scholarly journals Validation of case definitions of depression derived from administrative data against the CIDI-SF as reference standard: results from the PROspective Québec (PROQ) study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ana Paula Bruno Pena-Gralle ◽  
Denis Talbot ◽  
Xavier Trudel ◽  
Karine Aubé ◽  
Alain Lesage ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sensitivity And Specificity ◽  
Administrative Data ◽  
Short Form ◽  
High Specificity ◽  
Composite International Diagnostic Interview ◽  
Epidemiological Studies ◽  
Correct Identification ◽  
Reference Standard ◽  
Case Definitions

Abstract Background Administrative data have several advantages over questionnaire and interview data to identify cases of depression: they are usually inexpensive, available for a long period of time and are less subject to recall bias and differential classification errors. However, the validity of administrative data in the correct identification of depression has not yet been studied in general populations. The present study aimed to 1) evaluate the sensitivity and specificity of administrative cases of depression using the validated Composite International Diagnostic Interview – Short Form (CIDI-SF) as reference standard and 2) compare the known-groups validity between administrative and CIDI-SF cases of depression. Methods The 5487 participants seen at the last wave (2015–2018) of the PROQ cohort had CIDI-SF questionnaire data linked to hospitalization and medical reimbursement data provided by the provincial universal healthcare provider and coded using the International Classification of Disease. We analyzed the sensitivity and specificity of several case definitions of depression from this administrative data. Their association with known predictors of depression was estimated using robust Poisson regression models. Results Administrative cases of depression showed high specificity (≥ 96%), low sensitivity (19–32%), and rather low agreement (Cohen’s kappa of 0.21–0.25) compared with the CIDI-SF. These results were consistent over strata of sex, age and education level and with varying case definitions. In known-groups analysis, the administrative cases of depression were comparable to that of CIDI-SF cases (RR for sex: 1.80 vs 2.03 respectively, age: 1.53 vs 1.40, education: 1.52 vs 1.28, psychological distress: 2.21 vs 2.65). Conclusion The results obtained in this large sample of a general population suggest that the dimensions of depression captured by administrative data and by the CIDI-SF are partially distinct. However, their known-groups validity in relation to risk factors for depression was similar to that of CIDI-SF cases. We suggest that neither of these data sources is superior to the other in the context of large epidemiological studies aiming to identify and quantify risk factors for depression.

Performance of the Present-on-Admission Indicator for Clostridium difficile Infection

2015 ◽  
Vol 36 (7) ◽  
pp. 838-840 ◽  
Author(s):  
Amy L. Pakyz ◽  
Julie A. Patterson ◽  
Christine Motzkus-Feagans ◽  
Samuel F. Hohmann ◽  
Michael B. Edmond ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Sensitivity And Specificity ◽  
Administrative Data ◽  
Clostridium Difficile Infection ◽  
High Specificity ◽  
Infect Control Hosp ◽  
Clinical Surveillance ◽  
Moderate Sensitivity ◽  
Present On Admission ◽  
Community Onset

The performance of a hospital- and community-onset Clostridium difficile infection definition using administrative data with a present-on-admission indicator was compared with definitions using clinical surveillance. For hospital-onset C. difficile infection, there was moderate sensitivity (68%) and high specificity (93%); for community-onset, sensitivity and specificity were high (both 85%).Infect Control Hosp Epidemiol 2015;36(7):838–840

scholarly journals Ultrasonography for the diagnosis of extra-cranial carotid occlusion – diagnostic test accuracy meta-analysis

VASA ◽  
2020 ◽  
Vol 49 (3) ◽  
pp. 195-204
Author(s):  
Djamila M. Rojoa ◽  
Ahmad Q. D. Lodhi ◽  
Nikos Kontopodis ◽  
Christos V. Ioannou ◽  
Nicos Labropoulos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Diagnostic Test Accuracy ◽  
Carotid Occlusion ◽  
Test Accuracy ◽  
Free Text ◽  
Correct Identification ◽  
Reference Standard

