Diagnostic Accuracy of the Screening Instruments Used to Identify Postpartum Depression in the Primary Care Setting: Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Russy Novita Andriani ◽  
Siti Solichatul Makkiyyah ◽  
Amanda Safira Dea Hertika ◽  
Wahyudi Istiono ◽  
Mohammad Hakimi
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Postpartum Depression ◽  
Diagnostic Accuracy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Meta Analysis ◽  
Depression Screening ◽  
Screening Instruments ◽  
Meta Analyses

Abstract Background Postpartum depression (PPD) is a prevalent complication of pregnancy, this condition affects maternal and child well-being and functioning. Results from a meta-analysis showed an incidence of 13% PPD cases in the first 12 weeks after labor. Primary care is the first gate and continuing point of care for patients. Despite the controversy of screening and early identification in primary care settings, many PPD cases remain undetected. Given the uncertainty about this issue, screening instruments must be effective in identifying the cases. This systematic review and meta-analyses aim to identify the most suitable postpartum depression screening instrument for use in primary care. Methods PubMed, ScienceDirect, and ProQuest databases were used to search using relevant keywords or MeSH, with limitation of publication from January 1st, 2010 through December 31st, 2020. We will include screening studies on postpartum women using validated screening tools followed by validated structured or semi-structured interview for Diagnostic and Statistical Manual of Mental Disorders (DSM) as the reference standard in the primary care setting. Study designs included in the review are cross-sectional and randomized controlled trial without no screening arm on the diagnostic study. We will use a liberal accelerated method on the title and abstract review stage, then perform full-text article reviews on selected studies. Methodological quality will be assessed independently by two authors according to QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2). Extraction of the study data will be undertaken by one reviewer and checked by a second reviewer. Disagreements will be resolved by consensus and including a third investigator as necessary. The test characteristics will be extracted into 2x2 tables for all included studies. Study-specific estimates of sensitivity and specificity with 95% confidence intervals will be displayed in forest plots. Discussion The proposed systematic review and meta-analyses will allow us to obtain the most suitable postpartum depression screening instrument for use in primary care. Systematic review registration: PROSPERO CRD42020216067

scholarly journals A Practical and Validated Fall Risk Screening Instrument: A Systematic Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 233-233
Author(s):  
Wytske Meekes ◽  
J C Korevaar ◽  
C J Leemrijse ◽  
L A M van de Goor
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Older People ◽  
Fall Risk ◽  
Care Setting ◽  
Primary Care Setting ◽  
Screening Instrument ◽  
Screening Instruments ◽  
Risk Screening ◽  
Fall Risk Screening

Abstract Early detection of a high fall risk is important to start fall preventive interventions in time and to reduce fall risk among older people. Several fall risk screening instruments are available, however it is unclear which instrument is validated and most suitable for the primary care setting. This systematic review aims to identify the most suitable fall risk screening instrument(s) for the primary care setting (i.e. requires limited time, no expensive equipment and no additional space) with good prognostic ability to assess high fall risk among independently living older people. An extensive search was conducted in the databases PubMed, EMBASE CINAHL, Cochrane and PsycINFO. Twenty-six out of 2277 articles published between January 2000 and February 2019 were included. Six fall risk screening instruments were identified; TUG test, Gait Speed test, BBS, POMA, FR test, Fall History. Most articles reported AUCs ranging from 0.5-0.7 for all instruments. Sensitivity and specificity varied substantially across studies (e.g. TUG, sens.: 10-83.3%, spec.:37-96.6%). The results showed that none of the included screening instruments had sufficient (AUC>0.7) predictive performance (Šimundić, 2009). As suitability for the primary care setting prevails for now, Fall History appears to be the most suitable screening instrument. Compared to the other instruments, Fall History requires the least amount of time, no expensive equipment, no training, and no space (adjustments). Patient’s fall history together with a health care professional’s clinical judgment, might be a promising screening strategy for the primary care setting to identify high fall risk among older people.

scholarly journals Can physical testing be used to distinguish between migraine and cervicogenic headache sufferers? A protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031587 ◽  
Author(s):  
Ernesto Anarte ◽  
Gabriela Ferreira Carvalho ◽  
Annika Schwarz ◽  
Kerstin Luedtke ◽  
Deborah Falla
Keyword(s):  
Systematic Review ◽  
Differential Diagnosis ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Cervicogenic Headache ◽  
Ethical Approval ◽  
Black Scale ◽  
Physical Tests ◽  
Meta Analyses ◽  
Asymptomatic Subjects

