scholarly journals Psoriatic arthritis screening: a systematic review and meta-analysis

Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 692-707 ◽  
Author(s):  
Nicolas Iragorri ◽  
Glen Hazlewood ◽  
Braden Manns ◽  
Vishva Danthurebandara ◽  
Eldon Spackman
Keyword(s):  
Systematic Review ◽  
Psoriatic Arthritis ◽  
Sensitivity And Specificity ◽  
Screening Tool ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Screening Tools ◽  
Screening Questionnaire ◽  
Psa Screening ◽  
Early Psoriatic Arthritis

Abstract Objective To systematically review the accuracy and characteristics of different questionnaire-based PsA screening tools. Methods A systematic review of MEDLINE, Excerpta Medical Database, Cochrane Central Register of Controlled Trials and Web of Science was conducted to identify studies that evaluated the accuracy of self-administered PsA screening tools for patients with psoriasis. A bivariate meta-analysis was used to pool screening tool-specific accuracy estimates (sensitivity and specificity). Heterogeneity of the diagnostic odds ratio was evaluated through meta-regression. All full-text records were assessed for risk of bias with the QUADAS 2 tool. Results A total of 2280 references were identified and 130 records were assessed for full-text review, of which 42 were included for synthesis. Of these, 27 were included in quantitative syntheses. Of the records, 37% had an overall low risk of bias. Fourteen different screening tools and 104 separate accuracy estimates were identified. Pooled sensitivity and specificity estimates were calculated for the Psoriatic Arthritis Screening and Evaluation (cut-off = 44), Psoriatic Arthritis Screening and Evaluation (47), Toronto Psoriatic Arthritis Screening (8), Psoriasis Epidemiology Screening Tool (3) and Early Psoriatic Arthritis Screening Questionnaire (3). The Early Psoriatic Arthritis Screening Questionnaire reported the highest sensitivity and specificity (0.85 each). The I2 for the diagnostic odds ratios varied between 76 and 90.1%. Meta-regressions were conducted, in which the age, risk of bias for patient selection and the screening tool accounted for some of the observed heterogeneity. Conclusions Questionnaire-based tools have moderate accuracy to identify PsA among psoriasis patients. The Early Psoriatic Arthritis Screening Questionnaire appears to have slightly better accuracy compared with the Toronto Psoriatic Arthritis Screening, Psoriasis Epidemiology Screening Tool and Psoriatic Arthritis Screening and Evaluation. An economic evaluation could model the uncertainty and estimate the cost-effectiveness of PsA screening programs that use different tools.

scholarly journals Deep learning for pulmonary embolism detection on computed tomography pulmonary angiogram: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shelly Soffer ◽  
Eyal Klang ◽  
Orit Shimon ◽  
Yiftach Barash ◽  
Noa Cahan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Embolism ◽  
Deep Learning ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Future Research ◽  
Learning Models ◽  
Summary Receiver Operating Characteristic ◽  
Pulmonary Angiogram

AbstractComputed tomographic pulmonary angiography (CTPA) is the gold standard for pulmonary embolism (PE) diagnosis. However, this diagnosis is susceptible to misdiagnosis. In this study, we aimed to perform a systematic review of current literature applying deep learning for the diagnosis of PE on CTPA. MEDLINE/PUBMED were searched for studies that reported on the accuracy of deep learning algorithms for PE on CTPA. The risk of bias was evaluated using the QUADAS-2 tool. Pooled sensitivity and specificity were calculated. Summary receiver operating characteristic curves were plotted. Seven studies met our inclusion criteria. A total of 36,847 CTPA studies were analyzed. All studies were retrospective. Five studies provided enough data to calculate summary estimates. The pooled sensitivity and specificity for PE detection were 0.88 (95% CI 0.803–0.927) and 0.86 (95% CI 0.756–0.924), respectively. Most studies had a high risk of bias. Our study suggests that deep learning models can detect PE on CTPA with satisfactory sensitivity and an acceptable number of false positive cases. Yet, these are only preliminary retrospective works, indicating the need for future research to determine the clinical impact of automated PE detection on patient care. Deep learning models are gradually being implemented in hospital systems, and it is important to understand the strengths and limitations of these algorithms.