Summary: Background: The correct diagnosis of internal carotid artery (ICA) occlusion is crucial as it limits unnecessary intervention, whereas correct identification of patients with severe ICA stenosis is paramount in decision making and selecting patients who would benefit from intervention. We aimed to evaluate the accuracy of ultrasonography (US) in the diagnosis of ICA occlusion. Methods: We conducted a systematic review in compliance with the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) of diagnostic test accuracy studies. We interrogated electronic bibliographic sources using a combination of free text and thesaurus terms to identify studies assessing the diagnostic accuracy of US in ICA occlusion. We used a mixed-effects logistic regression bivariate model to estimate summary sensitivity and specificity. We developed hierarchical summary receiver operating characteristic (HSROC) curves. Results: We identified 23 studies reporting a total of 5,675 arteries of which 722 were proven to be occluded by the reference standard. The reference standard was digital subtraction or cerebral angiography in all but two studies, which used surgery to ascertain a carotid occlusion. The pooled estimates for sensitivity and specificity were 0.97 (95% confidence interval (CI) 0.94 to 0.99) and 0.99 (95% CI 0.98 to 1.00), respectively. The diagnostic odds ratio was 3,846.15 (95% CI 1,375.74 to 10,752.65). The positive and negative likelihood ratio were 114.71 (95% CI 58.84 to 223.63) and 0.03 (95% CI 0.01 to 0.06), respectively. Conclusions: US is a reliable and accurate method in diagnosing ICA occlusion. US can be used as a screening tool with cross-sectional imaging being reserved for ambiguous cases.

scholarly journals Identifying Cases of Sleep Disorders through International Classification of Diseases (ICD) Codes in Administrative Data

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Rachel J Jolley ◽  
Zhiying Liang ◽  
Mingkai Peng ◽  
Sachin R Pendharkar ◽  
Willis Tsai ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Ambulatory Care ◽  
Sleep Disorder ◽  
Administrative Data ◽  
Medical Records ◽  
Claims Data ◽  
Clinic Visit ◽  
Reference Standard ◽  
Case Definitions ◽  
Icd Codes

Objectives Prevalence, and associated morbidity and mortality of chronic sleep disorders have been limited to small cohort studies, however, administrative data may be used to provide representation of larger population estimates of disease. With no guidelines to inform the identification of cases of sleep disorders in administrative data, the objective of this study was to develop and validate a set of ICD-codes used to define sleep disorders including narcolepsy, insomnia, and obstructive sleep apnea (OSA) in administrative data. Methods A cohort of adult patients, with medical records reviewed by two independent board-certified sleep physicians from a sleep clinic in Calgary, Alberta between January 1, 2009 and December 31, 2011, was used as the reference standard. We developed a general ICD-coded case definition for sleep disorders which included conditions of narcolepsy, insomnia, and OSA using: 1) physician claims data, 2) inpatient visit data, 3) emergency department (ED) and ambulatory care data. We linked the reference standard data and administrative data to examine the validity of different case definitions, calculating estimates of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).  Results From a total of 1186 patients from the sleep clinic, 1045 (88.1%) were classified as sleep disorder positive, with 606 (51.1%) diagnosed with OSA, 407 (34.4%) with insomnia, and 59 (5.0%) with narcolepsy. The most frequently used ICD-9 codes were general codes of 307.4 (Nonorganic sleep disorder, unspecified), 780.5 (unspecified sleep disturbance) and ICD-10 codes of G47.8 (other sleep disorders), G47.9 (sleep disorder, unspecified). The best definition for identifying a sleep disorder was an ICD code (from physician claims) 2 years prior and 1 year post sleep clinic visit: sensitivity 79.2%, specificity 28.4%, PPV 89.1%, and NPV 15.6%. ICD codes from ED/ambulatory care data provided similar diagnostic performance when at least 2 codes appeared in a time period of 2 years prior and 1 year post sleep clinic visit: sensitivity 71.9%, specificity 54.6%, PPV 92.1%, and NPV 20.8%. The inpatient data yielded poor results in all tested ICD code combinations. Conclusion Sleep disorders in administrative data can be identified mainly through physician claims data and with some being determined through outpatient/ambulatory care data ICD codes, however these are poorly coded within inpatient data sources. This may be a function of how sleep disorders are diagnosed and/or reported by physicians in inpatient and outpatient settings within medical records. Future work to optimize administrative data case definitions through data linkage are needed.

