scholarly journals Effects of experience-based frequency learning on posterior probability judgments

2021 ◽  
Author(s):  
Bonnie A. Armstrong
Keyword(s):  
Older Adults ◽  
Posterior Probability ◽  
Natural Frequencies ◽  
Screening Tests ◽  
Conditional Probabilities ◽  
Medical Decisions ◽  
Predictive Values ◽  
Probability Judgments ◽  
Medical Tests ◽  
Probability Estimates

Aging is associated with an increase in the frequency of medical screening tests. Bayesian inference is used to estimate posterior probabilities of medical tests such as positive or negative predictive values (PPVs or NPVs). Both laypeople and experts are typically poor at estimating PPVs and NPVs when relevant probabilities are communicated descriptively. Decision making research has revealed dissociations between described and experience-based judgments. This study examined the accuracy of posterior probability estimates of 80 younger and 81 older adults when statistical information was presented through description or experience. Results show that both younger and older adults can make more accurate posterior probability estimates if they experience probabilities compared to when probabilities are described as either natural frequencies or conditional probabilities. Results also indicate that most people prefer to rely on physicians to make their medical decisions regardless of how confident they are in their judgments of probabilities.

scholarly journals Effects of experience-based frequency learning on posterior probability judgments

2021 ◽  
Author(s):  
Bonnie A. Armstrong
Keyword(s):  
Older Adults ◽  
Posterior Probability ◽  
Natural Frequencies ◽  
Screening Tests ◽  
Conditional Probabilities ◽  
Medical Decisions ◽  
Predictive Values ◽  
Probability Judgments ◽  
Medical Tests ◽  
Probability Estimates

Aging is associated with an increase in the frequency of medical screening tests. Bayesian inference is used to estimate posterior probabilities of medical tests such as positive or negative predictive values (PPVs or NPVs). Both laypeople and experts are typically poor at estimating PPVs and NPVs when relevant probabilities are communicated descriptively. Decision making research has revealed dissociations between described and experience-based judgments. This study examined the accuracy of posterior probability estimates of 80 younger and 81 older adults when statistical information was presented through description or experience. Results show that both younger and older adults can make more accurate posterior probability estimates if they experience probabilities compared to when probabilities are described as either natural frequencies or conditional probabilities. Results also indicate that most people prefer to rely on physicians to make their medical decisions regardless of how confident they are in their judgments of probabilities.

scholarly journals Indicadores antropométricos como instrumento de triagem para quedas em idosos

2016 ◽  
Vol 18 (5) ◽  
pp. 530
Author(s):  
Drielly Soares Freitas ◽  
Juleimar Soares Coelho de Amorim ◽  
Renata Maciulis Dip ◽  
Marcos Aparecido Sarria Cabrera ◽  
Mara Solange Gomes Dellaroza ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Lean Body Mass ◽  
Body Mass ◽  
The Elderly ◽  
Screening Tests ◽  
Systematic Sampling ◽  
Body Composition Assessment ◽  
Predictive Values ◽  
Anthropometric Indicators

DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n5p530 Anthropometric indicators enable professionals for predicting risk of falls in the elderly; however, there is a gap in literature on reference values. This study analyzes anthropometric indicators such as screening tests for falls in the elderly. Cross-sectional population-based systematic sampling was conducted through a household survey and body composition assessment. Anthropometric measurements were performed using portable electronic scale and stadiometer. Bioimpedance device was used to measure body mass index, body fat and lean body mass. Falls were evaluated in the 12 months preceding the interview as a dependent variable. Discriminatory analysis was performed for falls through the ROC curve, sensitivity, specificity, positive and negative predictive values. Overall, 275 older adults participated in this study, whose prevalence of falls was 23.6%. The average body mass index was 27.8kg/cm2 and 52.1% of individuals were overweight. Among older men, height (ROC=0.68; 95%CI 0.54-0.78) and lean body mass (ROC=0.63, 95%CI 0.58- 0.76) were associated to the occurrence of falls. When considering cutoff of 52.2kg and 166cm, sensitivity was obtained in 75% and high negative predictive values (88.1% and 89.1% respectively). For women, lean body mass (ROC=0.61, 95%CI 0.30-0.49) and body mass (ROC=0.60, 95%CI 0.53-0.72) were relevant from the optimal cutoff point of 28.9% and 57.2kg/m2. Lean body mass was more sensitive (63.2%) and body mass little more specific (64.3%), both with high negative predictive values (82.0% and 83.0%). The indicators used were able to discriminate older adults who have suffered from falls. 