scholarly journals Genetic Association Studies of Red Blood Cell Transfusion Related Alloimmunization: A Systematic Review and Meta-Analysis

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2459-2459
Author(s):  
Jorn Gerritsma ◽  
Ilja Oomen ◽  
Sanne Meinderts ◽  
C. Ellen van der Schoot ◽  
Bart J. Biemond ◽  
...  
Keyword(s):  
Systematic Review ◽  
Genetic Variants ◽  
Screening Tool ◽  
Association Studies ◽  
Data Extraction ◽  
Meta Analysis ◽  
Genetic Association Studies ◽  
Risk Of Bias ◽  
Cell Disease

Introduction: Blood transfusions are an important treatment modality for patients with either acute or chronic onset anemia such as trauma, sickle cell disease, and hematological malignancies. Transfusion poses a risk for alloimmunization, which may lead to potentially lethal transfusion reactions. A promising strategy to prevent alloimmunization is extensive matching on blood groups, yet this is a costly procedure and should be reserved for patients at highest risk for alloimmunization. Identification of genetic variants that increase the risk for alloimmunization might help to identify high-risk patients and could be used as a screening tool for patients receiving multiple transfusions. Objectives: To summarize all available evidence on genetic risk factors for alloimmunization after blood transfusion. Design: Systematic review with meta-analysis of observational studies. Studies were only included in the meta-analysis if polymorphisms were tested at least 3 times, and if ethnic background of the population and the control populations were comparable between studies. Data sources: The online databases Embase, MEDLINE and the Cochrane Library were search for relevant articles with search terms: 1) transfusion, 2) alloimmunization 3) genetics. The search was last updated March 2018. Eligibility criteria: 1) Primary study that assessed the association of genetic polymorphisms with transfusion related alloimmunization, 2) a human population, 3) studies with at least 50 patients, 4) full text availability. Data extraction: Two reviewers independently screened articles for eligibility, extracted data using a standardized data extraction form. Extracted data included study setting, study population, participant demographics, baseline characteristics, study methodology, comparisons and outcome, and risk of bias. Primary outcome measure: Alloimmunization after one or more blood transfusions. Risk of bias assessment: The quality of the included studies was assessed by the Q-genie tool for genetic association studies. Results: A total of 2045 cases and 24084 controls were derived from 18 genetic case-control studies that were included in this systematic review. Most commonly studied disease group was sickle cell disease (SCD) (8 studies). Three studies included patients with different diseases and seven studies did not report the underlying disease. Eleven studies identified the association of HLA polymorphisms with alloimmunization and 8 studies focused on non-HLA variants. Overall quality of the included studies was moderate (11 studies), 2 studies were of high quality, and 5 studies were ranked as poor. HLA-DRB1*04 (Odds Ratio 7.16, 95%CI 3.87-13.22, P<0.00001) and HLA-DRB1*15 (OR 3.01, 95%CI 1.84-5.53, P<0.0001) were by meta-analysis significantly associated with anti-Fy(a) formation, although there was considerable heterogeneity (I2=78% and 55% respectively). Moreover, HLA-DRB1*10 (OR 2.64, 95%CI 1.41-4.95, P=0.002), HLA*DRB1*11 (OR 2.11, 95%CI 1.34-3.32, P=0.001), and HLA-DRB1*13 (OR 1.71, 95%CI 1.26-2.33, P=0.0006) were overall associated with anti-Kell formation. Heterogeneity was less prominent with an I2 of 0%, 54% and 19% respectively (Figure 1). No other variants were eligible for meta-analysis. Non-HLA variants were tested less extensively, as most variants were reported by only 1 study. Polymorphisms of genes in the immunomodulatory pathways were assessed most frequently. Of these variants, FC-gamma-receptor 2C.nc-ORF was associated with a decreased risk of alloimmunization in SCD (OR 0.26, 95%CI 0.11-0.64, p=0.003). All other associations that were described as significant by the original articles were summarized in Figure 2. Discussion: There is limited evidence supporting the role of genetic risk factors for alloimmunization. The results of our meta-analysis suggest that several HLA polymorphisms potentially influence antigen presentation of the Duffy(a) and Kell antigen. Once confirmed by experimental studies, these polymorphisms could be used as a screening tool for the prevention of alloimmunization among frequently transfused patients. Overall, the effect of genetic variants on alloimmunization has mostly been assessed by small studies, hampering reliable interpretation of the results. Future studies should include large and well-defined cohorts when performing genetic analysis on this complicated subject. Disclosures No relevant conflicts of interest to declare.