Comparison and Agreement among Various Case Definitions of Periodontitis: A Secondary Data Analysis

2014 ◽  
Vol 6 (2) ◽  
pp. 40-46 ◽  
Author(s):  
Tan Pei Shian ◽  
Shaju Jacob Pulikkotil
Keyword(s):  
Gold Standard ◽  
Disease Surveillance ◽  
Secondary Data ◽  
High Specificity ◽  
Epidemiological Studies ◽  
Cross Sectional Study ◽  
Case Definition ◽  
Case Definitions ◽  
Cross Sectional ◽  
The Impact

Background and aims. A plethora of definitions has been used for periodontitis for epidemiological studies. The aim of this cross-sectional study was to assess the impact of different case definitions on the prevalence of periodontitis and to find the level of agreement among them. Materials and methods. Periodontal records of 300 subjects were randomly selected from the database of Oral Health Center, International Medical University. The prevalence of periodontitis was determined using six different case definitions of I, II, III, IV, Va and Vb previously used in various studies. The definition Va proposed by CDC Periodontal Disease Surveillance Workgroup was adopted as the gold standard to calculate sensitivity and specificity. Results. There were large variations in the prevalence of periodontitis based on different definitions, ranging from 28% to 76.7%. There was good agreement between definitions III and Vb (0.901) and definitions II and III (0.713). Definition II had the highest agreement with the gold standard (Va) among all the definitions. Excluding definition I, all had a high specificity to the gold standard. Conclusion. The prevalence of periodontitis is greatly influenced by the choice of the case definition. Prevalence rates with definition II could be more accurate if the true prevalence is determined by definition Va.

Spousal resemblance for history of major depressive episode in the previous year

2002 ◽  
Vol 32 (2) ◽  
pp. 363-367 ◽  
Author(s):  
S. LINDEMAN ◽  
J. KAPRIO ◽  
E. ISOMETSÄ ◽  
K. POIKOLAINEN ◽  
M. HEIKKINEN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Major Depression ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Short Form ◽  
Alcohol Intoxication ◽  
Strong Association ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Major Depressive

Background. There is discrepancy in findings on spousal concordance for major depression. Here we report the risk of depression and its determinants in spouses of persons with or without depression, taking into account several known risk factors for major depression.Methods. A random sample of non-institutionalized Finnish individual aged 15–75 years was interviewed in the 1996 National Health Care Survey. The sample included 1708 male–female spouse pairs. Major depressive episode (MDE) during the last 12 months was assessed using the Short Form of the University of Michigan version of the Composite International Diagnostic Interview (the UM-CIDI Short Form). Risk factors were assessed in the same interview.Results. Factors associating with MDE were spouse's MDE, own alcohol intoxication at least once a week and own chronic medical conditions. In addition, there was a strong association between female's current smoking and male's MDE, independently of other risk factors and spousal MDE. The association of MDE with spouses's MDE was not affected by taking into account other assessed risk factors (own or spouse's).Conclusions. The results indicate elevated spouse concordance for MDE independent of the risk factors assessed in the present study.

scholarly journals Mortality Associated with Major Depression in a Canadian Community Cohort

