scholarly journals Accuracy of Depression Screening Tools to Detect Major Depression in Children and Adolescents: A Systematic Review

2016 ◽  
Vol 61 (12) ◽  
pp. 746-757 ◽  
Author(s):  
Michelle Roseman ◽  
Lorie A. Kloda ◽  
Nazanin Saadat ◽  
Kira E. Riehm ◽  
Abel Ickowicz ◽  
...  

Objective: Depression screening among children and adolescents is controversial, and no clinical trials have evaluated benefits and harms of screening programs. A requirement for effective screening is a screening tool with demonstrated high accuracy. The objective of this systematic review was to evaluate the accuracy of depression screening instruments to detect major depressive disorder (MDD) in children and adolescents. Method: Data sources included the MEDLINE, MEDLINE In-Process, EMBASE, PsycINFO, HaPI, and LILACS databases from 2006 to September 30, 2015. Eligible studies compared a depression screening tool to a validated diagnostic interview for MDD and reported accuracy data for children and adolescents aged 6 to 18 years. Risk of bias was assessed with QUADAS-2. Results: We identified 17 studies with data on 20 depression screening tools. Few studies examined the accuracy of the same screening tools. Cut-off scores identified as optimal were inconsistent across studies. Width of 95% confidence intervals (CIs) for sensitivity ranged from 9% to 55% (median 32%), and only 1 study had a lower bound 95% CI ≥80%. For specificity, 95% CI width ranged from 2% to 27% (median 9%), and 3 studies had a lower bound ≥90%. Methodological limitations included small sample sizes, exploratory data analyses to identify optimal cut-offs, and the failure to exclude children and adolescents already diagnosed or treated for depression. Conclusions: There is insufficient evidence that any depression screening tool and cut-off accurately screens for MDD in children and adolescents. Screening could lead to overdiagnosis and the consumption of scarce health care resources.

2020 ◽  
Vol 37 (6) ◽  
pp. 423-430
Author(s):  
Deborah Tomlinson ◽  
Lillian Sung ◽  
Emily Vettese ◽  
Shelley Murphy ◽  
Erin Plenert

Psychological interventions have shown benefit in reducing symptoms in children and adolescents with cancer. More recently, mindfulness-based interventions (MBIs) have been shown to be a promising approach to symptom intervention in adolescents with chronic illnesses. In this systematic review, we aimed to describe MBIs or focused-breathing interventions that have been used to treat symptoms in children receiving cancer therapy. A systematic review was conducted using MEDLINE/PubMed, EMBASE, CINAHL, and PsycINFO from inception to September 2019. We identified relevant articles in which MBIs or focused-breathing interventions were the primary interventions delivered to improve symptoms in children or adolescents with cancer. Six studies met the inclusion criteria. MBIs included controlled breathing and belly breathing. Intervention effects were found to be beneficial with regard to symptoms that included procedural pain, distress, and quality of life. The interventions were generally well accepted and beneficial. All studies suffered limitations because of methodological flaws, including the lack of randomization, and small sample sizes. Despite the small numbers of studies and participants, MBIs delivered to children with cancer may have beneficial effects on certain symptoms. Implications for future research include interventions tailored to the specific symptom burden. Studies must aim to increase sample sizes as well as to include individuals at high risk for severe symptoms.


2021 ◽  
Vol 10 (8) ◽  
pp. 1740
Author(s):  
Marion Bareille ◽  
Michaël Hardy ◽  
Jonathan Douxfils ◽  
Stéphanie Roullet ◽  
Dominique Lasne ◽  
...  

Infection by SARS-CoV-2 is associated with a high risk of thrombosis. The laboratory documentation of hypercoagulability and impaired fibrinolysis remains a challenge. Our aim was to assess the potential usefulness of viscoelastometric testing (VET) to predict thrombotic events in COVID-19 patients according to the literature. We also (i) analyzed the impact of anticoagulation and the methods used to neutralize heparin, (ii) analyzed whether maximal clot mechanical strength brings more information than Clauss fibrinogen, and (iii) critically scrutinized the diagnosis of hypofibrinolysis. We performed a systematic search in PubMed and Scopus databases until December 31st, 2020. VET methods and parameters, and patients’ features and outcomes were extracted. VET was performed for 1063 patients (893 intensive care unit (ICU) and 170 non-ICU, 44 studies). There was extensive heterogeneity concerning study design, VET device used (ROTEM, TEG, Quantra and ClotPro) and reagents (with non-systematic use of heparin neutralization), timing of assay, and definition of hypercoagulable state. Notably, only 4 out of 25 studies using ROTEM reported data with heparinase (HEPTEM). The common findings were increased clot mechanical strength mainly due to excessive fibrinogen component and impaired to absent fibrinolysis, more conspicuous in the presence of an added plasminogen activator. Only 4 studies out of the 16 that addressed the point found an association of VETs with thrombotic events. So-called functional fibrinogen assessed by VETs showed a variable correlation with Clauss fibrinogen. Abnormal VET pattern, often evidenced despite standard prophylactic anticoagulation, tended to normalize after increased dosing. VET studies reported heterogeneity, and small sample sizes do not support an association between the poorly defined prothrombotic phenotype of COVID-19 and thrombotic events.


Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 692-707 ◽  
Author(s):  
Nicolas Iragorri ◽  
Glen Hazlewood ◽  
Braden Manns ◽  
Vishva Danthurebandara ◽  
Eldon Spackman

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.


2019 ◽  
Vol 34 (5) ◽  
pp. 754-754
Author(s):  
D P Terry ◽  
A J Gardner ◽  
G L Iverson

Abstract Purpose This systematic review examined clinical outcomes (i.e., prognosis) following a sport-related concussion in athletes who have a pre-injury history of migraines. Clinical recovery was defined functionally as recovery from symptoms or full return to activities following injury. Data Selection All studies published prior to February 2019 that addressed pre-injury migraines as a possible predictor of clinical recovery from concussion were included. Broadly, the search included (i) sport/athlete-related terms, (ii) concussion-related terms, and (iii) diverse predictor/modifier terms. The following databases were utilized: PubMed, PsycINFO®, MEDLINE®, CINAHL, Cochrane Library, EMBASE, SPORTDiscus, Scopus, and Web of Science. After removing duplicates from the 9,372 identified articles, 5,888 abstracts were screened, 358 full-text articles were reviewed, and 15 articles examining pre-injury migraines as a predictor of recovery were included. Data Synthesis Most articles examined pre-injury migraines as an exploratory/secondary predictor of concussion outcome. Migraine history was predominantly based on self-report. Studies included minimal other information about this condition (e.g., age of onset, migraine frequency/severity, past treatment). Methodological rigor varied greatly across studies. Most studies did not find pre-injury migraines to be associated with concussion outcome, but several of these studies had small or very small sample sizes. Larger, better-designed studies suggested pre-injury migraines may be a risk factor for worse concussion outcome. Effect sizes were rarely reported or able to be calculated. Conclusion There is some evidence to suggest pre-injury migraines may be a vulnerability factor for a prolonged recovery following concussion. Future studies should focus on improving methodological quality when assessing the relationship between pre-injury migraines and concussion outcome.


2017 ◽  
Vol 45 (2) ◽  
pp. 167-180 ◽  
Author(s):  
Nicole Farmer ◽  
Katherine Touchton-Leonard ◽  
Alyson Ross

Objectives. Cooking interventions are used in therapeutic and rehabilitative settings; however, little is known about the influence of these interventions on psychosocial outcomes. This systematic review examines the research evidence regarding the influence of cooking interventions on psychosocial outcomes. Methods. A systematic review of the literature examined peer-reviewed research using Embase, PubMed, CINALH Plus, and PsychInfo with the following search terms: cooking, culinary, baking, food preparation, cookery, occupational therapy, mental health, mood, psychosocial, affect, confidence, self-confidence, self-esteem, socialization, and rehabilitation. Inclusion criteria were the following: adults, English, influence of cooking interventions on psychosocial outcomes. PRISMA guidelines were used. Results. The search yielded 377 articles; and 11 ultimately met inclusion criteria and were reviewed. Generally, the quality of the research was weak due to nonrandomization, unvalidated research tools, and small sample sizes. However, inpatient and community-based cooking interventions yielded positive influences on socialization, self-esteem, quality of life, and affect. Conclusions. Finding benefits to cooking that extend beyond nutritional may be helpful in increasing motivation and frequency of cooking. This review suggests that cooking interventions may positively influence psychosocial outcomes, although this evidence is preliminary and limited. Further qualitative and rigorous quantitative research are needed to identify mechanisms by which cooking interventions may improve psychosocial outcomes.


Epilepsia ◽  
2017 ◽  
Vol 58 (5) ◽  
pp. 695-705 ◽  
Author(s):  
Stephanie J. Gill ◽  
Sara Lukmanji ◽  
Kirsten M. Fiest ◽  
Scott B. Patten ◽  
Samuel Wiebe ◽  
...  

2016 ◽  
Vol 17 (1) ◽  
pp. 16-27 ◽  
Author(s):  
Silvia Alonso ◽  
Ian Dohoo ◽  
Johanna Lindahl ◽  
Cristobal Verdugo ◽  
Isaiah Akuku ◽  
...  

