scholarly journals Universal language development screening: comparative performance of two questionnaires

2022 ◽  
Vol 6 (1) ◽  
pp. e001324
Author(s):  
Philip Wilson ◽  
Robert Rush ◽  
Jenna Charlton ◽  
Vicky Gilroy ◽  
Cristina McKean ◽  
...  

Background and objectiveLow language ability in early childhood is a strong predictor of later psychopathology as well as reduced school readiness, lower educational attainment, employment problems and involvement with the criminal justice system. Assessment of early language development is universally offered in many countries, but there has been little evaluation of assessment tools. We planned to compare the screening performance of two commonly used language assessment instruments.MethodsA pragmatic diagnostic accuracy study was carried out in five areas of England comparing the performance of two screening tools (Ages and Stages Questionnaire (ASQ) and Sure Start Language Measure (SSLM)) against a reference test (Preschool Language Scale, 5th edition).ResultsResults were available for 357 children aged 23–30 months. The ASQ Communication Scale using optimal cut-off values had a sensitivity of 0.55, a specificity of 0.95 and positive and negative predictive values of 0.53 and 0.95, respectively. The SSLM had corresponding values of 0.83, 0.81, 0.33 and 0.98, respectively. Both screening tools performed relatively poorly in families not using English exclusively in the home.ConclusionThe very widely used ASQ Communication Scale performs poorly as a language screening tool, missing over one-third of cases of low language ability. The SSLM performed better as a screening tool.

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025444 ◽  
Author(s):  
Petra Klanjsek ◽  
Majda Pajnkihar ◽  
Natasa Marcun Varda ◽  
Petra Povalej Brzan

ObjectiveThe aim of the present study was to identify all currently available screening and assessment tools for detection of malnutrition in hospitalised children, and to identify the most useful tools on the basis of published validation studies.DesignSystematic review.Data sourcesPubMed, CINAHL and MEDLINE were searched up to October 2017.Eligibility criteria for selecting studiesStudies in English that reported sensitivity, specificity and positive/negative predictive values (PPVs/NPVs) in the paediatric population were eligible for inclusion.Data extraction and synthesisTwo authors independently screened all of the studies identified, and extracted the data. The methodological qualities of the studies included were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.ResultsThe 26 validation studies that met the inclusion criteria for this systematic review used eight screening and three assessment tools. The number of participants varied from 32 to 14 477. There was considerable variability in the chosen reference standards, which prevented direct comparisons of the predictive performances of the tools. Anthropometric measurements were used as reference standards in 16 of the identified studies, and full nutritional assessment in 5. The Pediatric Yorkhill Malnutrition Score (PYMS) screening tool performed better than Screening Tool for the Assessment of Malnutrition and Screening Tool for Risk On Nutritional status and Growth when compared in terms of anthropometric measurements, especially for body mass index (Se=90.9, Sp=81.9) and triceps skinfold thickness (Se=80.0, Sp=75.0). However, low PPVs indicated the problem of overprediction of positive cases, which was typical for all of the studies that used anthropometric measurements as the reference standard.ConclusionsThis systematic review identifies the need for definition of the gold standard for validation of screening tools. Anthropometry measurements using WHO or Centers for Disease Control and Prevention growth charts should be considered as the possible reference standard in future validation studies. We would recommend the use of PYMS for hospitalised paediatric patients without chronic conditions, in combination with full nutritional assessment.PROSPERO registration numberCRD42017077477.


2016 ◽  
Vol 101 (12) ◽  
pp. 1119-1124 ◽  
Author(s):  
P C Thomas ◽  
L V Marino ◽  
S A Williams ◽  
R M Beattie

