scholarly journals Accuracy of Self-Reported Items for the Screening of Depression in the General Population

2020 ◽  
Vol 17 (21) ◽  
pp. 7955
Author(s):  
Jorge Arias-de la Torre ◽  
Gemma Vilagut ◽  
Antoni Serrano-Blanco ◽  
Vicente Martín ◽  
Antonio José Molina ◽  
...  
Keyword(s):  
Health Surveys ◽  
Measurement Properties ◽  
Country Of Birth ◽  
Predictive Values ◽  
Logistic Regression Models ◽  
Independent Variables ◽  
Metric Properties ◽  
Prevalence Of Depression ◽  
Low Sensitivity ◽  
Global Agreement

Introduction: Though self-reported items (SRD, self-reported depression) are commonly used in health surveys and cohort studies, their metric properties as a depression indicator remain unclear. The aims were to evaluate the measurement properties of SRD using the Patient Health Questionnaire-8 (PHQ-8) as reference and to identify factors related to the agreement between both indicators. Methods: Data from the European Health Interview Survey in Spain in 2014/2015 (n = 22,065) were analyzed. Two indicators of depression were considered: SRD based on two items yes/no (positive: both yes), and the PHQ-8 (positive ≥ 10). Socioeconomic factors and use of health services were considered as independent variables. The prevalence of depression, sensitivity, specificity, global agreement, and positive and negative predictive values (PPV and NPV) of SRDs were evaluated using the PHQ-8 as a reference. Logistic regression models were fitted to determine factors associated with the agreement between indicators. Results: The prevalence of depression was lower when assessed with PHQ-8 (5.9%) than with SRD (7.7%). SRD sensitivity and PPV were moderate–low (52.9% and 40.4%, respectively) whereas global agreement, specificity, and NPV were high (92.7%, 95.1%, and 97.0%, respectively). Positive agreement was associated with marital status, country of birth, employment status, and social class. Negative agreement was related to all independent variables except country of birth. Conclusions: SRD items tend to overestimate the current prevalence of depression. While its use in health surveys and cohorts may be appropriate as a quick assessment of possible depression, due to their low sensitivity, its use in clinical contexts is questionable.

scholarly journals Can Cut-Off-Values for Tumor Size or Patient Age in Breast Ultrasound Reduce Unnecessary Biopsies or is it all About Bi-rads?– A Retrospective Analysis of 763 Biopsied T1-Sized Lesions

2017 ◽  
Vol 03 (03) ◽  
pp. E94-E98 ◽  
Author(s):  
Laura Holzer-Fruehwald ◽  
Matthias Meissnitzer ◽  
Michael Weber ◽  
Stephan Holzer ◽  
Klaus Hergan ◽  
...  
Keyword(s):  
Regression Models ◽  
Breast Lesion ◽  
Binary Logistic Regression ◽  
Lesion Size ◽  
Breast Lesions ◽  
Predictive Values ◽  
Logistic Regression Models ◽  
Independent Variables ◽  
Oval Shape ◽  
Histological Result

Abstract Aims and Objectives To assess whether it is possible to establish a size cut-off-value for sonographically visible breast lesions in a screening situation, under which it is justifiable to obviate a biopsy and to evaluate the grayscale characteristics of the identified lesions. Materials and Methods Images of sonographically visible and biopsied breast lesions of 684 patients were retrospectively reviewed and assessed for the following parameters: size, shape, margin, lesion boundary, vascularity, patient’s age, side of breast, histological result, and initial BI-RADS category. Statistical analyses (t-test for independent variables, ROC analyses, binary logistic regression models, cross-tabulations, positive/negative predictive values) were performed using IBM SPSS (Version 21.0). Results Of all 763 biopsied lesions, 223 (29.2%) showed a malignant histologic result, while 540 (70.8%) were benign. Although we did find a statistically significant correlation of malignancy and lesion size (p=0.031), it was not possible to define a cut-off value, under which it would be justifiable to obviate a biopsy in terms of sensitivity and specificity (AUC: 0.558) at any age. Lesions showing the characteristics of a round or oval shape, a sharp delineation and no echogenic rim (n=112) were benign with an NPV of 99.1%. Conclusion It is not possible to define a cut-off value for size or age, under which a biopsy of a sonographically visible breast lesion can be obviated in the screening situation. The combination of the 3 grayscale characteristics, shape (round or oval), margin (circumscribed) and no echogenic-rim sign, showed an NPV of 99.1%. Therefore, it seems appropriate to classify such lesions as BI-RADS 2.

