abstract Objective We evaluated the extent to which studies that tested short message service (SMS)– and application (app)-based interventions for diabetes self-management education and support (DSMES) report on factors that inform both internal and external validity as measured by the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework. Materials and Methods We systematically searched PubMed, Embase, Web of Science, CINAHL (Cumulative Index of Nursing and Allied Health Literature), and IEEE Xplore Digital Library for articles from January 1, 2009, to February 28, 2019. We carried out a multistage screening process followed by email communications with study authors for missing or discrepant information. Two independent coders coded eligible articles using a 23-item validated data extraction tool based on the RE-AIM framework. Results Twenty studies (21 articles) were included in the analysis. The comprehensiveness of reporting on the RE-AIM criteria across the SMS- and app-based DSMES studies was low. With respect to internal validity, most interventions were well described and primary clinical or behavioral outcomes were measured and reported. However, gaps exist in areas of attrition, measures of potential negative outcomes, the extent to which the protocol was delivered as intended, and description on delivery agents. Likewise, we found limited information on external validity indicators across adoption, implementation, and maintenance domains. Conclusions Reporting gaps were found in internal validity but more so in external validity in the current SMS- and app-based DSMES literature. Because most studies in this review were efficacy studies, the generalizability of these interventions cannot be determined. Future research should adopt the RE-AIM dimensions to improve the quality of reporting and enhance the likelihood of translating research to practice.

scholarly journals Depression in women infected with HIV

2006 ◽  
Vol 28 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Valéria Antakly de Mello ◽  
André Malbergier
Keyword(s):  
Major Depression ◽  
Hiv Infection ◽  
Depressive Disorders ◽  
Depression Scale ◽  
Hamilton Depression Scale ◽  
Asymptomatic Group ◽  
Dsm Iv ◽  
Women With Hiv ◽  
Major Depressive Episodes ◽  
Depressive Episodes

OBJETIVE:The number of women with HIV infection has been on the rise in recent years, making studies of the psychiatric aspects of this condition very important. The aim of this study was to evaluate the prevalence of major depression in women with HIV infection. METHOD: A total of 120 women were studied, 60 symptomatic (with AIDS symptoms) and 60 asymptomatic (without AIDS symptoms). Sociodemographic data were collected, and depressive disorders were identified. The instruments used to evaluate the depressive disorders were the SCID, DSM-IV, 17-item Hamilton depression scale, Hamilton depression scale for nonsomatic symptoms and the Beck depression scale. RESULTS: The prevalence of major depression was 25.8% and was higher in the symptomatic group than in the asymptomatic group (p = 0.002). CONCLUSIONS: The prevalence of major depressive episodes in women with HIV infection is high, and women with AIDS-related symptoms are more often depressed than are those who have never presented such symptoms.

Internal and External Validity in Ethical Reasoning

2021 ◽  
pp. 40-61
Author(s):  
James Wilson
Keyword(s):  
Real World ◽  
External Validity ◽  
Thought Experiment ◽  
Ethical Reasoning ◽  
Internal Validity ◽  
Thought Experiments ◽  
American Philosophy ◽  
Anglo American ◽  
Internal And External Validity ◽  
Rigorous Method

A particular approach to ethical reasoning has come to dominate much Anglo-American philosophy, one which assumes that the most rigorous method is to proceed by analysis of thought experiments. In thought experiments, features such as context and history are stripped away, and all factors other than those of ethical interest are stipulated to be equal. This chapter argues that even if a thought experiment produces results that are internally valid—in that it provides a genuine ethical insight about the highly controlled and simplified experimental scenario under discussion—this does not imply external validity. Just as in empirical experiments, there is a yawning gap between succeeding in the relatively easy project of establishing internal validity in a controlled and simplified context, and the more difficult one of establishing external validity in the messier and more complex real world.

scholarly journals Depression in Parkinson's disease: clinical-epidemiological correlates and comparison with a controlled group of non-parkinsonian geriatric patients

2009 ◽  
Vol 31 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Beatriz Azevedo dos Anjos Godke Veiga ◽  
Vanderci Borges ◽  
Sonia Maria César de Azevedo Silva ◽  
Fabrício de Oliveira Goulart ◽  
Maysa Seabra Cendoroglo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Major Depression ◽  
Beck Depression Inventory ◽  
Geriatric Patients ◽  
Rating Scale ◽  
Depression Scale ◽  
Hamilton Depression Scale ◽  
Yahr Scale ◽  
Disease Rating