scholarly journals Triple Test Plus Rapid Cognitive Screening Test: A Combination of Clinical Signs and A Tool for Cognitive Assessment in Older Adults

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 97 ◽  
Author(s):  
Saadet Koc Okudur ◽  
Ozge Dokuzlar ◽  
Derya Kaya ◽  
Pinar Soysal ◽  
Ahmet Turan Isik
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Clinical Signs ◽  
Diagnostic Value ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Head Turning ◽  
Predictive Values ◽  
Triple Test ◽  
Cognitive Screen

Less time-consuming, easy-to-apply and more reliable cognitive screening tests are essential for use in primary care. The aim of this study was to investigate the diagnostic value of the Turkish version of the Rapid Cognitive Screen (RCS-T) and Triple Test individually and the combination of RCS-T with each sign and Triple Test to screen elderly patients for cognitive impairment (CI). A total of 357 outpatients aged 60 or older, who underwent comprehensive geriatric assessment, were included in the study. Presence or absence of attended alone sign (AAS), head-turning sign, and applause sign was investigated. The mean age of the patients was 74.29 ± 7.46. Of those, 61 patients (28 men, 33 women) had Alzheimer’s disease (AD), 59 patients had mild cognitive impairment (MCI) (29 men, 30 women), and 237 (80 men, 157 women) were cognitively robust. The sensitivity of the combination of RCS-T and negative for AAS for CI, AD and MCI is 0.79, 0.86 and 0.61, respectively; the specificity was 0.92, 0.93 and 0.92, respectively; and the positive and negative predictive values revealed good diagnostic accuracy. The combination of RCS-T and negative for AAS is a simple, effective and rapid way to identify possible CI in older adults.

Effects of Transport Medium Composition on in vitro Drug Permeation across Excised Pig Intestinal Tissue

2020 ◽  
Vol 10 ◽  
Author(s):  
Bianca Peterson ◽  
Henrico Heystek ◽  
Josias H. Hamman ◽  
Johan D. Steyn
Keyword(s):  
Medium Composition ◽  
Screening Tests ◽  
Intestinal Tissue ◽  
Predictive Values ◽  
Transport Medium ◽  
Intestinal Fluids ◽  
Lower Permeability ◽  
The Impact ◽  
Simulated Intestinal Fluids

Background:: Knowledge of the permeation characteristics of new chemical entities across biological membranes is essential to drug research and development. Transport medium composition may affect the absorption of compounds during in vitro drug transport testing. To preserve the predictive values of screening tests, the possible influence of transport media on the solubility of model drugs, and on the activities of tight junctions and efflux transporter proteins (e.g. P-glycoprotein) must be known. Objective:: The aim of this study was to compare the impact of different transport media on the bi-directional transport of standard compounds, selected from the four classes of the Biopharmaceutical Classification System (BCS), across excised pig intestinal tissue. Methods:: The Sweetana-Grass diffusion apparatus was used for the transport studies. Krebs-Ringer bicarbonate (KRB) buffer and simulated intestinal fluids in the fed (FeSSIF) and fasted (FaSSIF) states were used as the three transport media, while the chosen compounds were abacavir (BCS class 1), dapsone (BCS class 2), lamivudine (BCS class 3) and furosemide (BCS class 4). Results:: Abacavir exhibited lower permeability in both the simulated intestinal fluids than in the KRB buffer. Dapsone showed similar permeability in all media. Lamivudine exhibited lower permeability in FaSSIF than in the other two media. Furosemide exhibited improved transport with pronounced efflux in FaSSIF. Conclusion:: Different permeation behaviors were observed for the selected drugs in the respective media, which may have resulted from their different physico-chemical properties, as well as from the effects that dissimilar transport media components had on excised pig intestinal tissue.

scholarly journals A Modified CAIDE Risk Score as a Screening Tool for Cognitive Impairment in Older Adults