Validity of hearTest Smartphone-Based Audiometry for Hearing Screening in Workers Exposed to Noise

2020 ◽  
Author(s):  
Luma Cordeiro Rodrigues ◽  
Silvia Ferrite ◽  
Ana Paula Corona
Keyword(s):  
Hearing Loss ◽  
High Specificity ◽  
Hearing Screening ◽  
Youden Index ◽  
Hearing Level ◽  
Predictive Values ◽  
Auditory Thresholds ◽  
The Mean ◽  
Low Sensitivity ◽  
Sensitivity Specificity

Abstract Purpose This article investigates the validity of a smartphone-based audiometry for hearing screening to identify hearing loss in workers exposed to noise. Research Design This is a validation study comparing hearing screening with the hearTest to conventional audiometry. The study population included all workers who attended the Brazilian Social Service of Industry to undergo periodic examinations. Sensitivity, specificity, the Youden index, and positive (PPV) and negative predictive values (NPV) for hearing screening obtained by the hearTest were estimated according to three definitions of hearing loss: any threshold greater than 25 dB hearing level (HL), the mean auditory thresholds for 0.5, 1, 2, and 4 kHz greater than 25 dB HL, and the mean thresholds for 3, 4, and 6 kHz greater than 25 dB HL. Note that 95% confidence intervals were calculated for all measurements. Results A total of 232 workers participated in the study. Hearing screening with the hearTest presented good sensitivity (93.8%), specificity (83.9%), and Youden index (77.7%) values, a NPV (97.2%), and a low PPV (69.0%) for the identification of hearing loss defined as any auditory threshold greater than 25 dB HL. For the other definitions of hearing loss, we observed high specificity, PPV and NPV, as well as low sensitivity and Youden index. Conclusion The hearTest is an accurate hearing screening tool to identify hearing loss in workers exposed to noise, including those with noise-induced hearing loss, although it does not replace conventional audiometry.

scholarly journals Sonographic Cervical Shortening after Labor Induction is a Predictor of Vaginal Delivery

2016 ◽  
Vol 38 (12) ◽  
pp. 585-588 ◽  
Author(s):  
Ugo Indraccolo ◽  
Gennaro Scutiero ◽  
Pantaleo Greco
Keyword(s):  
Logistic Regression ◽  
Vaginal Delivery ◽  
Regression Models ◽  
Operating Characteristic ◽  
Roc Curves ◽  
Cervical Length ◽  
Labor Induction ◽  
Logistic Regression Models ◽  
Independent Variables ◽  
Sonographic Evaluation

Objective Analyzing if the sonographic evaluation of the cervix (cervical shortening) is a prognostic marker for vaginal delivery. Methods Women who underwent labor induction by using dinoprostone were enrolled. Before the induction and three hours after it, the cervical length was measured by ultrasonography to obtain the cervical shortening. The cervical shortening was introduced in logistic regression models among independent variables and for calculating receiver operating characteristic (ROC) curves. Results Each centimeter in the cervical shortening increases the odds of vaginal delivery in 24.4% within 6 hours; in 16.1% within 24 hours; and in 10.5% within 48 hours. The best predictions for vaginal delivery are achieved for births within 6 and 24 hours, while the cervical shortening poorly predicts vaginal delivery within 48 hours. Conclusion The greater the cervical shortening 3 hours after labor induction, the higher the likelihood of vaginal delivery within 6, 24 and 48 hours.

scholarly journals Evaluation and management of blunt injury abdomen based on focussed assessment with sonography in trauma

2020 ◽  
Vol 9 (1) ◽  
pp. 61
Author(s):  
Sameer Ahmed
Keyword(s):  
Computed Tomography ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Blunt Injury ◽  
Predictive Values ◽  
Bedside Test ◽  
Intraabdominal Injuries ◽  
Low Sensitivity