scholarly journals Rapid diagnostic test for antenatal syphilis screening in low-income and middle-income countries: a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018132 ◽  
Author(s):  
Carmen Phang Romero Casas ◽  
Marrissa Martyn-St James ◽  
Jean Hamilton ◽  
Daniel S Marinho ◽  
Rodolfo Castro ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Diagnostic Accuracy ◽  
Pregnant Women ◽  
Sensitivity And Specificity ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Antenatal Clinics

ObjectivesTo undertake a systematic review and meta-analysis to evaluate the test performance including sensitivity and specificity of rapid immunochromatographic syphilis (ICS) point-of-care (POC) tests at antenatal clinics compared with reference standard tests (non-treponemal (TP) and TP tests) for active syphilis in pregnant women.MethodsFive electronic databases were searched (PubMed, EMBASE, CRD, Cochrane Library and LILACS) to March 2016 for diagnostic accuracy studies of ICS test and standard reference tests for syphilis in pregnant women. Methodological quality was assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). A bivariate meta-analysis was undertaken to generate pooled estimates of diagnostic parameters. Results were presented using a coupled forest plot of sensitivity and specificity and a scatter plot.ResultsThe methodological quality of the five included studies with regards to risk of bias and applicability concern judgements was either low or unclear. One study was judged as high risk of bias for patient selection due to exclusion of pregnant women with a previous history of syphilis, and one study was judged at high risk of bias for study flow and timing as not all patients were included in the analysis. Five studies contributed to the meta-analysis, providing a pooled sensitivity and specificity for ICS of 0.85 (95% CrI: 0.73 to 0.92) and 0.98 (95% CrI: 0.95 to 0.99), respectively.ConclusionsThis review and meta-analysis observed that rapid ICS POC tests have a high sensitivity and specificity when performed in pregnant women at antenatal clinics. However, the methodological quality of the existing evidence base should be taken into consideration when interpreting these results.PROSPERO registration numberCRD42016036335.

scholarly journals Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis

BMJ ◽  
2020 ◽  
pp. m2516 ◽  
Author(s):  
Mayara Lisboa Bastos ◽  
Gamuchirai Tavaziva ◽  
Syed Kunal Abidi ◽  
Jonathon R Campbell ◽  
Louis-Patrick Haraoui ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Symptom Onset ◽  
Serological Test ◽  
Point Of Care ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Serological Tests ◽  
Immunoglobulin Class

