Recognizing depression in patients with Parkinson’s disease: accuracy and specificity of two depression rating scale

This study aimed to find cut-off scores for the Montgomery-Asberg rating scale (MADRS) and the Beck depression inventory (BDI) that can relate to specific clinical diagnoses of depression in Parkinson´s disease (PD). Mild and moderate PD patients (n=46) were evaluated for depression according to the DSM IV criteria. All patients were assessed with the MADRS and the BDI. A "receiver operating characteristics" (ROC) curve was obtained and the sensibility, specificity, positive and the negative predictive values were calculated for different cut-off scores of the MADRS and the BDI. The Kappa statistic was calculated for different cut-off scores to assess the agreement between the clinical judgment and both scales. Depression was present in 18 patients. MADRS cut-off scores of 6 and 10 showed Kappa 0.5 and 0.56, respectively. Specificity of cut-off score of 6 was 78.6% and of cut-off score of 10 was 96.4%. Kappa agreement of BDI cut-off scores of 10 and 18 were 0.36 and 0.62, respectively. Specificity was 60.7% for 10 and 92.9% for 18. Both rating scales show similar accuracy within the ROC curves (84.3% for MADRS and 79.7% for BDI). The MADRS and the BDI show a good accuracy and correlation to the clinical diagnosis when a cut-off score of 10 is used to MADRS and a cut-off score of 18 is used to BDI to recognize depression in mild to moderate PD patients. This may help clinicians to recognize depression in PD.

Download Full-text

The Validity of the Hospital Anxiety and Depression Scale and the Geriatric Depression Scale in Parkinson’s Disease

Behavioural Neurology ◽

10.1155/2006/136945 ◽

2006 ◽

Vol 17 (2) ◽

pp. 109-115 ◽

Cited By ~ 50

Author(s):

Federica Mondolo ◽

Marjan Jahanshahi ◽

Alessia Granà ◽

Emanuele Biasutti ◽

Emanuela Cacciatori ◽

...

Keyword(s):

Rating Scales ◽

Rating Scale ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Anxiety And Depression ◽

Geriatric Depression ◽

Operating Characteristics ◽

Hospital Anxiety ◽

Predictive Values ◽

Face Scale

We assessed the concurrent validity of the Hospital Anxiety and Depression Scale (HADS) and the Geriatric Depression Scale (GDS) against the Hamilton Rating Scale for Depression (Ham-D) in patients with Parkinson’ disease (PD). Forty-six non-demented PD patients were assessed by a neurologist on the Ham-D. Patients also completed four mood rating scales: the HADS, the GDS, the VAS and the Face Scale. For the HADS and the GDS, Receiver Operating Characteristics (ROC) curves were obtained and the positive and negative predictive values (PPV, NPV) were calculated for different cut-off scores. Maximum discrimination between depressed and non-depressed PD patients was reached at a cut-off score of 10/11 for both the HADS and the GDS. At the same cut-off score of 10/11 for both the HADS and the GDS, the high sensitivity and NPV make these scales appropriate screening instruments for depression in PD. A high specificity and PPV, which is necessary for a diagnostic test, was reached at a cut-off score of 12/13 for the GDS and at a cut-off score of 11/12 for the HADS. The results indicate the validity of using the HADS and the GDS to screen for depressive symptoms and to diagnose depressive illness in PD.

Download Full-text

Using Differential Item Functioning to Test for Interrater Reliability in Constructed Response Items

Educational and Psychological Measurement ◽

10.1177/0013164419899731 ◽

2020 ◽

Vol 80 (4) ◽

pp. 808-820

Author(s):

Cindy M. Walker ◽

Sakine Göçer Şahin

Keyword(s):