Background: The initial evaluation of patient with multiple trauma is a challenging task. FAST (focussed assessment with sonography in trauma) provides a viable alternative to computed tomography in blunt abdominal trauma patient. The aim of this study was to find the accuracy and utility of FAST in clinical decision making, as well as limitations.Methods: A total of 100 patients with blunt abdominal trauma who underwent FAST examination were included. Positive scan was defined as the presence of free intraperitoneal fluid. The sonographic scoring for operating room triage in trauma (SSORTT Score) was calculated using cumulative sum of ultrasound score, systolic blood pressure, and pulse rate. FAST findings were compared with computed tomography findings and in operated cases compared with surgical findings & clinical outcome.Results: We determined SSORTT score in all 100 cases. In our study, the sensitivity, specificity, positive and negative predictive values for FAST in identifying intraabdominal injuries were 93.9%, 94.2%, 87.5%, and 97.2%. In our study we found out that patients with a SSORTT score of 2 and above had a high likelihood of requiring a therapeutic laparotomy.Conclusions: In our study we found that FAST is a rapid, reproducible, portable and non-invasive bedside test, and can be performed at the same time as resuscitation. Ultrasound is limited mainly by its low sensitivity in directly demonstrating solid organs injuries.

scholarly journals Trends of caesarean section deliveries in Pakistan: secondary data analysis from Demographic and Health Surveys, 1990–2018

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aaisha Amjad ◽  
Abeeha Imran ◽  
Nabeeha Shahram ◽  
Rubeena Zakar ◽  
Ahmed Usman ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Urban Areas ◽  
Health Surveys ◽  
Secondary Data ◽  
Demographic And Health Surveys ◽  
Independent Variables ◽  
Economic Class ◽  
The Past ◽  
Child Bearing ◽  
Socio Demographic Factors

Abstract Background Pakistan is among those countries where the number of caesarean section births has increased unusually in the past two decades. Therefore, the aim of the present study is to analyse the trend of caesarean section deliveries among child-bearing women (aged 15–49 years) in Pakistan and to identify maternal socio-demographic factors and pregnancy-related variables associated with the change in caesarean deliveries from 1990 to 2018. Methods Secondary data from Pakistan Demographic and Health Surveys (1990–2018) were analysed. The analysis of data was confined to child-bearing mothers. Sample sizes were 4029, 5721, 7461 and 8287 for the time periods of 1990–91, 2006–07, 2012–13 and 2017–18, respectively. Socio-demographic information of the mothers and pregnancy-related variables were taken as independent variables for the present study. The association between independent variables and caesarean deliveries was measured in terms of unadjusted odds ratios (OR) and adjusted OR (AOR). Results The percentages of the mothers who had at least one delivery during the 5 years prior to each survey who had caesarean deliveries increased continuously from 3.2% in 1990–91 to 19.6% in 2017–18. Results indicate that mothers over 24 years of age, located in Punjab, from the richest socio-economic class and living in urban areas were more likely to have delivered by caesarean section. Mothers with a first child in birth order and who had five and more children, as well as mothers who had more antenatal care visits and delivered babies in private hospitals showed a higher probability of caesarean section births. Conclusions The findings of the present study confirm the gradual upsurge in the percentage of mothers delivering by caesarean section during the past two decades in Pakistan. Against this backdrop, some measures need to be taken by health departments to regulate the number of caesarean deliveries. Awareness among women about pregnancy complications and elaborated details by gynaecologists about the medically indicated reasons for caesarean delivery are a few important steps in Pakistan that can help in reducing caesarean deliveries which are not medically indicated.

scholarly journals Suicidal and self-harm presentations to Emergency Departments: The challenges of identification through diagnostic codes and presenting complaints

2019 ◽  
Vol 49 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Jerneja Sveticic ◽  
Nicholas CJ Stapelberg ◽  
Kathryn Turner
Keyword(s):  
Suicidal Ideation ◽  
Gold Standard ◽  
Emergency Departments ◽  
Policy Development ◽  
Suicide Attempts ◽  
Predictive Values ◽  
Diagnostic Codes ◽  
Icd 10 ◽  
Self Harm ◽  
Low Sensitivity