IntroductionMultiple nutritional risk assessment tools are available, but there are limited data on their application in the acute setting. We explored the validity of two tools in a tertiary Children's Hospital's acute unit and the cohort's nutritional status using WHO definitions.MethodsProspective study n=300 (median 38 months; 44.6% female; 25.7% ≤12 months). Participants had standard anthropometry measured, all were screened using the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), the Paediatric Malnutrition Screening Tool (PMST) (modified STAMP) and 125 were additionally screened using the Paediatric Yorkhill Malnutrition Screening (PYMS) tool.ResultsThe percentages with medium/high nutritional risk were as follows: STAMP 73.1%, PMST 79.3% and PYMS 30%. Height/weight were normally distributed with: 3.4% stunted (height-for-age z-score <−2); aged ≤ 5 years, 6.8% wasted (weight-for-height z-score (WHZ) <−2), 17.9% overweight (WHZ 1–2) and 6.2% obese (WHZ >2); aged >5 years, 5.8% thin (body mass index (BMI)-z-score (BAZ) <−2), 17.3% overweight (BAZ 1–2) and 5.8% obese (BAZ >2). The tools showed poor specificity and variable sensitivities when compared with WHO malnutrition criteria, with positive predictive values of <50%. κ-Analysis also showed poor agreement between the tools and the WHO cut-offs.ConclusionThese results suggest that nutritional screening tools have poor sensitivity and are difficult to interpret in the acute setting. It may be more effective to include the assessment of weight and height and nutritional intake in the context of the acute presentation as part of routine clinical assessment rather than relying on screening tools to identify those at risk.


CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 181-183
Author(s):  
Michael E. Thase ◽  
Stephen M. Stahl ◽  
Roger S. McIntyre ◽  
Tina Matthews-Hayes ◽  
Mehul Patel ◽  
...  

AbstractIntroductionAlthough mania is the hallmark symptom of bipolar I disorder (BD-I), most patients initially present for treatment with depressive symptoms. Misdiagnosis of BD-I as major depressive disorder (MDD) is common, potentially resulting in poor outcomes and inappropriate antidepressant monotherapy treatment. Screening patients with depressive symptoms is a practical strategy to help healthcare providers (HCPs) identify when additional assessment for BD-I is warranted. The new 6-item Rapid Mood Screener (RMS) is a pragmatic patient-reported BD-I screening tool that relies on easily understood terminology to screen for manic symptoms and other BD-I features in <2 minutes. The RMS was validated in an observational study in patients with clinically confirmed BD-I (n=67) or MDD (n=72). When 4 or more items were endorsed (“yes”), the sensitivity of the RMS for identifying patients with BP-I was 0.88 and specificity was 0.80; positive and negative predictive values were 0.80 and 0.88, respectively. To more thoroughly understand screening tool use among HCPs, a 10-minute survey was conducted.MethodsA nationwide sample of HCPs (N=200) was selected using multiple HCP panels; HCPs were asked to describe their opinions/current use of screening tools, assess the RMS, and evaluate the RMS versus the widely recognized Mood Disorder Questionnaire (MDQ). Results were reported by grouped specialties (primary care physicians, general nurse practitioners [NPs]/physician assistants [PAs], psychiatrists, and psychiatric NPs/PAs). Included HCPs were in practice <30 years, spent at least 75% of their time in clinical practice, saw at least 10 patients with depression per month, and diagnosed MDD or BD in at least 1 patient per month. Findings were reported using descriptive statistics; statistical significance was reported at the 95% confidence interval.ResultsAmong HCPs, 82% used a tool to screen for MDD, while 32% used a tool for BD. Screening tool attributes considered to be of the greatest value included sensitivity (68%), easy to answer questions (66%), specificity (65%), confidence in results (64%), and practicality (62%). Of HCPs familiar with screening tools, 70% thought the RMS was at least somewhat better than other screening tools. Most HCPs were aware of the MDQ (85%), but only 29% reported current use. Most HCPs (81%) preferred the RMS to the MDQ, and the RMS significantly outperformed the MDQ across valued attributes; 76% reported that they were likely to use the RMS to screen new patients with depressive symptoms. A total of 84% said the RMS would have a positive impact on their practice, with 46% saying they would screen more patients for bipolar disorder.DiscussionThe RMS was viewed positively by HCPs who participated in a brief survey. A large percentage of respondents preferred the RMS over the MDQ and indicated that they would use it in their practice. Collectively, responses indicated that the RMS is likely to have a positive impact on screening behavior.FundingAbbVie Inc.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Rachel Deer ◽  
Mackenzie McCall ◽  
Elena Volpi

