Abstract 68: Bedside Dysphagia Screening Tool Validation Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Melissa M Meighan ◽  
Barbara A Schumacher Finnegan ◽  
Noelani C Warren ◽  
Jorge Lipiz ◽  
Mai N Nguyen-Huynh
Keyword(s):  
Screening Tool ◽  
High Sensitivity ◽  
Stroke Care ◽  
Feeding Tube ◽  
Screening Tools ◽  
Point Estimate ◽  
Kappa Score ◽  
Rater Reliability ◽  
Predictive Values ◽  
Speech Language Pathologist

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.

scholarly journals Healthcare Provider Perspectives on Bipolar I Disorder Screening and the Rapid Mood Screener (RMS), a Pragmatic, New Tool

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 ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
Screening Tool ◽  
Positive Impact ◽  
Screening Tools ◽  
Predictive Values ◽  
Bipolar I Disorder ◽  
Provider Perspectives ◽  
Patient Reported

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.

scholarly journals Comparison of Malnutrition Screening Tools for Use in Hospitalized Older Adults (OR36-02-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Rachel Deer ◽  
Mackenzie McCall ◽  
Elena Volpi
Keyword(s):  
Older Adults ◽  
Elderly Patients ◽  
Screening Tool ◽  
Screening Tools ◽  
Good Sensitivity ◽  
Predictive Values ◽  
Hospitalized Elderly ◽  
Nrs 2002 ◽  
Hospitalized Elderly Patients ◽  
Hospitalized Older Adults

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

scholarly journals Searching for the Fetal Alcohol Behavioral Phenotype

2020 ◽  
Vol 7 ◽  
pp. 2333794X2094133
Author(s):  
Gideon Koren ◽  
Asher Ornoy
Keyword(s):  
High Sensitivity ◽  
Behavioral Phenotype ◽  
Narrative Review ◽  
Screening Tools ◽  
Fetal Alcohol ◽  
Predictive Values ◽  
Published Evidence ◽  
Sensitivity Specificity ◽  
Fetal Alcohol Spectrum

This narrative review presents the emerging published evidence on the existence of a phenotypic behavior in children with fetal alcohol spectrum behavior. Such a phenotype, exhibiting high sensitivity, specificity, and predictive values, may assist clinicians and families in identifying children who often miss some of the information needed for full diagnosis, but who may benefit from these screening tools in mobilizing help to these youngsters and their families.

scholarly journals A four-stage evaluation of the Paediatric Yorkhill Malnutrition Score in a tertiary paediatric hospital and a district general hospital

2010 ◽  
Vol 104 (5) ◽  
pp. 751-756 ◽  
Author(s):  
Konstantinos Gerasimidis ◽  
Orla Keane ◽  
Isobel Macleod ◽  
Diana M. Flynn ◽  
Charlotte M. Wright
Keyword(s):  
High Risk ◽  
General Hospital ◽  
Nursing Staff ◽  
Screening Tool ◽  
Nutritional Assessment ◽  
District General Hospital ◽  
Screening Tools ◽  
Lower Sensitivity ◽  
Tertiary Referral Hospital ◽  
Rater Reliability

Paediatric in-patients are at high risk of malnutrition but validated paediatric screening tools suitable for use by nursing staff are scarce. The present study aimed to assess the diagnostic accuracy of the new Paediatric Yorkhill Malnutrition Score (PYMS). During a pilot introduction in a tertiary referral hospital and a district general hospital, two research dietitians assessed the validity of the PYMS by comparing the nursing screening outcome with a full dietetic assessment, anthropometry and body composition measurements. An additional PYMS form was completed by the research dietitians to assess its inter-rater reliability with the nursing staff and for comparison with the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the Paediatric Subjective Global Nutritional Assessment (SGNA). Of the 247 children studied, the nurse-rated PYMS identified 59 % of those rated at high risk by full dietetic assessment. Of those rated at high risk by the nursing PYMS, 47 % were confirmed as high risk on full assessment. The PYMS showed moderate agreement with the full assessment (κ = 0·46) and inter-rater reliability (κ = 0·53) with the research dietitians. Children who screened as high risk for malnutrition had significantly lower lean mass index than those at moderate or low risk, but no difference in fat. When completed by the research dietitians, the PYMS showed similar sensitivity to the STAMP, but a higher positive predictive value. The SGNA had higher specificity than the PYMS but much lower sensitivity. The PYMS screening tool is an acceptable screening tool for identifying children at risk of malnutrition without producing unmanageable numbers of false-positive cases.

scholarly journals Visual Impairment Screening Assessment (VISA) tool: pilot validation