OBJECTIVE: To evaluate and compare the frequency and severity of major depression in patients with Parkinson's disease and in individuals older than 60 years without neurological, rheumatological and/or oncological comorbidities. METHOD: We studied 50 patients with Parkinson's disease older than 60 years and 50 geriatric patients. Subjects with scores of Mini Mental State Examination indicating cognitive impairment were excluded. We used Diagnostic Statistical Manual of Mental Diseases-IV criteria to diagnose major depression and the Hamilton Depression Scale and the Beck Depression Inventory to rate it. The Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were used to evaluate the motor severity of Parkinson's disease. RESULTS: Major depression was found in 42% of Parkinson's disease patients and in 10% of the geriatric patients (p < 0.001). The scores of the Hamilton Depression Scale and the Beck Depression Inventory were higher in Parkinson's disease patients (p < 0.001). Depressed Parkinson's disease patients had longer duration of Parkinson's disease (p = 0.020) and higher scores on the Unified Parkinson's Disease Rating Scale part 3 (p = 0.029) and the Yahr Scale (p = 0.027). CONCLUSIONS: The frequency (42%) and severity of major depression were higher in Parkinson's disease patients. Longer duration of Parkinson's disease, higher scores on the Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were significantly associated with major depression.

scholarly journals Experimental and Non-Experimental Methods in Development Economics: A Porous Dialectic

2015 ◽  
Vol 6 (1) ◽  
Author(s):  
Rajeev Dehejia
Keyword(s):  
Randomized Controlled Trials ◽  
External Validity ◽  
Internal Validity ◽  
Experimental Methods ◽  
Controlled Trials ◽  
Data Sets ◽  
Randomized Controlled ◽  
Nationally Representative ◽  
High Degree ◽  
Internal And External Validity

AbstractThis paper surveys six widely-used non-experimental methods for estimating treatment effects (instrumental variables, regression discontinuity, direct matching, propensity score matching, linear regression and non-parametric methods, and difference-in-differences), and assesses their internal and external validity relative both to each other and to randomized controlled trials. While randomized controlled trials can achieve the highest degree of internal validity when cleanly implemented in the field, the availability of large, nationally representative data sets offers the opportunity for a high degree of external validity using non-experimental methods. We argue that each method has merits in some context and they are complements rather than substitutes.

A Patient with a Resistant Major Depression Disorder Treated with Deep Brain Stimulation in the Inferior Thalamic Peduncle

Neurosurgery ◽  
2005 ◽  
Vol 57 (3) ◽  
pp. 585-593 ◽  
Author(s):  
Fiacro Jiménez ◽  
Francisco Velasco ◽  
Rafael Salin-Pascual ◽  
José A. Hernández ◽  
Marcos Velasco ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Major Depression ◽  
Depression Scale ◽  
Borderline Personality ◽  
Hamilton Depression Scale ◽  
Global Assessment Of Functioning ◽  
Major Depression Disorder ◽  
Depression Disorder ◽  
Deep Brain ◽  
Stimulation Of

ABSTRACT OBJECTIVE AND IMPORTANCE: The present report explored the effect of electrical stimulation on the inferior thalamic peduncle in a patient with resistant major depression disorder (MDD). CLINICAL PRESENTATION: This report refers to a 49-year-old woman with a history of recurrent episodes of major depression for 20 years (12 episodes and 2 hospitalizations), fulfilling Diagnostic and Statistical Manual of Mental Disorders, 4th edition, revised, criteria for MDD; in addition, the patient met criteria for borderline personality disorder and bulimia. Her longest episode of depression with suicidal ideation began 5 years before surgery. The patient's symptom array responded poorly to different combinations of antidepressants, cognitive therapy, and electroconvulsive therapy, which induced improvement only for short periods of time. Immediately before surgery, her Global Assessment of Functioning score was 20 and her Hamilton Depression Scale score ranged from 33 to 42. The patient was proposed for surgery for MDD. INTERVENTION: The patient had bilateral eight-contact electrodes stereotactically implanted for stimulation of areas at and around the inferior thalamic peduncle. Electrode position was corroborated by unilateral electrical stimulation searching for recruiting responses and regional direct current shifts in the electroencephalogram. Recording electrodes were replaced by tetrapolar electrodes for deep brain stimulation and connected to an internalized stimulation system for continuous bipolar stimulation at 130 Hz, 0.45 milliseconds, 2.5 V. Bimonthly follow-up included psychiatric and neuropsychological evaluations performed over the course of 24 months. After 8 months of ON stimulation, the patient entered a double-blind protocol with stimulators turned OFF. Improvement of depression measured by the Hamilton Depression Scale score was evident after initial placement of electrodes without electrical stimulation. Depression relapsed partially at the end of the first week. Electrical stimulation further improved depression, normalizing depression scores and neuropsychological performance. Patient depression scores ranked between 2 and 8 during 8 months of ON stimulation without antidepressant medication. After stimulation was turned OFF, spontaneous fluctuations in patient symptoms reflected by Hamilton Depression Scale and Global Assessment of Functioning scores were documented; these fluctuations disappeared after stimulation was turned on by Month 20. CONCLUSION: Complicated patients with comorbid conditions are common referrals to psychosurgery services. In this report, we present promising results of electrical stimulation of the inferior thalamic peduncle to treat recurrent unipolar depression in a patient with MDD and borderline personality disorder who responded poorly to treatment.

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