2021 ◽  
pp. 1-14
Author(s):  
Magdalena I. Tolea ◽  
Jaeyeong Heo ◽  
Stephanie Chrisphonte ◽  
James E. Galvin
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Risk Score ◽  
Clinical Sample ◽  
Community Sample ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Risk Scores ◽  
Predictive Values

Background: Although an efficacious dementia-risk score system, Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) was derived using midlife risk factors in a population with low educational attainment that does not reflect today’s US population, and requires laboratory biomarkers, which are not always available. Objective: Develop and validate a modified CAIDE (mCAIDE) system and test its ability to predict presence, severity, and etiology of cognitive impairment in older adults. Methods: Population consisted of 449 participants in dementia research (N = 230; community sample; 67.9±10.0 years old, 29.6%male, 13.7±4.1 years education) or receiving dementia clinical services (N = 219; clinical sample; 74.3±9.8 years old, 50.2%male, 15.5±2.6 years education). The mCAIDE, which includes self-reported and performance-based rather than blood-derived measures, was developed in the community sample and tested in the independent clinical sample. Validity against Framingham, Hachinski, and CAIDE risk scores was assessed. Results: Higher mCAIDE quartiles were associated with lower performance on global and domain-specific cognitive tests. Each one-point increase in mCAIDE increased the odds of mild cognitive impairment (MCI) by up to 65%, those of AD by 69%, and those for non-AD dementia by >  85%, with highest scores in cases with vascular etiologies. Being in the highest mCAIDE risk group improved ability to discriminate dementia from MCI and controls and MCI from controls, with a cut-off of ≥7 points offering the highest sensitivity, specificity, and positive and negative predictive values. Conclusion: mCAIDE is a robust indicator of cognitive impairment in community-dwelling seniors, which can discriminate well between dementia severity including MCI versus controls. The mCAIDE may be a valuable tool for case ascertainment in research studies, helping flag primary care patients for cognitive testing, and identify those in need of lifestyle interventions for symptomatic control.

scholarly journals The relationship between memory complaints and age in normal aging

2009 ◽  
Vol 3 (2) ◽  
pp. 94-100 ◽  
Author(s):  
Thaís Bento Lima-Silva ◽  
Mônica Sanches Yassuda
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Digit Span ◽  
Normal Aging ◽  
Screening Tests ◽  
Memory Complaint ◽  
Memory Complaints ◽  
The Impact ◽  
The Relationship

Abstract Normal aging can be characterized by a gradual decline in some cognitive functions, such as memory. Memory complaints are common among older adults, and may indicate depression, anxiety, or cognitive decline. Objectives: To investigate the association between memory complaints and age in cognitively unimpaired older adults, and the relationship between memory complaints and memory performance. Methods: Cognitive screening tests as well as memory complaint questionnaires validated for the Brazilian population were used: the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Memory Complaint Questionnaire (MAC-Q), Memory test of 18 pictures, Forward and Backward Digit Span (WAIS-III). Fifty seven regular members of the SESC social club participated (50 women), having a mean age of 71.4 years, and 4 to 8 years of education - 34 from 4 to 7 years and 23 with 8 years of education. Results: Results revealed no significant association between cognitive complaints and age or cognitive performance. Older participants in this sample did not show worse performance or a higher level of complaints. There was no significant association between age and GDS scores. Conclusions: The studied sample constitutes a particular group of older adults whose participation in activities may be protecting them from cognitive decline, thus highlighting the impact of lifestyle on cognitive performance during the aging process.

scholarly journals Screening for frailty in older adults using a self-reported instrument

2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Daniella Pires Nunes ◽  
Yeda Aparecida de Oliveira Duarte ◽  
Jair Lício Ferreira Santos ◽  
Maria Lúcia Lebrão
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Walking Speed ◽  
Screening Instrument ◽  
The Self ◽  
Southeastern Brazil ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Predictive Values ◽  
Physical Strength