Background: The accuracy of data on suicide-related presentations to Emergency Departments (EDs) has implications for the provision of care and policy development, yet research on its validity is scarce. Objective: To test the reliability of allocation of ICD-10 codes assigned to suicide and self-related presentations to EDs in Queensland, Australia. Method: All presentations due to suicide attempts, non-suicidal self-injury (NSSI) and suicidal ideation between 1 July 2017 and 31 December 2017 were reviewed. The number of presentations identified through relevant ICD-10-AM codes and presenting complaints in the Emergency Department Information System were compared to those identified through an application of an evolutionary algorithm and medical record review (gold standard). Results: A total of 2540 relevant presentations were identified through the gold standard methodology. Great heterogeneity of ICD-10-AM codes and presenting complaints was observed for suicide attempts (40 diagnostic codes and 27 presenting complaints), NSSI (27 and 16, respectively) and suicidal ideation (38 and 34, respectively). Relevant ICD codes applied as primary or secondary diagnosis had very low sensitivity in detecting cases of suicide attempts (18.7%), NSSI (38.5%) and suicidal ideation (42.3%). A combination of ICD-10-AM code and a relevant presenting complaint increased specificity, however substantially reduced specificity and positive predictive values for all types of presentations. ED data showed bias in detecting higher percentages of suicide attempts by Indigenous persons (10.1% vs. 6.9%) or by cutting (28.1% vs. 10.3%), and NSSI by female presenters (76.4% vs. 67.4%). Conclusion: Suicidal and self-harm presentations are grossly under-enumerated in ED datasets and should be used with caution until a more standardised approach to their formulation and recording is implemented.

Bioremediation Condition Optimization of Hydrocarbon in Soil Using Response Surface Methodology by Microbial Consortium KL9-1

2012 ◽  
Vol 518-523 ◽  
pp. 2073-2078 ◽  
Author(s):  
Qi You Liu ◽  
Yun Bo Zhang ◽  
Dong Feng Zhao ◽  
Chao Cheng Zhao
Keyword(s):  
Response Surface Methodology ◽  
Response Surface ◽  
Microbial Consortium ◽  
Ph Value ◽  
Removal Rate ◽  
Desirability Function ◽  
Nitrogen And Phosphorus ◽  
Predictive Values ◽  
Independent Variables ◽  
Condition Optimization

A response surface methodology was applied to optimize the bioremediation condition of hydrocarbon in soil by microbial consortium KL9-1. A four-level Box-Behnken factorial design was employed to study the relationship of independent variables and dependent variable by applying pH value, inoculation amount of microbial consortium KL9-1, ratio of nitrogen and phosphorus (N/P ) and surfactant (SDBS) concentration as independent variables (factors) and crude oil removal rate as dependent variable (response). Then the statistically significant model was obtained and numerical optimization based on desirability function was carried out for pH 7.0, inoculation amount 50.0 mL, N/P 2: 1 and SDBS concentration 4.0 g, and the hydrocarbon removal rate reached as high as 52.58%. The predictive values showed good agreement with the experimental values under the optimization conditions, by standard variance <1.3%. It showed that the optimal result was reliable.

Frailty and depression in centenarians

2017 ◽  
Vol 30 (1) ◽  
pp. 115-124 ◽  
Author(s):  
Oscar Ribeiro ◽  
Natália Duarte ◽  
Laetitia Teixeira ◽  
Constança Paúl
Keyword(s):  
Living Arrangements ◽  
Clinical Signs ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Binary Logistic Regression ◽  
Subjective Health ◽  
Activity Level ◽  
Logistic Regression Models ◽  
Final Sample ◽  
Prevalence Of Depression

ABSTRACTBackground:Physical frailty and depression are common comorbid conditions that have important impact on older adults. Few studies however have examined their co-occurrence in centenarians. This paper explores the relationship between the two conditions and the most characteristic depressive symptoms associated with the frailty syndrome.Methods:Data come from two Portuguese Centenarian Studies. Frailty was measured using Fried's phenotype, which includes at least three clinical signs: exhaustion, weight loss, weakness, slowness, and low physical activity level; the Geriatric Depression Scale was used to assess depression. Descriptive comparison and binary logistic regression models were used for data analysis.Results:The final sample comprised 91 centenarians (mean age = 101.0, SD = 1.3; 85.7% female). From these, 5.5% were classified as robust, 42.9% as pre-frail, and 51.6% as frail. The prevalence of depression in the whole sample was 35.2% (51.1% in frail centenarians; 21.1% in pre-frail centenarians; 0% in robust centenarians). Frail centenarians presented higher risk of depression (OR = 3.92; 95% CI 1.48–10.4) when compared to pre-frail centenarians. Findings from the multivariable model (gender, living arrangements, education, cognition, subjective health, current illness, and functionality) revealed that only subjective health remained significant.Conclusion:It seems that depression is a comorbid clinical independent condition that is frequent in frail and pre-frail centenarians.