Abstract Objectives Malnutrition is a common problem in geriatric patients that often goes unrecognized. Undernutrition is a primary health concern for older adults due to associations with increased mortality, complications, and length of hospital stay. Yet, there is no consensus on which malnutrition screening tool should be used for hospitalized older adults. Therefore, the objective of this study was to determine which screening tool is best to rapidly detect malnutrition in hospitalized older adults so that patient outcomes may be improved. Methods Older adult patients (n = 211; ≥65 yrs old) were enrolled during acute hospitalization. Testing occurring within 72 hours of admission and included the following screening tools included: Malnutrition Screening Tool (MST), Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening 2002 (NRS-2002), and Geriatric Nutritional Risk Index (GNRI). These screening tools were compared to a malnutrition diagnostic tool, the Subjective Global Assessment (SGA). Results According to SGA, 49% of patients were at risk of being malnourished. The other screening tools indicated a wide range of malnutrition prevalence, from 18% (MST) to 76% (MNA-SF). MST (93%) and MUST (92%) were highest in sensitivity. NRS-2002 had moderately good sensitivity (71%). MNA-SF and GNRI had poor sensitivity, eliminating them as good screening tools for hospitalized elderly patients. Of the remaining tools, NRS-2002 had the highest specificity (77%). MST and MUST had poor specificity (31%, 39%, respectively), eliminating them as good screening tools for hospitalized elderly patients. The remaining screening tool, NRS-2002, had moderately good positive and negative predictive values (76%, 72%, respectively). It also had the highest kappa (0.479). Overall, NRS-2002 had the best agreement to SGA and showed moderately good sensitivity, specificity and predictive values. Conclusions Our data suggests NRS-2002 is the best malnutrition screening tool for rapid detection of malnutrition in elderly hospitalized patients, when compared to the diagnostic tool, SGA. Future research is needed to determine which screening tool is most effective for use in different settings. Additional research can assist in standardizing malnutrition criteria and care processes. Funding Sources National Dairy Council, National Institutes of Health-National Center for Advancing Translational Sciences, and UTMB Claude D. Pepper OAIC. Supporting Tables, Images and/or Graphs


2017 ◽  
Vol 35 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Kristie J Harper ◽  
Annette D Barton ◽  
Glenn Arendts ◽  
Deborah G Edwards ◽  
Antonio C Petta ◽  
...  

ObjectiveTo compare the Falls Risk for Older Persons—Community Setting Screening Tool (FROP Com Screen) with the Two-Item Screening Tool in older adults presenting to the ED.MethodsA prospective cohort study, comparing the efficacy of the two falls risk assessment tools by applying them simultaneously in a sample of hospital ED presentations.ResultsTwo hundred and one patients over 65 years old were recruited. Thirty-six per cent reported falls in the 6-month follow-up period. The area under the receiver operating characteristic curve was 0.57 (95% CI 0.48 to 0.66) for the FROP Com Screen and 0.54 (95% CI 0.45 to 0.63) for the Two-Item Screening Tool. FROP Com Screen had a sensitivity of 39% (95% CI 0.27 to 0.51) and a specificity of 70% (95% CI 0.61 to 0.78), while the Two-Item Screening Tool had a sensitivity of 48% (95% CI 0.36 to 0.60) and a specificity of 57% (95% CI 0.47 to 0.66).ConclusionBoth tools have limited predictive ability in the ED setting.


2018 ◽  
Vol 26 (3) ◽  
pp. 281-284 ◽  
Author(s):  
Alison Bautovich ◽  
Ivor Katz ◽  
Colleen Ken Loo ◽  
Samuel B Harvey

Objectives: To evaluate the psychometric properties of the Beck Depression Inventory (BDI) and Cognitive Depression Index (CDI) as a potential screening tool for major depression in haemodialysis (HD) patients. Methods: Forty-five HD patients completed both the BDI/CDI and diagnostic interview. The interview was conducted by two experienced clinicians and was based on DSM-IV criteria. The sensitivity, specificity and positive (PPV) and negative (NPV) predictive values were then calculated. Results: A diagnosis of depression was found in 6 of the 45 participants (13.3%). Optimal cut-offs were ≥18 for the BDI (sensitivity 1.0, specificity 0.90, PPV 0.60, NPV 1.0) and ≥11 for the CDI (sensitivity 1.0, specificity 0.92, PPV 0.67, NPV 1.0). Conclusions: Both the BDI and CDI were shown to be acceptable screening tools for depression in this population of chronic HD patients. The recommended cut-off scores for both scales are higher than those suggested for the general population and slightly higher than previously found in the chronic kidney disease literature, suggesting that altered thresholds are required when using these screening tools amongst HD patients.