AbstractObjectiveTo determine the diagnostic accuracy of serological tests for coronavirus disease-2019 (covid-19).DesignSystematic review and meta-analysis.Data sourcesMedline, bioRxiv, and medRxiv from 1 January to 30 April 2020, using subject headings or subheadings combined with text words for the concepts of covid-19 and serological tests for covid-19.Eligibility criteria and data analysisEligible studies measured sensitivity or specificity, or both of a covid-19 serological test compared with a reference standard of viral culture or reverse transcriptase polymerase chain reaction. Studies were excluded with fewer than five participants or samples. Risk of bias was assessed using quality assessment of diagnostic accuracy studies 2 (QUADAS-2). Pooled sensitivity and specificity were estimated using random effects bivariate meta-analyses.Main outcome measuresThe primary outcome was overall sensitivity and specificity, stratified by method of serological testing (enzyme linked immunosorbent assays (ELISAs), lateral flow immunoassays (LFIAs), or chemiluminescent immunoassays (CLIAs)) and immunoglobulin class (IgG, IgM, or both). Secondary outcomes were stratum specific sensitivity and specificity within subgroups defined by study or participant characteristics, including time since symptom onset.Results5016 references were identified and 40 studies included. 49 risk of bias assessments were carried out (one for each population and method evaluated). High risk of patient selection bias was found in 98% (48/49) of assessments and high or unclear risk of bias from performance or interpretation of the serological test in 73% (36/49). Only 10% (4/40) of studies included outpatients. Only two studies evaluated tests at the point of care. For each method of testing, pooled sensitivity and specificity were not associated with the immunoglobulin class measured. The pooled sensitivity of ELISAs measuring IgG or IgM was 84.3% (95% confidence interval 75.6% to 90.9%), of LFIAs was 66.0% (49.3% to 79.3%), and of CLIAs was 97.8% (46.2% to 100%). In all analyses, pooled sensitivity was lower for LFIAs, the potential point-of-care method. Pooled specificities ranged from 96.6% to 99.7%. Of the samples used for estimating specificity, 83% (10 465/12 547) were from populations tested before the epidemic or not suspected of having covid-19. Among LFIAs, pooled sensitivity of commercial kits (65.0%, 49.0% to 78.2%) was lower than that of non-commercial tests (88.2%, 83.6% to 91.3%). Heterogeneity was seen in all analyses. Sensitivity was higher at least three weeks after symptom onset (ranging from 69.9% to 98.9%) compared with within the first week (from 13.4% to 50.3%).ConclusionHigher quality clinical studies assessing the diagnostic accuracy of serological tests for covid-19 are urgently needed. Currently, available evidence does not support the continued use of existing point-of-care serological tests.Study registrationPROSPERO CRD42020179452.

scholarly journals Diagnostic Accuracy of Confocal Laser Endomicroscopy for the Diagnosis of Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (23) ◽  
pp. 12390
Author(s):  
Sneha Sethi ◽  
Xiangqun Ju ◽  
Richard M. Logan ◽  
Paul Sambrook ◽  
Robert A. McLaughlin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Squamous Cell Carcinoma ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Risk Of Bias ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Likelihood Ratios

Background: Advances in treatment approaches for patients with oral squamous cell carcinoma (OSCC) have been unsuccessful in preventing frequent recurrences and distant metastases, leading to a poor prognosis. Early detection and prevention enable an improved 5-year survival and better prognosis. Confocal Laser Endomicroscopy (CLE) is a non-invasive imaging instrument that could enable an earlier diagnosis and possibly help in reducing unnecessary invasive surgical procedures. Objective: To present an up to date systematic review and meta-analysis assessing the diagnostic accuracy of CLE in diagnosing OSCC. Materials and Methods. PubMed, Scopus, and Web of Science databases were explored up to 30 June 2021, to collect articles concerning the diagnosis of OSCC through CLE. Screening: data extraction and appraisal was done by two reviewers. The quality of the methodology followed by the studies included in this review was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A random effects model was used for the meta-analysis. Results: Six studies were included, leading to a total number of 361 lesions in 213 patients. The pooled sensitivity and specificity were 95% (95% CI, 92–97%; I2 = 77.5%) and 93% (95% CI, 90–95%; I2 = 68.6%); the pooled positive likelihood ratios and negative likelihood ratios were 10.85 (95% CI, 5.4–21.7; I2 = 55.9%) and 0.08 (95% CI, 0.03–0.2; I2 = 83.5%); and the pooled diagnostic odds ratio was 174.45 (95% CI, 34.51–881.69; I2 = 73.6%). Although risk of bias and heterogeneity is observed, this study validates that CLE may have a noteworthy clinical influence on the diagnosis of OSCC, through its high sensitivity and specificity. Conclusions: This review indicates an exceptionally high sensitivity and specificity of CLE for diagnosing OSCC. Whilst it is a promising diagnostic instrument, the limited number of existing studies and potential risk of bias of included studies does not allow us to draw firm conclusions. A conclusive inference can be drawn when more studies, possibly with homogeneous methodological approach, are performed.