2011 ◽  
Vol 56 (11) ◽  
pp. 658-666 ◽  
Author(s):  
Scott B Patten ◽  
Jeanne VA Williams ◽  
Dina Lavorato ◽  
Jian Li Wang ◽  
Salma Khaled ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Risk ◽  
Short Form ◽  
Strong Predictor ◽  
Composite International Diagnostic Interview ◽  
Vital Statistics ◽  
Independent Effect ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Objective: Prior studies have reported that major depressive episodes (MDEs) are associated with elevated mortality. However, the association has not always persisted after adjustment for other mortality risk factors. In our study, we examine this issue using data from a longitudinal Canadian study (the National Population Health Survey [NPHS]). The NPHS included a more comprehensive set of mortality determinants than prior studies, allowing a more comprehensive assessment of the effect of MDEs on mortality. Methods: The NPHS began data collection in 1994 and follow-up data were available to 2006 at the time of this analysis. The NPHS assessed depression using a short-form version of the Composite International Diagnostic Interview. Mortality was assessed as part of the cohort's follow-up, including linkage to vital statistics data. Results: During follow-up, 2019 deaths occurred in the eligible part of the NPHS cohort. Consistent with prior studies, MDEs were strongly predictive of mortality when basic adjustments were made for age and sex (hazard ratio [HR] 2.0, 95% Cl 1.4 to 2.9). The association disappeared with adjustment for other variables that predict mortality risk (HR 1.1, 95% Cl 0.7 to 1.7). Conclusions: MDE is a strong predictor of mortality in the general population. This analysis failed to identify an independent effect of MDE when adjustments were made for other risk factors. However, the lack of a strong independent effect on mortality does not preclude an etiologic impact of MDE. MDE itself is intertwined with health-related changes that predict mortality and its impact may be mediated by these variables.

Protective Factors and Suicidality in Members of Arab Kindred

Crisis ◽  
2012 ◽  
Vol 33 (2) ◽  
pp. 80-86 ◽  
Author(s):  
Sami Hamdan ◽  
Nadine Melhem ◽  
Israel Orbach ◽  
Ilana Farbstein ◽  
Mohammad El-Haib ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factors ◽  
Suicidal Behavior ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Suicidal Risk ◽  
Arab Population ◽  
Psychiatric Interview ◽  
History Of

Background: Relatively little is known about the role of protective factors in an Arab population in the presence of suicidal risk factors. Aims: To examine the role of protective factors in a subsample of in large Arab Kindred participants in the presence of suicidal risk factors. Methods: We assessed protective and risk factors in a sample of 64 participants (16 suicidal and 48 nonsuicidal) between 15 and 55 years of age, using a comprehensive structured psychiatric interview, the Composite International Diagnostic Interview (CIDI), self-reported depression, anxiety, hopelessness, impulsivity, hostility, and suicidal behavior in first-degree and second-relatives. We also used the Religiosity Questionnaire and suicide attitude (SUIATT) and multidimensional perceived support scale. Results: Suicidal as opposed to nonsuicidal participants were more likely to have a lifetime history of major depressive disorder (MDD) (68.8% vs. 22.9% χ2 = 11.17, p = .001), an anxiety disorder (87.5% vs. 22.9, χ2 = 21.02, p < .001), or posttraumatic stress disorder (PTSD) (25% vs. 0.0%, Fisher’s, p = .003). Individuals who are otherwise at high risk for suicidality have a much lower risk when they experience higher perceived social support (3.31 ± 1.36 vs. 4.96 ± 1.40, t = 4.10, df = 62, p < .001), and they have the view that suicide is somehow unacceptable (1.83 ± .10 vs. 1.89 ± .07, t = 2.76, df = 60, p = .008). Conclusions: Taken together with other studies, these data suggest that the augmentation of protective factors could play a very important role in the prevention of incidental and recurrent suicidal behavior in Arab populations, where suicidal behavior in increasing rapidly.