2016 ◽  
Vol 33 (S1) ◽  
pp. S423-S423
Author(s):  
K. Pękala ◽  
T. Sobow

IntroductionSelf-assessment tools are frequently used as screening tools for depression. However, they are usually long and time-consuming.Aim of the studyTo assess specificity, sensitivity and overall accuracy of a novel, very short, 5 questions tool.Subjects and methodsThe questionnaire consists of 3 phenomenological (based on main symptoms of depression) and 2 questions to assess functional impact of the symptoms. One hundred and ninety patients diagnosed clinically as having major depression (according to ICD-10 criteria and with the help of MINI tool) filled the questionnaire in twice, during episode and remission.ResultsAt least two (out of three possible) “yes” answers to phenomenological questions and both two “yes” functional answers yielded 100% specificity (no person in remission). At least one “yes” answer to phenomenological questions and both “yes” answers to functional question yielded 82.8% specificity, 83.7% sensitivity and 83,3% overall accuracy. These results varied insignificantly in subgroups with different depression severity.ConclusionA short, 5-question questionnaire may be used as a screening tool for depression. Specificity, sensitivity and overall accuracy are above 80% largely independently of depression severity.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Melissa M Meighan ◽  
Barbara A Schumacher Finnegan ◽  
Noelani C Warren ◽  
Jorge Lipiz ◽  
Mai N Nguyen-Huynh

Background: Dysphagia or difficulty swallowing occurs in up to 50% of patients with acute stroke symptoms. Dysphagia screening is considered standard stroke care. Few dysphagia screening tools have been well validated with high sensitivity and specificity. Purpose: The purpose was to validate our system’s dysphagia screening tool. Methods: From August 17, 2015 through September 30, 2015, bedside dysphagia screening was prospectively performed by 2 blinded nurses on all patients age ≥18 years admitted through the emergency department with stroke symptoms at 22 stroke centers in an integrated healthcare system. The tool consisted of three parts: history, physical exam and progressive testing from ice chips to water. A speech language pathologist blinded to the results performed an evaluation on the same patient. Patients with a feeding tube or intubation on arrival, treated with alteplase, or were discharged with a diagnosis other than stroke were excluded from final study analyses. The study quantified the reproducibility of the dysphagia screening tool by computing the percent agreement and kappa score for inter-rater reliability. Validity of dysphagia screening tool was determined using the speech pathologist evaluation as the reference standard. We assessed the sensitivity, specificity, and negative (NPV) and positive predictive values (PPV) for the dysphagia screening tool. The point estimate and 95% confidence interval (CI) were calculated. Results: Dysphagia screening was performed in 726 patients with stroke symptoms. There were 370 patients included in the analysis. Average age was 70 ± 14 years, and 48.2% female. Inter-rater reliability of the dysphagia screen was excellent between both raters at 93.5% agreement (k’= 0.83). The screen performed well when compared to speech language pathologist evaluation, demonstrating both high sensitivity (86.4%, CI: 73.3% to 93.6%) and high NPV (93.6%, CI: 86.8% to 97.0%). Conclusion: Our bedside dysphagia screening tool is highly reliable and valid. The tool had been used in over thirty-five facilities since 2007. The hospital acquired pneumonia rate for ischemic stroke patients has averaged 2-3% a year. This dysphagia screening tool requires minimal training and is easily administered in a timely manner.


2021 ◽  
Author(s):  
Yanfei Wang ◽  
Ziqi Liu ◽  
yunyi Wang ◽  
Xiaoyan Chen ◽  
Zhongfen Liu ◽  
...  