Differential Item Functioning ◽

Interrater Reliability ◽

Rating Scales ◽

Rating Scale ◽

Intraclass Correlation ◽

Kappa Statistic ◽

Promising Alternative ◽

Constructed Response ◽

Polytomous Item ◽

Item Functioning

The purpose of this study was to investigate a new way of evaluating interrater reliability that can allow one to determine if two raters differ with respect to their rating on a polytomous rating scale or constructed response item. Specifically, differential item functioning (DIF) analyses were used to assess interrater reliability and compared with traditional interrater reliability measures. Three different procedures that can be used as measures of interrater reliability were compared: (1) intraclass correlation coefficient (ICC), (2) Cohen’s kappa statistic, and (3) DIF statistic obtained from Poly-SIBTEST. The results of this investigation indicated that DIF procedures appear to be a promising alternative to assess the interrater reliability of constructed response items, or other polytomous types of items, such as rating scales. Furthermore, using DIF to assess interrater reliability does not require a fully crossed design and allows one to determine if a rater is either more severe, or more lenient, in their scoring of each individual polytomous item on a test or rating scale.

Download Full-text

Endoscopist’s Judgment Is as Useful as Risk Scores for Predicting Outcome in Peptic Ulcer Bleeding: A Multicenter Study

Journal of Clinical Medicine ◽

10.3390/jcm9020408 ◽

2020 ◽

Vol 9 (2) ◽

pp. 408

Author(s):

Enric Brullet ◽

Pilar Garcia-Iglesias ◽

Xavier Calvet ◽

Michel Papo ◽

Montserrat Planella ◽

...

Keyword(s):

Peptic Ulcer ◽

Roc Curve ◽

Clinical Judgment ◽

Scoring Systems ◽

Subjective Assessment ◽

Risk Scores ◽

Ulcer Bleeding ◽

Operating Characteristics ◽

Peptic Ulcer Bleeding ◽

Predictive Values

Background: Guidelines recommend using prognostic scales for risk stratification in patients with non-variceal upper gastrointestinal bleeding. It remains unclear whether risk scores offer greater accuracy than clinical evaluation. Objective: Compare the diagnostic accuracy of the endoscopist’s judgment against different risk-scoring systems (Rockall, Glasgow–Blatchford, Baylor and the Cedars–Sinai scores) for predicting outcomes in peptic ulcer bleeding (PUB). Methods: Between February 2006 and April 2010 we prospectively recruited 401 patients with peptic ulcer bleeding; 225 received endoscopic treatment. The endoscopist recorded his/her subjective assessment (“endoscopist judgment”) of the risk of rebleeding and death immediately after endoscopy for each patient. Independent evaluators calculated the different scores. Area under the receiver-operating-characteristics (ROC) curve, sensitivity, specificity, positive and negative predictive values were calculated for rebleeding and mortality. Results: The areas under ROC curve of the endoscopist’s clinical judgment for rebleeding (0.67–0.75) and mortality (0.84–0.9) were similar or even superior to the different risk scores in both the whole group and in patients receiving endoscopic therapy. Conclusions: The accuracy of the currently available risk scores for predicting rebleeding and mortality in PUB patients was moderate and not superior to the endoscopist’s judgment. More precise prognostic scales are needed.

Download Full-text

Global Longitudinal Strain in Heart Transplantation Recipients Using Different Vendors: Reliability and Validity in a Tertiary Hospital in Colombia.

10.21203/rs.3.rs-357760/v1 ◽

2021 ◽

Author(s):

Oscar Mauricio Perez Fernandez ◽

Hector M. Medina ◽

Mónica López ◽

Madeleine Barrera ◽

Azucena Martinez ◽

...

Keyword(s):