Family-, Media-, and School-Related Risk Factors of Video Game Addiction

2013 ◽  
Vol 25 (3) ◽  
pp. 118-128 ◽  
Author(s):  
Florian Rehbein ◽  
Dirk Baier
Keyword(s):  
Risk Factors ◽  
Video Game ◽  
Age Groups ◽  
Well Being ◽  
Epidemiological Studies ◽  
Prevention Measures ◽  
School Life ◽  
Video Game Addiction ◽  
Effective Prevention ◽  
Game Addiction

In recent years, a variety of epidemiological studies have provided empirical data on the prevalence of video game addiction (GA) in different age groups. However, few studies investigated the causes of GA and could explain why video game playing as a widespread phenomenon leads to a comparatively small percentage of addicted players. Additionally, the existing longitudinal studies mainly consider psychological trait variables and neglect the possible explanatory value of predictors in socialization regarding media availability, media use, and family and everyday school life. In this paper, the results of a two-wave longitudinal study comprising a sample of students from Grades 4 to 9 (N = 406) are presented. The data show that 15-year-old video game addicts had already exhibited a number of specific risk factors at the age of 10. Students from single-parent families seem to be particularly at risk, as are students with low experienced school well-being and with a weaker social integration in class. The data also indicate that problematic use of video games in childhood increases the risk of GA in adolescence. Male students are especially vulnerable for developing GA. The results of this study are an important contribution to understanding risk factors for GA in adolescents, thereby laying the groundwork for effective prevention measures.

319 Validation of the Insomnia Severity Index Short-Form for Identifying Insomnia Disorder in Young Adult Cancer Survivors

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A128-A128
Author(s):  
Lydia Chevalier ◽  
Alexis Michaud ◽  
Eric Zhou ◽  
Grace Chang ◽  
Christopher Recklitis
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Sensitivity And Specificity ◽  
Short Form ◽  
A Priori ◽  
Severity Index ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer ◽  
Insomnia Severity

Abstract Introduction Insomnia is a common and impairing late effect experienced by many young adult cancer survivors (YACS). Although routine evaluation of sleep disorders in cancer survivors is recommended, lack of consensus on appropriate screening measures contributes to under-identification and under-treatment of these disorders in YACS. As screening measures are ideally as brief as possible while maintaining validity, we sought to validate the recently published three-item Insomnia Severity Index Short-Form (ISI-SF) in YACS. Methods 250 YACS completed the ISI and the Structured Clinical Interview for the DSM-5 (SCID-5). The ISI-SF was created by summing three ISI items: distress (item #6), interference (item #7), and satisfaction (item #4). In receiver operating characteristic (ROC) analyses, area under the curve (AUC) was calculated to compare discrimination on the ISI-SF to two criteria: the full-scale ISI using a cutoff of ≥8 recently validated in this sample, and the SCID-5 insomnia module. Consistent with previous research, we specified a priori that a cut-off score on the ISI-SF with sensitivity ≥.85 and specificity ≥.75 would be acceptable. Results The ISI-SF had excellent discrimination when compared to the full-scale ISI (AUC = .97) and a cut-off score of ≥4 met criteria with a sensitivity of 97% and specificity of 86%. The ISI-SF had good discrimination when compared to the SCID-5 (AUC = .88), but none of the cut-off scores met a priori criteria for sensitivity and specificity. A cut-off score of ≥4 came closest with a sensitivity of 94% and specificity of 70%. Conclusion Although the ISI-SF did not meet sensitivity and specificity criteria for a stand-alone screening measure when compared to a diagnostic interview, it demonstrated utility as the first step in a two-step screening procedure. Specifically, the high sensitivity of the ≥4 ISI-F cut-off score is well-suited to accurately screening out YACS who do not need insomnia services; as a second screen, the SCID-5 insomnia module could be administered only to those elevated on the ISI-SF in order to identify false positives cases before making referrals for insomnia specialists. Support (if any) National Cancer Institute (1R21CA223832), Swim Across America

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