A depression screening tool finds that 54% of acute cardiac patients are at risk of depression; use of the tool improves documentation and referral

Abstract Background Depression in children presents a significant health burden to society and often co-exists with chronic illnesses, such as human immunodeficiency virus (HIV). Research has demonstrated that 10–37% of children and adolescents living with HIV also suffer from depression. Low-and-middle income countries (LMICs) shoulder a disproportionate burden of HIV among other health challenges, but reliable estimates of co-morbid depression are lacking in these settings. Prior studies in Rwanda, a LMIC of 12 million people in East Africa, found that 25% of children living with HIV met criteria for depression. Though depression may negatively affect adherence to HIV treatment among children and adolescents, most LMICs fail to routinely screen children for mental health problems due to a shortage of trained health care providers. While some screening tools exist, they can be costly to implement in resource-constrained settings and are often lacking a contextual appropriateness. Methods Relying on international guidelines for diagnosing depression, Rwandan health experts developed a freely available, open-access Child Depression Screening Tool (CDST). To validate this tool in Rwanda, a sample of 296 children with a known diagnosis of HIV between ages 7–14 years were recruited as study participants. In addition to completing the CDST, all participants were evaluated by a mental health professional using a structured clinical interview. The validity of the CDST was assessed in terms of sensitivity, specificity, and a receiver operating characteristic (ROC) curve. Results This analysis found that depression continues to be a co-morbid condition among children living with HIV in Rwanda. For identifying these at-risk children, the CDST had a sensitivity of 88.1% and specificity of 96.5% in identifying risk for depression among children living with HIV at a cutoff score of 6 points. This corresponded with an area under the ROC curve of 92.3%. Conclusions This study provides evidence that the CDST is a valid tool for screening depression among children affected by HIV in a resource-constrained setting. As an open-access and freely available tool in LMICs, the CDST can allow any health practitioner to identify children at risk of depression and refer them in a timely manner to more specialized mental health services. Future work can show if and how this tool has the potential to be useful in screening depression in children suffering from other chronic illnesses.

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Depression Scale-Short Form: Validation of a New 60 Second Depression Screening Tool for Cardiac Patients

Heart Lung and Circulation ◽

10.1016/j.hlc.2008.05.057 ◽

2008 ◽

Vol 17 ◽

pp. S24 ◽

Cited By ~ 6

Author(s):

William Shi ◽

Nibo Wu ◽

Andrew Stewart ◽

Deidre Toia ◽

David Hare

Keyword(s):

Screening Tool ◽

Short Form ◽

Depression Scale ◽

Cardiac Patients ◽

Depression Screening

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Smartphone as a disease screening tool: a systematic review (Preprint)

10.2196/preprints.24941 ◽

2020 ◽

Author(s):

Sasan Adibi ◽

Nilmini Wichramasinghe

Keyword(s):

Screening Tool ◽

Disease Screening ◽

Sleep Apnoea ◽

Depression Screening ◽

Eye Care ◽

Digital Version ◽

Paper Version ◽

Care Utilisation ◽

Patient Health ◽

Standard Paper

BACKGROUND Disease screening identifies a disease in an individual/community at an early stage to prevent or treat the condition effectively. The current COVID-19 pandemic has restricted hospital visits for screening and other healthcare services resulting in the disruption of screening for diseases such as cancer, diabetes and CVD. Smartphone technologies, coupled with built-in sensors and wireless technologies, enable the smartphone to function as a device for disease screening and monitoring with negligible additional costs. OBJECTIVE This review aimed to evaluate the use of smartphone applications (apps) in the disease screening and acceptability of this technology in the medical and healthcare sectors. METHODS We followed a systematic review process to assess the scope for the app in the disease screening process. Four databases (Medline complete, Web of Science, Embase, and Proquest) were searched. Articles published in English and examining the use of the app in disease screening were included. Primary outcomes for the research articles and their statistically significant Results showed that app-based screening group had significant (OR:1.7, 95% CI: 1.2–2.4) eye care utilisation compared to their traditional screening counterparts. A good correlation between clinical Snellen and smartphone visual acuity measurements (ρ=.91) is observed. For depression screening, the ROC curve is .8012, indicating that mental-health ratings are comparable to Patient Health Questionnaire-9 (PHQ-9) results, and could be used as a depression screening tool in practice. Although the findings of cognitive impairment suggest that the digital-version readings are similar to the standard paper-version readings, the participants preferred devices with larger screen (e.g. tablet). Also, the smartphone-compatible oximeter is a weak predictor to detect central sleep apnoea in stable heart failure participants. value, where applicable are presented and discussed. RESULTS Results showed that app-based screening group had significant (OR:1.7, 95% CI: 1.2–2.4) eye care utilisation compared to their traditional screening counterparts. A good correlation between clinical Snellen and smartphone visual acuity measurements (ρ=.91) is observed. For depression screening, the ROC curve is .8012, indicating that mental-health ratings are comparable to Patient Health Questionnaire-9 (PHQ-9) results, and could be used as a depression screening tool in practice. Although the findings of cognitive impairment suggest that the digital-version readings are similar to the standard paper-version readings, the participants preferred devices with larger screen (e.g. tablet). Also, the smartphone-compatible oximeter is a weak predictor to detect central sleep apnoea in stable heart failure participants. CONCLUSIONS The review observed a significant statistical relationship between the app and standard clinical screening. Critical considerations when designing, developing, and deploying smartphone solutions is laid forth to provide equitable healthcare solutions without barriers. Furthermore, the findings might increase the research prospects to evaluate smartphone solutions as valid and reliable screening solutions.