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Intraclass Correlation ◽

Reliability And Validity ◽

Roc Curves ◽

Tertiary Hospital ◽

Operating Characteristics ◽

Predictive Values ◽

Left Ventricle Function

Abstract Global Longitudinal Strain (GLS) is a useful tool to follow-up heart transplant (HT) recipients. Important inter-vendor variability of GLS measurements has been reported in healthy subjects and different conditions, but there is still limited evidence among HT patients. We assessed the reliability and validity of GLS using two vendors (General Electric and Philips) in a group of consecutive and stable adult HT recipients. Patients underwent two concurrent GLS analyses during their echocardiographic follow-up. We evaluated GLS inter-vendor reliability using Bland-Altman’s limits of agreement (LOA) plots, computing its coverage probability (CP) and the intraclass correlation coefficient (ICC). Validity was assessed though receiver operating characteristics (ROC) curves, predictive values, sensitivity and specificity of GLS for each vendor to detect a normal left ventricle function. 78 pairs of GLS studies in 53 stable HT patients were analyzed. We observed a modest inter-vendor reliability with a broad LOA (less than 50% of values falling out our CP of 2% and an ICC of 0.49). ROC analyses (areas under the curve of 0.824 Vs. 0.631, p<0.05) and diagnosis test indices (Sensitivity of 0.73 Vs. 0.64; and Specificity of 0.79 Vs. 0.50) favored GE over Philips. Inter-vendor variability for GLS analysis exceeded clinically acceptable limits in HT recipients. GLS from GE software seemed to show higher validity as compared to Philips’. The present study provides evidence to consider caution for the interpretation of GLS for clinical management in the follow-up of HT patients, especially when GLS is measured by different vendors.

Download Full-text

Iowa's Severity Rating Scales for Communication Disabilities

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1303.156 ◽

1982 ◽

Vol 13 (3) ◽

pp. 156-162 ◽

Cited By ~ 2

Author(s):

Kenneth D. Barker ◽

Robert A. Baldes ◽

Phillip H. Jenkinson ◽

Kenyon D. Wilson ◽

J. Joseph Freilinger

Keyword(s):

Service Delivery ◽

Clinical Judgment ◽

Rating Scales ◽

Rating Scale ◽

Language Fluency ◽

State Laws ◽

Severity Rating ◽

Speech Language Pathologist ◽

Restrictive Environment ◽

The Continuum

PL 94-142 mandates that all pupils who are handicapped receive an appropriate program in the least restrictive environment. In implementing both federal and state laws, it was necessary to depart from the traditional methods of service delivery, and so a continuum of services concept was adopted. Attached to the continuum of services are severity rating scales that indicate milestones along the continuum. A severity rating scale was developed for articulation, language, fluency, and voice. Although providing direction for the speech-language pathologist, clinical judgment was not compromised. The severity rating scale assists the clinician in case selection and suggests the intensity of the service delivery model. Data obtained from use of the scale can be employed to appropriately assign staff. Each scale is reproduced in an appendix to this article.

Download Full-text

Serum Exosomal MicroRNAs Predict Acute Respiratory Distress Syndrome Events in Patients with Severe Community-Acquired Pneumonia

BioMed Research International ◽

10.1155/2019/3612020 ◽

2019 ◽

Vol 2019 ◽

pp. 1-11 ◽

Cited By ~ 5

Author(s):

Xu Wu ◽

Chengzhi Wu ◽

Wenyu Gu ◽

Haiying Ji ◽

Lei Zhu

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Area Under The Curve ◽

Roc Curves ◽

Community Acquired Pneumonia ◽

Operating Characteristics ◽

Predictive Values ◽

Severe Community Acquired Pneumonia

Background. Severe community-acquired pneumonia (SCAP) requiring intensive care unit (ICU) treatment commonly causes acute respiratory distress syndrome (ARDS) with high mortality. This study was aimed at evaluating whether microRNAs (miRNAs) in circulating exosomes have the predictive values for patients at risk of developing ARDS due to SCAP. Methods. ARDS/ALI-relevant miRNAs were obtained by literature search. Exosomes in serum were isolated by ultracentrifugation method and identified by Transmission Electron Microscopy. Then the miR profiling in the exosomes using real-time PCR was analyzed in SCAP patients with or without ARDS. Moreover, multivariate Cox proportional regression analysis was performed to estimate the odds ratio of miRNA for the occurrence of ARDS and prognosis. The receiver operating characteristics (ROC) curves were calculated to discriminate ARDS cases. Finally, the Kaplan-Meier curve using log-rank method was performed to test the equality for survival distributions with different miRNA classifiers. Results. A total of 53 SCAP patients were finally recruited. Ten miRNAs were picked out. Further, a subset of exosomal miRNAs, including the miR-146a, miR-27a, miR-126, and miR-155 in ARDS group exhibited significantly elevated levels than those in non-ARDS group. The combined expression of miR-126, miR-27a, miR-146a, and miR-155 predicted ARDS with an area under the curve of 0.909 (95 % CI 0.815 –1). Only miR-126 was selected to have potential to predict the 28-day mortality (OR=1.002, P=0.024) with its median value classifier. Conclusions. The altered levels of circulating exosomal microRNAs may be useful biologic confirmation of ARDS in patients with SCAP.