IntroductionDifferential diagnosis of migraine and cervicogenic headache (CGH) can be challenging given the large overlap of symptoms, commonly leading to misdiagnosis and ineffective treatment. In order to strengthen the differential diagnosis of headache, previous studies have evaluated the utility of physical tests to examine for musculoskeletal impairment, mainly in the cervical spine, which could be provoking or triggering headache. However, no systematic review has attempted to evaluate whether physical tests can differentiate CGH from migraine or both conditions from asymptomatic subjects.Methods/analysisA systematic review protocol has been designed and is reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). A sensitive topic-based search strategy is planned which will include databases, hand searching of key journals and consultation of relevant leading authors in this field. Terms and keywords will be selected after discussion and agreement. Two independent reviewers will perform the search and select studies according to inclusion and exclusion criteria, including any cohort or observational studies evaluating the topic of this review; a third reviewer will confirm accuracy. A narrative synthesis will be developed for all included studies and, if possible, a meta-analysis will be conducted. The overall quality of the evidence will be assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist for diagnostic accuracy studies and the Downs and Black scale for those studies where the QUADAS-2 checklist cannot be applied.Ethics and disseminationEthical approval is not required since no patient information will be collected. The results will provide a deeper understanding about the possibility of using physical tests to differentiate cervicogenic headache from migraine and from asymptomatic subjects, which has direct relevance for clinicians managing people with headache. The results will be published in a peer-reviewed journal and presented at scientific conferences.PROSPERO registration numberCRD42019135269.

Diagnostic accuracy of transient elastography (FibroScan) versus the aspartate transaminase to platelet ratio index in assessing liver fibrosis in chronic hepatitis B: The role in primary care setting

2011 ◽  
Vol 64 (10) ◽  
pp. 916-920 ◽  
Author(s):  
C Rinaldi A Lesmana ◽  
Simon Salim ◽  
Irsan Hasan ◽  
Andri S Sulaiman ◽  
Rino A Gani ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Diagnostic Accuracy ◽  
Chronic Hepatitis B ◽  
Care Setting ◽  
Primary Care Setting ◽  
Transient Elastography ◽  
Liver Stiffness

BackgroundA non-invasive method to assess liver fibrosis by measuring liver stiffness with transient elastography (TE) has been recently introduced. The role of TE among chronic hepatitis B (CHB) patients in starting antiviral therapy in the primary care setting is still controversial because of its high cost. The AST to platelet ratio index (APRI) could be a much cheaper alternative.ObjectivesThis study compares the diagnostic accuracy of TE and APRI in assessing liver fibrosis in CHB patients.Patients and MethodsA cross-sectional study in CHB patients intending to start antiviral treatment. Liver fibrosis was staged according to the METAVIR scoring system. Liver stiffness was measured by TE performed on the same day with liver biopsy, while APRI was calculated as follows: APRI=(AST/upper limit of normal)×100/platelet count (109/l). Cutoff levels of liver stiffness and APRI were calculated by using the receiver operating characteristic curve to detect significant liver fibrosis, defined as fibrosis stage F2 or more.Results117 patients were enrolled in the study; their mean age was 40.6±10.97 years. The median liver stiffness was 5.9 kPa (2.5–48 kPa) and the median APRI was 0.239 (0.09–2.73). The cutoff level of liver stiffness was 5.85 kPa for ≥F2 with an AUC of 0.614, 60.3% sensitivity, 63.6% specificity, 73.3% PPV, 49.1% NPV and a LR+ of 1.66. The APRI cutoff level was 0.235 for F≥2 with an AUC of 0.693, 64.4% sensitivity, 70.5% specificity, 78.3% PPV, 54.4% NPV and a LR+ of 2.18. Both methods gave comparable diagnostic accuracy.ConclusionAPRI is a useful marker to screen liver fibrosis in the primary care setting when TE is not available.

Screening questionnaires to identify problem drinking in the primary care setting: a systematic review

2015 ◽  
Vol 24 (1) ◽  
pp. 9-19 ◽  
Author(s):  
Gerhard Mueller ◽  
Petra Schumacher ◽  
Jutta Wetzlmair ◽  
Martin Pallauf
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Problem Drinking ◽  
Screening Questionnaires
Sign in / Sign up

Export Citation Format

Share Document