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020562 ◽  
Author(s):  
Fiona J Rowe ◽  
Lauren R Hepworth ◽  
Kerry L Hanna ◽  
Claire Howard
Keyword(s):  
Visual Impairment ◽  
Sensitivity And Specificity ◽  
Screening Tool ◽  
Stroke Care ◽  
Detection Accuracy ◽  
Stroke Survivors ◽  
Predictive Values ◽  
Vision Assessment ◽  
Screening Assessment ◽  
Visual Inattention

ObjectiveTo report and evaluate a new Vision Impairment Screening Assessment (VISA) tool intended for use by the stroke team to improve identification of visual impairment in stroke survivors.DesignProspective case cohort comparative study.SettingStroke units at two secondary care hospitals and one tertiary centre.Participants116 stroke survivors were screened, 62 by naïve and 54 by non-naïve screeners.Main outcome measuresBoth the VISA screening tool and the comprehensive specialist vision assessment measured case history, visual acuity, eye alignment, eye movements, visual field and visual inattention.ResultsFull completion of VISA tool and specialist vision assessment was achieved for 89 stroke survivors. Missing data for one or more sections typically related to patient’s inability to complete the assessment. Sensitivity and specificity of the VISA screening tool were 90.24% and 85.29%, respectively; the positive and negative predictive values were 93.67% and 78.36%, respectively. Overall agreement was significant; k=0.736. Lowest agreement was found for screening of eye movement and visual inattention deficits.ConclusionsThis early validation of the VISA screening tool shows promise in improving detection accuracy for clinicians involved in stroke care who are not specialists in vision problems and lack formal eye training, with potential to lead to more prompt referral with fewer false positives and negatives. Pilot validation indicates acceptability of the VISA tool for screening of visual impairment in stroke survivors. Sensitivity and specificity were high indicating the potential accuracy of the VISA tool for screening purposes. Results of this study have guided the revision of the VISA screening tool ahead of full clinical validation.

scholarly journals Blood pressure-to-height ratio for diagnosing hypertension in adolescents

2017 ◽  
Vol 57 (2) ◽  
pp. 84
Author(s):  
Kristina Ambarita ◽  
Oke Rina Ramayani ◽  
Munar Lubis ◽  
Isti Ilmiati Fujiati ◽  
Rafita Ramayati ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Children And Adolescents ◽  
High Blood Pressure ◽  
Screening Tool ◽  
High Sensitivity ◽  
Likelihood Ratios ◽  
Height Ratio ◽  
Cross Sectional ◽  
Predictive Values ◽  
National High Blood Pressure

Background Diagnosing hypertension in children and adolescents is not always straightforward. The blood pressure-to-height ratio (BPHR) has been reported as a screening tool for diagnosing hypertension.Objective To evaluate the diagnostic value of blood pressure-to-height ratio for evaluating hypertension in adolescents.Methods A cross-sectional study was conducted among 432 healthy adolescents aged 12-17 years in Singkuang, North Sumatera from April to May 2016. Blood pressure tables from the National High Blood Pressure Education Program (NHBPEP) Working Group on High Blood Pressure in Children and Adolescents were used as our standard of comparison. Sex-specific systolic and diastolic blood pressure-to-height ratios (SBPHR and DBPHR) were calculated. ROC curve analyses were performed to assess the accuracy of BPHR for discriminating between hypertensive and non-hypertensive adolescents. Optimal thresholds of BPHR were determined and validated using 2x2 table analyses.Results The accuracies of BPHR for diagnosing hypertension were > 90% (P<0.001), for both males and females. Optimal SBPHR and DBPHR thresholds for defining hypertension were 0.787 and 0.507 in boys, respectively, and 0.836 and 0.541 in girls, respectively. The sensitivities of SBPHR and DBPHR in both sexes were all >93%, and specificities in both sexes were all >81%. Positive predictive values for SBPHR and DBPHR were 38.7% and 45.2% in boys, respectively; and 55.9% and 42.4% in girls, respectively; negative predictive values in both sexes were all >97%, positive likelihood ratios in both sexes were all >5, and negative likelihood ratios in both sexes were all <1.Conclusion Blood pressure-to-height ratio is a simple screening tool with high sensitivity and specificity for diagnosing hypertension in adolescents.