Download Full-text

Using patient-reported symptoms of dyspnea for screening reduced respiratory function in patients with motor neuron diseases

Journal of Neurology ◽

10.1007/s00415-020-10003-5 ◽

2020 ◽

Vol 267 (11) ◽

pp. 3310-3318

Author(s):

Jochem Helleman ◽

Esther T. Kruitwagen-van Reenen ◽

J. Bakers ◽

Willeke J. Kruithof ◽

Annerieke C. van Groenestijn ◽

...

Keyword(s):

Sleep Quality ◽

Motor Neuron ◽

Respiratory Function ◽

Diagnostic Performance ◽

Vital Capacity ◽

Rating Scale ◽

Roc Curves ◽

Motor Neuron Diseases ◽

Predictive Values ◽

Patient Reported

Abstract Background Poor monitoring of respiratory function may lead to late initiation of non-invasive ventilation (NIV) in patients with motor neuron diseases (MND). Monitoring could be improved by remotely assessing hypoventilation symptoms between clinic visits. We aimed to determine which patient-reported hypoventilation symptoms are best for screening reduced respiratory function in patients with MND, and compared them to the respiratory domain of the amyotrophic lateral sclerosis functional rating scale (ALSFRS-R). Methods This prospective multi-center study included 100 patients with MND, who were able to perform a supine vital capacity test. Reduced respiratory function was defined as a predicted supine vital capacity ≤ 80%. We developed a 14-item hypoventilation symptom questionnaire (HYSQ) based on guidelines, expert opinion and think-aloud interviews with patients. Symptoms of the HYSQ were related to dyspnea, sleep quality, sleepiness/fatigue and pneumonia. The diagnostic performances of these symptoms and the ALSFRS-R respiratory domain were determined from the receiver operating characteristic (ROC) curves, area under the curve (AUC), sensitivity, specificity, predictive values and accuracy. Results Dyspnea-related symptoms (dyspnea while eating/talking, while lying flat and during light activity) were combined into the MND Dyspnea Scale (MND-DS). ROC curves showed that the MND-DS had the best diagnostic performance, with the highest AUC = 0.72, sensitivity = 75% and accuracy = 71%. Sleep-quality symptoms, sleepiness/fatigue-related symptoms and the ALSFRS-R respiratory domain showed weak diagnostic performance. Conclusion The diagnostic performance of the MND-DS was better than the respiratory domain of the ALSFRS-R for screening reduced respiratory function in patients with MND, and is, therefore, the preferred method for (remotely) monitoring respiratory function.

Download Full-text

Introduction, development, and evaluation of the miniclinical evaluation exercise in postgraduate education of chiropractors

Journal of Chiropractic Education ◽

10.7899/jce-14-14 ◽

2015 ◽

Vol 29 (1) ◽

pp. 22-28 ◽

Cited By ~ 3

Author(s):

Inga Paravicini ◽

Cynthia K. Peterson

Keyword(s):