OBJECTIVE To validate a screening instrument using self-reported assessment of frailty syndrome in older adults.METHODS This cross-sectional study used data from the Saúde, Bem-estar e Envelhecimento study conducted in Sao Paulo, SP, Southeastern Brazil. The sample consisted of 433 older adult individuals (≥ 75 years) assessed in 2009. The self-reported instrument can be applied to older adults or their proxy respondents and consists of dichotomous questions directly related to each component of the frailty phenotype, which is considered the gold standard model: unintentional weight loss, fatigue, low physical activity, decreased physical strength, and decreased walking speed. The same classification proposed in the phenotype was utilized: not frail (no component identified); pre-frail (presence of one or two components), and frail (presence of three or more components). Because this is a screening instrument, “process of frailty” was included as a category (pre-frail and frail). Cronbach’s α was used in psychometric analysis to evaluate the reliability and validity of the criterion, the sensitivity, the specificity, as well as positive and negative predictive values. Factor analysis was used to assess the suitability of the proposed number of components.RESULTS Decreased walking speed and decreased physical strength showed good internal consistency (α = 0.77 and 0.72, respectively); however, low physical activity was less satisfactory (α = 0.63). The sensitivity and specificity for identifying pre-frail individuals were 89.7% and 24.3%, respectively, while those for identifying frail individuals were 63.2% and 71.6%, respectively. In addition, 89.7% of the individuals from both the evaluations were identified in the “process of frailty” category.CONCLUSIONS The self-reported assessment of frailty can identify the syndrome among older adults and can be used as a screening tool. Its advantages include simplicity, rapidity, low cost, and ability to be used by different professionals.

scholarly journals Design and reporting considerations for genetic screening tests

2019 ◽  
Author(s):  
Jill Hagenkord ◽  
Birgit Funke ◽  
Emily Qian ◽  
Madhuri Hegde ◽  
Kevin B Jacobs ◽  
...  
Keyword(s):  
Genetic Screening ◽  
World Health ◽  
Screening Tests ◽  
Clinical Indication ◽  
Test Design ◽  
Design Strategies ◽  
Predictive Values ◽  
Inherited Diseases ◽  
Health Communities ◽  
Health Organization

Testing asymptomatic individuals for unsuspected conditions is not new to the medical and public health communities and protocols to develop screening tests are well-established. However, the application of screening principles to inherited diseases presents unique challenges. Unlike most screening tests, the natural history and disease prevalence of most rare inherited diseases in an unselected population are unknown. It is difficult or impossible to obtain a “truth set” cohort for clinical validation studies. As a result, it is not possible to accurately calculate clinical positive and negative predictive values for “likely pathogenic” genetic variants, which are commonly returned in genetic screening assays. In addition, many of the genetic conditions included in screening panels do not have clinical confirmatory tests. All of these elements are typically required to justify the development of a screening test, according to the World Health Organization screening principles. Nevertheless, as the cost of DNA sequencing continues to fall, more individuals are opting to undergo genomic testing in the absence of a clinical indication. Despite the challenges, reasonable estimates can be deduced and used to inform test design strategies. Here, we review test design principles and apply them to genetic screening.

scholarly journals Design and reporting considerations for genetic screening tests

2019 ◽  
Author(s):  
Jill Hagenkord ◽  
Birgit Funke ◽  
Emily Qian ◽  
Madhuri Hegde ◽  
Kevin B Jacobs ◽  
...  
Keyword(s):  
Genetic Screening ◽  
World Health ◽  
Screening Tests ◽  
Clinical Indication ◽  
Test Design ◽  
Design Strategies ◽  
Predictive Values ◽  
Inherited Diseases ◽  
Health Communities ◽  
Health Organization

Testing asymptomatic individuals for unsuspected conditions is not new to the medical and public health communities and protocols to develop screening tests are well-established. However, the application of screening principles to inherited diseases presents unique challenges. Unlike most screening tests, the natural history and disease prevalence of most rare inherited diseases in an unselected population are unknown. It is difficult or impossible to obtain a “truth set” cohort for clinical validation studies. As a result, it is not possible to accurately calculate clinical positive and negative predictive values for “likely pathogenic” genetic variants, which are commonly returned in genetic screening assays. In addition, many of the genetic conditions included in screening panels do not have clinical confirmatory tests. All of these elements are typically required to justify the development of a screening test, according to the World Health Organization screening principles. Nevertheless, as the cost of DNA sequencing continues to fall, more individuals are opting to undergo genomic testing in the absence of a clinical indication. Despite the challenges, reasonable estimates can be deduced and used to inform test design strategies. Here, we review test design principles and apply them to genetic screening.

Sign in / Sign up

Export Citation Format

Share Document