scholarly journals OP0305 VALIDATION OF THE PSORIASIS EPIDEMIOLOGY SCREENING TOOL (PEST) AND THE NEW EARLY ARTHRITIS FOR PSORIATIC PATIENTS (EARP) IN PEDIATRIC POPULATION - PILOT STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 187.2-187
Author(s):  
Y. Butbul
Keyword(s):  
Psoriatic Arthritis ◽  
Sensitivity And Specificity ◽  
Pediatric Patients ◽  
Screening Tool ◽  
Pediatric Population ◽  
Joint Damage ◽  
High Sensitivity ◽  
Early Arthritis ◽  
Screening Tools ◽  
Questionnaire Score

Background:Juvenile Psoriatic Arthritis (JPsA) is an inflammatory arthritis associated with irreversible joint damage among the pediatric population, which is associated with psoriasis in most cases.While there are few validated screening tools for diagnosis of arthritis for adult patients with psoriasis, those screening tools were never evaluated in children.Objectives:The aims of this study were to evaluate two screening tools among pediatric patients with psoriasis.Methods:Thirty-nine patients with the diagnosis of psoriasis were administered two screening questionnaires: the new Early Arthritis for Psoriatic Patients (EARP) questionnaire and the Psoriatic Arthritis Screening and Evaluation (PASE) questionnaire.All patients were evaluated by a rheumatologist for the diagnosis of JPsA, and the accuracy of the two questionnaires compared.Results:The 4/39 (10.1%) patients diagnosed with JPsA had a PEST questionnaire score of ≥ 3, compared to a median PEST score of the patients without the diagnosis of JPsA of 0 (0-2). Thus both the sensitivity and specificity of the PEST in diagnosing JPsA were 100%.For the EARP questionnaire, 8/39 patients had a screening questionnaire score of ≥ 3, suggestive of JPsA, four were true positive, and four false positive. Thus, the sensitivity and specificity of EARP in diagnosing JPsA were 100% and 89%, respectively.Conclusion:Both the PEST and EARP questionnaires were easy to use and had high sensitivity for pediatric population with psoriasis, however the PEST questionnaire had a higher specificity than the EARP.Disclosure of Interests:None declared.

scholarly journals Bleeding Assessment Tools in the Diagnosis of von Willebrand Disease: Systematic Review & Meta-Analysis of Test Accuracy

2021 ◽  
Author(s):  
Mohamad A. Kalot ◽  
Nedaa Husainat ◽  
Sammy Tayiem ◽  
Abdallah El Alayli ◽  
Ahmad Bilal Dimassi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Pediatric Patients ◽  
Screening Tool ◽  
Reference Lists ◽  
Meta Analysis ◽  
Von Willebrand Disease ◽  
Assessment Tools ◽  
Test Accuracy ◽  
Von Willebrand