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 Validity and reliability of the Neurodevelopmental Screening Tool (NDST) in screening for neurodevelopmental disorders in children living in rural Kenyan coast

2021 ◽  
Vol 6 ◽  
pp. 137
Author(s):  
Mary A. Bitta ◽  
Patricia Kipkemoi ◽  
Symon M. Kariuki ◽  
Amina Abubakar ◽  
Joseph Gona ◽  
...  
Keyword(s):  
Neurodevelopmental Disorders ◽  
Screening Tool ◽  
High Sensitivity ◽  
Clinical History ◽  
Autism Spectrum ◽  
Hearing Impairments ◽  
Validity And Reliability ◽  
Motor Impairments ◽  
Predictive Values ◽  
Kenyan Coast

Background: There are no data on the precise burden of neurodevelopmental disorders (NDD) in Africa, despite high incidence of risk factors. Ten Questions Questionnaire (TQQ) has been used extensively in Africa to screen neurological impairments but not autism spectrum disorders (ASD) and attention-deficit hyperactivity disorders (ADHD). The Neurodevelopmental Screening Tool (NDST) has reliably assessed NDD in Asia; its validity in Africa is unknown. Methods: Using NDST and TQQ, we screened 11,223 children aged 6-9 years in Kilifi, Kenya. We invited all screen-positives and a proportion of screen-negative children for confirmatory diagnosis of NDD using clinical history, neuropsychological assessments and interviews. Results: In total, 2,245 (20%) children screened positive for NDD. Confirmatory testing was completed for 1,564 (69.7%) screen-positive and 598 (6.7%) screen-negative children. NDST’s sensitivity was 87.8% (95%CI: 88.3-88.5%) for any NDD, 96.5% (95%CI:96.1-96.8%) ASD and 89.2% (95%CI: 88.7-89.8%) for ADHD. Moderate/severe neurological impairments’ sensitivities ranged from 85.7% (95%CI: 85.1-86.3%) for hearing impairments to 100.00% (100.0-100.0%) for motor impairments. NDST had higher sensitivities than TQQ for epilepsy (88.8 vs 86.7), motor impairments (100.0 vs 93.7) and cognitive impairment (88.2 vs 84.3). Sensitivities for visual and hearing impairments were comparable in both tools. NDST specificity was 82.8% (95%CI: 82.1-83.5%) for any NDD, 94.5% (95%CI: 94.0-94.9%) for ASD and 81.7% (95%CI: 81.0-82.4%) for ADHD. The specificities range for neurological impairments was 80.0% (95%CI: 79.3-80.7%) for visual impairments to 93.8% (95%CI: 93.4-94.3%) for epilepsy. Negative predictive values were generally very high (≤100%), but most positive predictive values (PPV) were low (≤17.8%). Domain specific internal consistency ranged from 0.72 (95%CI: 0.70-0.74) for ADHD to 0.89 (95%CI: 0.87-0.90) for epilepsy. Conclusions: NDST possesses high sensitivity and specificity for detecting different domains of NDD in Kilifi. Low PPV suggest that positive diagnoses should be confirmed when samples are drawn from a population with low disease prevalence.

Beck Depression Inventory as a screening tool for depression in chronic haemodialysis patients

2018 ◽  
Vol 26 (3) ◽  
pp. 281-284 ◽  
Author(s):  
Alison Bautovich ◽  
Ivor Katz ◽  
Colleen Ken Loo ◽  
Samuel B Harvey
Keyword(s):  
Chronic Kidney Disease ◽  
Major Depression ◽  
Beck Depression Inventory ◽  
Screening Tool ◽  
Diagnostic Interview ◽  
Screening Tools ◽  
Chronic Haemodialysis ◽  
Predictive Values ◽  
Dsm Iv ◽  
Sensitivity Specificity

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.

scholarly journals Construction and validation of an ADHD screening tool for preschool children: A study with Spanish population

2019 ◽  
Vol 19 (2) ◽  
Author(s):  
Manuel Rodríguez-Becerra ◽  
Luz María Fernández-Mateos ◽  
Cristina Jenaro-Río
Keyword(s):  
Preschool Children ◽  
Screening Tool ◽  
High Sensitivity ◽  
Screening Tools ◽  
Face Validity ◽  
Spanish Population ◽  
Receiver Operating Characteristic Curves ◽  
Promising Tool ◽  
Discriminant Power ◽  
Item Scale

Most cases of ADHD occur in children under five, and this situation calls for screening tools with high sensitivity and specificity for early age. This study presents the ADHD-3P, a new screening tool developed with Spanish population for preschool children. From an initial pool of 151 items, face validity analyses, followed by item analyses and analysis of the scale, were carried out. A 27-item scale (? = .95) composed of three factors: hyperactivity (? = .92), inattention (? = .92), and other symptoms (? = .81) resulted from the analyses. Discriminant power was high (89.7% for ADHD, and 88.3% for non-ADHD). Diagnostic performance was evaluated through Receiver-Operating Characteristic curves, and excellent sensitivity (92.86%) and specificity (89.86%) were obtained. In sum, the ADHD-3Pis a promising tool to be used by parents, teachers, and pediatricians.

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