Abstract Background and Aims: The Global Leadership Initiative on Malnutrition (GLIM) criteria is a new framework for diagnosing malnutrition in combination of phenotypic and etiologic criteria after nutrition screening using validated screening tools. The aim of this study was to evaluate the efficacy of malnutrition screening tool (MST), malnutrition universal screening tool (MUST) and nutritional risk screening 2002 (NRS2002) as the first step of GLIM framework in comparison to Patients-Generated Subjective Global Assessment (PG-SGA) in Chinese ambulatory cancer patients.Methods: A single-center prospective cross-sectional study was conducted. Nutritional screening and assessment were performed within 4h after admission to the hospital using a structured questionnaire including MST, MUST, NRS2002, PG-SGA and GLIM, with supplement information of calf circumference (CC) measurement and body composition measurement using bioelectrical impedance analysis (BIA). Malnutrition diagnosis made by GLIM framework using MST, MUST or NRS2002 as the first step or without screening step were compared to PG-SGA separately. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and κ values were used to evaluate performance of the screening tools.Results: Of the 562 included patients, Of the participants 62.8% (355/562) were male and 37.2% (210/562) were female, with a male to female radio of 1.69:1. The median age of the patients was 59.0 years (range, 21-82y; interquels range 52.0-65.0y). From the 562 patients included in the study, 41.8% of patients were evaluated as malnutrition (PG-SGA≥4) and 11.9% were diagnosed as severe malnutrition (PG-SGA D). For GLIM criteria, omitting the screening step yielded fair accordance with PG-SGA in diagnosing malnutrition (κ=0.623) and severe malnutrition (κ=0.515). Using MUST as the first step of GLIM framework has better performance (κ=0.614; κ=0.515) than using MST (κ=0.504, κ=0.496) or NRS2002 (κ=0.363, κ=0.503) as the screening tool regardless of severity gradings.Conclusions: Using PG-SGA as the standard, GLIM framework omitting first step has better performance compared with using MST, MUST or NRS2002 as the screening tool. Among the screening tools validated to be used in the first step of GLIM framework, MUST may be the better choice for ambulatory cancer patients.


2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 106-107
Author(s):  
A N Sasson ◽  
L Targownik ◽  
K Vagianos ◽  
C N Bernstein

Abstract Background Inflammatory bowel disease (IBD) has a profound impact on psychosocial aspects of food and nutrition, thereby affecting food-related quality of life (QoL). While there is literature on associated prevalence of increased anxiety in individuals with IBD, there is limited data on its contribution to hypervigilance and orthorexia with food intake. Many patients with IBD have strong beliefs about dietary symptom triggers, which can lead to avoidance behaviors and decreased nutrient intake. This can exacerbate malnutrition and disordered eating, as well as increase disease-related stress and negatively impact coping. While there are validated scales evaluating anxiety-related, QoL-related and food-related behaviors in IBD, a combined screening tool to assess this comorbid axis is not well described. Aims To conduct a systematic review of existing literature in order to inform practice and facilitate development of an effective food-related hypervigilance and QoL evaluation in IBD patients Methods The literature was systematically searched through September 2019, using an electronic database querying Embase, PubMed, MEDLINE, Cochrane Library and PsycINFO. We searched original articles describing development, validation and measurement properties for screening tools on anxiety, QoL and food-related behaviors in IBD from 1975 to 2018. The primary outcome of interest was to evaluate the current measurements of the validated tools to identify whether a screening tool highlighting all above parameters exists for patients with IBD. Results Initial database search resulted in 5548 articles. After screening titles and abstracts, 168 were included. After full text review and deduplication, 23 validated scales were identified for use in IBD patients with respect to measuring anxiety, health-related QoL and food-related behaviors. There was substantial heterogeneity in IBD populations using the assessment tools (adult vs. pediatric, CD vs. UC, inpatient vs. outpatient). The breakdown of studies identified: 2 studies (8.6%) evaluated QoL and anxiety, 2 studies (8.6%) evaluated QoL and food-related behaviors. The remainder of studies individually assessed QoL, anxiety and food-related behaviors (47.8%, 26% and 8.6% respectively). None of the tools performed satisfactory to establish all three measurements in individuals with IBD. Conclusions Recent evidence suggests the presence of dietary hypervigilance in individuals with chronic GI conditions potentially leading to food restrictive behaviors impacting QoL. Screening models evaluating multivariable relations of anxiety in food-related behaviors and QoL in IBD is lacking. Efforts should be made to develop and validate a multi-assessment screening tool to aid in early identification of this prevalence in IBD patients to facilitate improved management outcomes. Funding Agencies None


Sign in / Sign up

Export Citation Format

Share Document