scholarly journals Mental health of migrant elders – the Islington study

2001 ◽  
Vol 179 (4) ◽  
pp. 361-366 ◽  
Author(s):  
G. Livingston ◽  
G. Leavey ◽  
G. Kitchen ◽  
M. Manela ◽  
S. Sembhi ◽  
...  
Keyword(s):  
Relative Risk ◽  
Inner City ◽  
Antihypertensive Drugs ◽  
Country Of Birth ◽  
Cross Sectional ◽  
Prevalence Of Depression ◽  
Caribbean Country ◽  
African Caribbean ◽  
The Uk ◽  
Prevalence Of Dementia

BackgroundIn the UK, 6% of those aged 65 years and over were born abroad, most of whom now live in inner-city areas. It has been suggested that ethnic elders are particularly vulnerable to mental illness.AimsTo compare the prevalence of dementia and depression in older migrants with those born in the UK.MethodA cross-sectional community study of 1085 people aged 65 years or older in an inner-London borough.ResultsCompared with those born in the UK, the prevalence of dementia was raised in African–Caribbeans (17.3%, relative risk=1.72, Cl=1.06–2.81) and lower for the Irish-born (3.6%, relative risk=0.36, Cl=0.17–0.87). All those of African–Caribbean country of birth were significantly younger (P=0.000) but no more likely to be taking antihypertensive drugs. They were no more likely to report having cardiovascular problems but had increased rates of diabetes (P < 0.0000). The overall prevalence of depression was 18.3% (95% Cl=16.1–20.7). The highest prevalence rate was found among those born in Greece and Turkey (27.2%, Cl=179–39.6). Migration per se does not appear to be a risk for depression and dementia in this population.ConclusionsThe excess of dementia may be of vascular aetiology. There is the potential for primary or secondary prevention.

scholarly journals Low sensitivity of ParaHIT-f rapid malaria test among patients with fever in rural health centers, Northern Tanzania

2011 ◽  
Vol 5 (03) ◽  
pp. 204-208 ◽  
Author(s):  
Eliningaya John Kweka ◽  
Asanterabi Lowassa ◽  
Shandala Msangi ◽  
Epiphania E Kimaro ◽  
Ester E Lyatuu ◽  
...  
Keyword(s):  
Rapid Test ◽  
Health Centers ◽  
Diagnostic Tools ◽  
Test Results ◽  
Predictive Values ◽  
Rural Tanzania ◽  
Northern Tanzania ◽  
Low Sensitivity ◽  
Sensitivity Specificity ◽  
Malaria Test

Introduction: Several rapid diagnostic tools for malaria are currently available in local markets. However, diagnostic accuracy varies widely. The present study was conducted to evaluate a cheaply and easily available rapid diagnostic malaria test (ParaHIT-f) in rural Tanzania. Methodology: Participants presenting with fever at health centers in the Kilimanjaro and Manyara regions were eligible. Parasitological thin and thick smears were examined from finger-prick blood samples and compared to ParaHIT-f test results. Sensitivity, specificity and predictive values were calculated using microscopic parasitological examination as the gold standard. Results: In total, 236/743 (31.8%) individuals had a positive malaria microscopy, and 25/715 (3.4%) were positive in the rapid diagnostic test. The sensitivity of ParaHIT-f was 10.7% (95% CI, 6.7-14.7) and specificity was 100% (95% CI, 97.4-102), with positive and negative predictive values (PPV and NPV) of 100% (95% CI, 99.1-100.2) and 70.9% (95% CI, 66.9-74.9) respectively. Sensitivity of ParaHIT-f increased with increasing P. falciparum density (P > 0.003) from 5.8% (95% CI, 0-12.9) at < 100 parasites/μl to 20.5% (95% CI, 13.5-27) at ≥ 100 parasites/μl. Conclusions: Sensitivity of the ParaHIT-f rapid test was very low in this setting, therefore concomitant use of rapid diagnostic tests and microscopy is recommended. In the case of positive test results, confirmation by parasitological techniques is not necessary. Further monitoring of ParaHIT-f in various epidemiological settings in Tanzania is warranted. 

Sign in / Sign up

Export Citation Format

Share Document