Background: Von Willebrand Disease (VWD) can be associated with significant morbidity. Patients with VWD can experience bruising, mucocutaneous bleeding, and bleeding after dental and surgical procedures. Early diagnosis and treatment are important to minimize the risk of these complications. Several bleeding assessment tools (BATs) have been used to quantify bleeding symptoms as a screening tool for VWD. Objective: We systematically reviewed diagnostic test accuracy results of bleeding assessment tools (BATs) to screen patients for VWD. Methods: We searched Cochrane Central, MEDLINE, and EMBASE for eligible studies, reference lists of relevant reviews, registered trials, and relevant conference proceedings. Two investigators screened and abstracted data. Risk of bias was assessed using QUADAS-2 and certainty of evidence using the GRADE framework. We pooled estimates of sensitivity and specificity. Results: The review included 7 cohort studies that evaluated the use of BATs to screen adult and pediatric patients for VWD. The pooled estimates for sensitivity and specificity were 75% (95% confidence interval [CI] 66%-83%) and 54% (29%-77%), respectively. Certainty of evidence varied from moderate to high. Conclusion: This systematic review provides accuracy estimates for validated BATs as a screening modality for VWD. A BAT is a useful initial screening test to determine who needs specific blood testing. The pretest probability of VWD (often determined by the clinical setting/patient population), along with sensitivity and specificity estimates will influence patient management.

FRI0573 VALIDATION OF FOUR SCREENING TOOLS FOR PSORIATIC ARTHRITIS IN CHINESE PATIENTS WITH PSORIASIS: A MULTICENTER STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 889.1-889
Author(s):  
R. Cui ◽  
M. Chen ◽  
X. LI ◽  
X. L. Bi ◽  
Y. Ding ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
American Academy ◽  
Multicenter Study ◽  
Screening Tool ◽  
Screening Tools ◽  
Chinese Patients ◽  
Fast Method ◽  
Newly Diagnosed ◽  
Screening Questionnaire ◽  
New Instrument

Background:Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy affecting 6~30% of patients with skin or nail psoriasis. If PsA is not identified early and managed appropriately, progressive joint damage with deformities and disability may occur. Preliminary efforts to develop screening tools for the identification of PsA have met with variable success. Whether the tools function well or not in Chinese patients remains unknown.Objectives:We aimed to validate and compare the performance of 4 PsA screening tools in Chinese psoriasis patients.Methods:Consecutive psoriasis patients (dermatology cohort) attending dermatology clinics without previous diagnosis of inflammatory arthritis and consecutive newly diagnosed PsA patients (rheumatology cohort) attending rheumatology clinics were invited to complete the questionnaires: early arthritis for psoriatic patients (EARP), psoriatic arthritis screening and evaluation(PASE), psoriasis and arthritis screening questionnaire(PASQ), and psoriasis epidemiology screening tool (PEST). Receiver operating characteristic (ROC) curves were utilized to calculate diagnostic accuracy, least absolute shrinkage and selection operator(lasso) and binary logistic regressions to identify the most discriminative questions.Results:In this multicenter study, 379 patients in the dermatology cohort and 72 in the rheumatology cohort were recruited. In the dermatology cohort, 7.9% (30/379) were newly diagnosed with PsA. The EARP and PASQ tools demonstrated better discriminating ability for identifying PsA from psoriasis patients (yielded sensitivities/specificities were: 93.3%/92.3% and 90.0%/90.5%, while optimal cut-off values were: 3 and 5, respectively), and the good performance of EARP and PASQ was further confirmed in the rheumatology cohort. However, all these tools demonstrated low sensitivities (about 30%) with regard to screening the axial PsA. Based on the questions, a risk prediction model of PsA was established.Conclusion:The prevalence rate of undiagnosed PsA in the patients with psoriasis is 7.9%. Both EARP and PASQ tools show better favorable trade-off between sensitivity and specificity than PASE and PEST, while all the 4 tools are not sensitive to identify axial PsA.References:[1] Villani AP, Rouzaud M, Sevrain M, et al. Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: Systematic review and meta-analysis.Journal of the American Academy of Dermatology2015;73(2): 242-8.[2] Tinazzi I, Adami S, Zanolin EM, et al. The early psoriatic arthritis screening questionnaire: a simple and fast method for the identification of arthritis in patients with psoriasis.Rheumatology (Oxford, England) 2012;51(11): 2058-63.[3] Majed Khraishi IL, Gerry Mugford. The Self-Administered Psoriasis and Arthritis Screening Questionnaire (PASQ): A Sensitive and Specific Tool for the Diagnosis of Early and Established Psoriatic Arthritis.Psoriasis Forum2010;16(2): 9-16.[4] Husni ME, Meyer KH, Cohen DS, Mody E, Qureshi AA. The PASE questionnaire: pilot-testing a psoriatic arthritis screening and evaluation tool.Journal of the American Academy of Dermatology2007;57(4): 581-7.[5] Ibrahim GH, Buch MH, Lawson C, Waxman R, Helliwell PS. Evaluation of an existing screening tool for psoriatic arthritis in people with psoriasis and the development of a new instrument: the Psoriasis Epidemiology Screening Tool (PEST) questionnaire.Clinical and experimental rheumatology2009;27(3): 469-74.Acknowledgments:This project was supported by grants from National Natural Science Foundation of China (81771746 and 81471604).Disclosure of Interests:None declared