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The South African dysphagia screening tool (SADS): A screening tool for a developing context

South African Journal of Communication Disorders ◽

10.4102/sajcd.v63i1.117 ◽

2016 ◽

Vol 63 (1) ◽

Cited By ~ 2

Author(s):

Calli Ostrofsky ◽

Jaishika Seedat

Keyword(s):

At Risk ◽

Acute Stroke ◽

South African ◽

Screening Tool ◽

Diagnostic Assessment ◽

The South ◽

Stroke Patients ◽

Cohen’S Kappa ◽

Cohen's Kappa ◽

Government Hospitals

Background: Notwithstanding its value, there are challenges and limitations to implementing a dysphagia screening tool from a developed contexts in a developing context. The need for a reliable and valid screening tool for dysphagia that considers context, systemic rules and resources was identified to prevent further medical compromise, optimise dysphagia prognosis and ultimately hasten patients’ return to home or work.Methodology: To establish the validity and reliability of the South African dysphagia screening tool (SADS) for acute stroke patients accessing government hospital services. The study was a quantitative, non-experimental, correlational cross-sectional design with a retrospective component. Convenient sampling was used to recruit 18 speech-language therapists and 63 acute stroke patients from three South African government hospitals. The SADS consists of 20 test items and was administered by speech-language therapists. Screening was followed by a diagnostic dysphagia assessment. The administrator of the tool was not involved in completing the diagnostic assessment, to eliminate bias and prevent contamination of results from screener to diagnostic assessment. Sensitivity, validity and efficacy of the screening tool were evaluated against the results of the diagnostic dysphagia assessment. Cohen’s kappa measures determined inter-rater agreement between the results of the SADS and the diagnostic assessment.Results and conclusion: The SADS was proven to be valid and reliable. Cohen’s kappa indicated a high inter-rater reliability and showed high sensitivity and adequate specificity in detecting dysphagia amongst acute stroke patients who were at risk for dysphagia. The SADS was characterised by concurrent, content and face validity. As a first step in establishing contextual appropriateness, the SADS is a valid and reliable screening tool that is sensitive in identifying stroke patients at risk for dysphagia within government hospitals in South Africa.

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Evaluation of the Use of a Diabetes Risk Test to Identify Prediabetes in an Employee Wellness Screening

Journal of Pharmacy Practice ◽

10.1177/0897190021997010 ◽

2021 ◽

pp. 089719002199701

Author(s):

Eileen D. Ward ◽

Whitney A. Hopkins ◽

Kayce Shealy

Keyword(s):

At Risk ◽

American Diabetes Association ◽

Hemoglobin A1c ◽

Screening Tool ◽

Screening Program ◽

Diabetes Risk ◽

Risk Scores ◽

Cutoff Score ◽

Employee Wellness ◽

History Of

Background: The American Diabetes Association (ADA) Diabetes Risk Test (DRT) is a screening tool to identify people at risk for developing diabetes. Individuals with a DRT score of 5 or higher may have prediabetes or diabetes and should see a healthcare provider. Objective: To determine how many additional employees are identified as being at risk for developing diabetes during an employee wellness screening by using a more stringent DRT cutoff score of 4 instead of 5. Methods: During an annual employee wellness screening event, a hemoglobin A1C (A1c) was drawn for participants with a DRT score of > 4 or by request regardless of risk score. A1C values were classified as normal (<5.7%), prediabetes (>5.7 and <6.5%) or diabetes (>6.5%). Risk scores and A1C values were analyzed using descriptive statistics. Cost of additional laboratory testing was also reviewed. Results: An A1C was collected for 158 participants. Fourteen of 50 (28%) participants with a DRT of 4 had A1c values in the prediabetes range and no history of diabetes or prediabetes. Using the lower DRT score of 4 resulted in an additional expenditure of $305 with $85.40 resulting in the identification of an otherwise unaware person at risk for developing diabetes. Conclusion: Using a DRT cutoff score of 4 as part of an employee wellness screening program resulted in additional laboratory costs to identify persons at risk for developing diabetes but also allowed for earlier education to slow or stop the progression to diabetes which may reduce healthcare costs over time.

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