Correlation Coefficient ◽

Clinical Judgment ◽

Rating Scales ◽

Rating Scale ◽

Clinical Performance ◽

Intraclass Correlation ◽

Postgraduate Education ◽

Clinical Encounter ◽

Formative Feedback ◽

Evaluation Exercise

Objective To determine if the clinical evaluation exercise (CEX) format is reliable, applicable and useful for evaluating clinical competency in the postgraduate chiropractic program as formative feedback. Methods Twelve mini-CEX clinical encounters were evaluated by 2 assessors per clinical encounter (7 assessors per session) in 23 chiropractic residents over a 12-month period. Two different rating scales (9 point and 5 point) were used, and the 2 assessors completed the forms independently. Individual competencies assessed consisted of history taking, physical examination, organization/efficiency, clinical judgment, professionalism/communication, counseling, and overall clinical performance. Interassessor reliability was calculated using κ and intraclass correlation coefficient statistics. Cronbach α assessed internal consistency of the mini-CEX. Spearman correlation coefficient evaluated correlation between the various competencies. The Mann-Whitney U test evaluated differences between the assessors' median numerical scores. Results The κ value for the 9-point rating scale was 0.31 (fair) and for the 5-point scale was 0.42 (moderate) with statistically significant intraclass correlation values (p < .05) for 4 of the 6 competencies. High correlation coefficients (p = .0001) were found when comparing the various competencies at each clinical encounter. There were no significant differences between the 2 assessors per clinical encounter for the scores awarded to the residents. Conclusions The mini-CEX is a reliable and useful tool to provide valuable formative feedback to postgraduate chiropractic residents. The 5-point grading scale was more user-friendly with better reliability.

Download Full-text

AAC Collaboration Using the Self-Anchored Rating Scales (SARS): An Aphasia Case Study

Perspectives on Augmentative and Alternative Communication ◽

10.1044/aac21.4.136 ◽

2012 ◽

Vol 21 (4) ◽

pp. 136-143

Author(s):

Lynn E. Fox

Keyword(s):

Augmentative And Alternative Communication ◽

Rating Scales ◽

Rating Scale ◽

Therapeutic Process ◽

Family Counseling ◽

The Self ◽

Alternative Communication ◽

Her Family ◽

Solution Focused

Abstract The self-anchored rating scale (SARS) is a technique that augments collaboration between Augmentative and Alternative Communication (AAC) interventionists, their clients, and their clients' support networks. SARS is a technique used in Solution-Focused Brief Therapy, a branch of systemic family counseling. It has been applied to treating speech and language disorders across the life span, and recent case studies show it has promise for promoting adoption and long-term use of high and low tech AAC. I will describe 2 key principles of solution-focused therapy and present 7 steps in the SARS process that illustrate how clinicians can use the SARS to involve a person with aphasia and his or her family in all aspects of the therapeutic process. I will use a case study to illustrate the SARS process and present outcomes for one individual living with aphasia.

Download Full-text

Childbirth and Posttraumatic Stress Responses

European Journal of Psychological Assessment ◽

10.1027/1015-5759.22.4.259 ◽

2006 ◽

Vol 22 (4) ◽

pp. 259-267 ◽

Cited By ~ 40

Author(s):

Eelco Olde ◽

Rolf J. Kleber ◽

Onno van der Hart ◽

Victor J.M. Pop

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Responses ◽

Rating Scales ◽

Rating Scale ◽

Stress Disorder ◽

Traumatic Experience ◽

Event Scale ◽

Self Rating ◽

The Impact

Childbirth has been identified as a possible traumatic experience, leading to traumatic stress responses and even to the development of posttraumatic stress disorder (PTSD). The current study investigated the psychometric properties of the Dutch version of the Impact of Event Scale-Revised (IES-R) in a group of women who recently gave birth (N = 435). In addition, a comparison was made between the original IES and the IES-R. The scale showed high internal consistency (α = 0.88). Using confirmatory factor analysis no support was found for a three-factor structure of an intrusion, an avoidance, and a hyperarousal factor. Goodness of fit was only reasonable, even after fitting one intrusion item on the hyperarousal scale. The IES-R correlated significantly with scores on depression and anxiety self-rating scales, as well as with scores on a self-rating scale of posttraumatic stress disorder. Although the IES-R can be used for studying posttraumatic stress reactions in women who recently gave birth, the original IES proved to be a better instrument compared to the IES-R. It is concluded that adding the hyperarousal scale to the IES-R did not make the scale stronger.

Download Full-text