scholarly journals A Systematic Review of Validated Screening Tools for Anxiety Disorders and PTSD in Low to Middle Income Countries

2020 ◽  
Author(s):  
Anisa Mughal ◽  
Jackson Devadas ◽  
Eric Ardman ◽  
Brooke Levis ◽  
Vivian F Go ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anxiety Disorders ◽  
Screening Tool ◽  
Meta Analysis ◽  
Screening Tools ◽  
Clinical Population ◽  
Post Traumatic Stress ◽  
Middle Income ◽  
Middle Income Countries ◽  
Life Years

Abstract Background: Anxiety and post-traumatic stress disorder (PTSD) contribute significantly to disability adjusted life years in low- to middle-income countries (LMICs). Screening has been proposed to improve identification and management of these disorders, but little is known about the validity of screening tools for these disorders. We conducted a systematic review of validated screening tools for detecting anxiety and PTSD in LMICs. Methods: MEDLINE, EMBASE, Global Health and PsychINFO were searched (inception-January 10, 2019). Eligible studies (1) screened for anxiety disorders and/or PTSD; (2) reported sensitivity and specificity for a given cut-off value; (3) were conducted in LMICs; and (4) compared screening results to diagnostic classifications based on a reference standard. Screening tool, cut-off, disorder, region, country, and clinical population were extracted for each included study. We assed quality using a modified version of Greenhalgh’s ten item checklist. Accuracy results were organized based on screening tool, cut-off, and specific disorder. Accuracy estimates for the same cut-off for the same screening tool and disorder were combined via meta-analysis.ResultsOf 5343 unique citations identified, 57 articles including 75 screening tools were included. There were 44, 20 and 11 validations for anxiety, PTSD, and combined depression and anxiety, respectively. Continentally, Asia had the most validations (34). Regionally, South Asia (10) had the most validations, followed by West Asia (9) and South Africa (9). The Kessler-10 (7) and the Generalized Anxiety Disorder-7 item scale (GAD-7) (6) were the most commonly validated tools for anxiety disorders, while the Harvard Trauma Questionnaire (3) and Posttraumatic Diagnostic Scale (3) were the most commonly validated tools for PTSD. Most studies (27) had the lowest quality rating (unblinded) followed by good (21). Due to incomplete reporting, we combined only two sets of accuracy values in meta-analysis (GAD-7 cut-off ≥10; sensitivity: 76%, specificity: 64%).ConclusionUse of brief screening instruments can bring much needed attention and research opportunities to various at-risk LMIC populations, yet many have been validated in inadequately designed studies. Locally validated screening tools for anxiety and PTSD need further evaluation and well-designed studies, including clinical trials, to determine whether their use can reduce the burden of disease. PROSPERO registry number: CRD42019121794

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