AbstractA meta-analysis was performed to derive prevalence estimates for Brucella spp., Mycobacterium spp. and Trypanosoma spp. in cattle in Tanzania using data derived from a systematic review of zoonotic hazards in cattle production systems. Articles published before 2012 reporting prevalence and considered at least moderate in quality were included in the analysis. Results showed high heterogeneity between studies, with wide ranges in the reported prevalence: Brucella (0.3–60.8%), Mycobacterium (0.1–13.2%) and Trypanosoma (0.82–33.3%). Overall meta-analytic mean prevalence estimates were 8.2% (95% CI 6.5–10.2), 1.28% (95% CI 0.35–4.58) and 10.3% (95% CI 6.20–16.70) respectively, for Brucella spp., Mycobacterium spp. and Trypanosoma spp. Time and region were predictors of variability of Brucella spp. prevalence, while diagnostic test was a strong predictor of Mycobacterium spp. prevalence, with higher prevalence estimates given by skin tests compared with post-mortem inspection. None of the studied factors were associated with prevalence of Trypanosoma spp. The small sample sizes, range of study locations, study designs and diagnostics used, contributed to high variability among prevalence estimates. Larger and more robust prevalence studies are needed to adequately support risk assessment and management of animal and public health threats.


2017 ◽  
Vol 176 (5) ◽  
pp. R247-R267 ◽  
Author(s):  
Gunn-Helen Moen ◽  
Christine Sommer ◽  
Rashmi B Prasad ◽  
Line Sletner ◽  
Leif Groop ◽  
...  

ObjectiveTo summarize the current knowledge on epigenetic alterations in mother and offspring subjected to gestational diabetes (GDM) and indicate future topics for research.DesignSystematic review.MethodsWe performed extensive searches in PubMed, EMBASE and Google scholar, using a combination of the search terms: GDM, gestational diabetes, epigenetic(s), methylation, histone modification, histone methylation, histone acetylation, microRNA and miRNA. Studies that compared women diagnosed with GDM and healthy controls were included. Two authors independently scanned the abstracts, and all included papers were read by at least two authors. The searches were completed on October 31st, 2016.ResultsWe identified 236 articles, of which 43 were considered relevant for this systematic review. Studies published showed that epigenetic alterations could be found in both mothers with GDM and their offspring. However, differences in methodology, diagnostic criteria for GDM and populations studied, together with a limited number of published studies and small sample sizes, preclude clear conclusions about the role of epigenetic modifications in transmitting risk from GDM mothers to their offspring.ConclusionThe current research literature suggests that GDM may have impact on epigenetic modifications in the mother and offspring. However, larger studies that include multiple cohorts of GDM patients and their offspring are needed.


2021 ◽  
Author(s):  
Esperanza M. Garcia-Oropesa ◽  
Yoscelina E. Martinez-Lopez ◽  
Sonia Maria Ruiz-Cejudo ◽  
Jose Dario Martinez-Ezquerro ◽  
Alvaro Diaz-Badillo ◽  
...  

Mexicans and Mexican Americans share culture, genetic background, and predisposition for chronic complications associated with obesity and diabetes making imperative efficacious treatments and prevention. Obesity has been treated for centuries focused-on weight loss while other treatments on associated conditions like gout, diabetes (T2D), and hypertriglyceridemia. To date, there is no systematic review that synthetize the origin of obesity clinics in Mexico and the efforts to investigate treatments for obesity tested by randomized clinical trials (RCT). We conducted systematic searches in Pubmed, Scopus, and Web of Science to retrieve anti-obesity RCT through 2019 and without inferior temporal limit. The systematic review included RCT of anti-obesity treatments in the Mexican adult population, including alternative medicine, pharmacological, nutritional, behavioral, and surgical interventions reporting biometric outcomes such as BMI, weight, waist circumference, triglycerides, glucose, among others. Studies with at least three months of treatment were included in the meta-analysis. We found 634 entries, after removal of duplicates and screening the studies based on eligibility criteria, we analyzed 43, and 2 multinational-collaborative studies. Most of the national studies have small sample sizes, and the studied strategies do not have replications in the population. The nutrition/behavioral interventions were difficult to blind, and most studies have medium to high risk of bias. Nutritional/behavioral interventions and medications showed effects on BMI, waist circumference, and blood pressure. Simple measures like plain water instead of sweet beverages decrease triglycerides and systolic blood pressure. Participants with obesity and hypertension can have benefic effects with antioxidants, and treatment with insulin increase weight in those with T2D. The study of obesity in Mexico has been on-going for more than four decades, but the interest on RCT just increased until this millennium, but with small sample sizes and lack of replication. The interventions affect different metabolic syndrome components, which should be analyzed in detail with the population living on the U.S.-Mexico border; therefore, bi-national collaboration is desirable to disentangle the cultural effects on this population's treatment response.


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