Predicting relapse or recurrence of depression: systematic review of prognostic models

Background Relapse and recurrence of depression are common, contributing to the overall burden of depression globally. Accurate prediction of relapse or recurrence while patients are well would allow the identification of high-risk individuals and may effectively guide the allocation of interventions to prevent relapse and recurrence. Aims To review prognostic models developed to predict the risk of relapse, recurrence, sustained remission, or recovery in adults with remitted major depressive disorder. Method We searched the Cochrane Library (current issue); Ovid MEDLINE (1946 onwards); Ovid Embase (1980 onwards); Ovid PsycINFO (1806 onwards); and Web of Science (1900 onwards) up to May 2021. We included development and external validation studies of multivariable prognostic models. We assessed risk of bias of included studies using the Prediction model risk of bias assessment tool (PROBAST). Results We identified 12 eligible prognostic model studies (11 unique prognostic models): 8 model development-only studies, 3 model development and external validation studies and 1 external validation-only study. Multiple estimates of performance measures were not available and meta-analysis was therefore not necessary. Eleven out of the 12 included studies were assessed as being at high overall risk of bias and none examined clinical utility. Conclusions Due to high risk of bias of the included studies, poor predictive performance and limited external validation of the models identified, presently available clinical prediction models for relapse and recurrence of depression are not yet sufficiently developed for deploying in clinical settings. There is a need for improved prognosis research in this clinical area and future studies should conform to best practice methodological and reporting guidelines.

Inflammatory breast cancer defined: proposed common diagnostic criteria to guide treatment and research

Purpose Inflammatory breast cancer is a deadly and aggressive type of breast cancer. A key challenge relates to the need for a more detailed, formal, objective definition of IBC, the lack of which compromises clinical care, hampers the conduct of clinical trials, and hinders the search for IBC-specific biomarkers and treatments because of the heterogeneity of patients considered to have IBC. Methods Susan G. Komen, the Inflammatory Breast Cancer Research Foundation, and the Milburn Foundation convened patient advocates, clinicians, and researchers to review the state of IBC and to propose initiatives to advance the field. After literature review of the defining clinical, pathologic, and imaging characteristics of IBC, the experts developed a novel quantitative scoring system for diagnosis. Results The experts identified through consensus several “defining characteristics” of IBC, including factors related to timing of onset and specific symptoms. These reflect common pathophysiologic changes, sometimes detectable on biopsy in the form of dermal lymphovascular tumor emboli and often reflected in imaging findings. Based on the importance and extent of these characteristics, the experts developed a scoring scale that yields a continuous score from 0 to 48 and proposed cut-points for categorization that can be tested in subsequent validation studies. Conclusion To move beyond subjective ‘clinical diagnosis’ of IBC, we propose a quantitative scoring system to define IBC, based on clinical, pathologic, and imaging features. This system is intended to predict outcome and biology, guide treatment decisions and inclusion in clinical trials, and increase diagnostic accuracy to aid basic research; future validation studies are necessary to evaluate its performance.

Interactive Assessments of CT (IACT): Digital Interactive Logic Puzzles to Assess Computational Thinking in Grades 3–8

Background and Context: The Inclusive Assessment of Computational Thinking (CT) designed for accessibility and learner variability was studied in over 50 classes in US schools (grades 3-8). Objective: The validation studies of IACT sampled thousands of students to establish IACT’s construct and concurrent validity as well as test-retest reliability. Method: IACT items for each CT practice were correlated to examine construct validity. The CT pre-measures were correlated with post-measures to examine test-retest reliability. The CT post-measures were correlated with external measures to examine concurrent validity. Findings: IACT studies showed moderate evidence of test-retest reliability and concurrent validity and low to moderate evidence of construct validity for an aggregated measure of CT, but weaker validity and reliability evidence for individual CT practices. These findings were similar for students with and without IEPs or 504s. Implications: IACT is the first CT tool for grades 3-8 that has been validated in a large-scale study among students with and without IEPs or 504s. While improvements are needed for stronger validity, it is a promising start.

Assessment Tools for Executive Function and Adaptive Function Following Brain Pathology Among Children in Developing Country Contexts: a Scoping Review of Current Tools

Several tools have been developed to assess executive function (EFs) and adaptive functioning, although in mainly Western populations. Information on tools for low-and-middle-income country children is scanty. A scoping review of such instruments was therefore undertaken.We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis- Scoping Review extension (PRISMA-ScR) checklist (Tricco et al., in Annals of Internal Medicine 169(7), 467–473, 2018). A search was made for primary research papers of all study designs that focused on development or adaptation of EF or adaptive function tools in low-and-middle-income countries, published between 1st January 1894 to 15th September 2020. 14 bibliographic databases were searched, including several non-English databases and the data were independently charted by at least 2 reviewers.The search strategy identified 5675 eligible abstracts, which was pruned down to 570 full text articles. These full-text articles were then manually screened for eligibility with 51 being eligible. 41 unique tools coming in 49 versions were reviewed. Of these, the Behaviour Rating Inventory of Executive Functioning (BRIEF- multiple versions), Wisconsin Card Sorting Test (WCST), Go/No-go and the Rey-Osterrieth complex figure (ROCF) had the most validations undertaken for EF tests. For adaptive functions, the tools with the most validation studies were the Vineland Adaptive Behaviour Scales (VABS- multiple versions) and the Child Function Impairment Rating Scale (CFIRS- first edition).There is a fair assortment of tests available that have either been developed or adapted for use among children in developing countries but with limited range of validation studies. However, their psychometric adequacy for this population was beyond the scope of this paper.

ADAPTATIONS TO SUBJECTIVE INSTRUMENTS FOR DYNAMIC VIEW ASSESSMENT EVALUATION

Although daylight changes seen through windows are likely to mediate positive responses in occupants, there are no specialized instruments capturing responses to dynamic attributes in views. This study mapped self-report instruments that could be readily adjusted to measure subjective responses to dynamic views. Through a revision of the literature, 55 papers in view assessment were clustered as a function of prevalent label types and constructs used to investigate responses to static outdoor views. Feature-type was the prevalent label distinction to investigate responses to window views, whilst preference and restoration were the predominant constructs in view out research. Four instruments were deemed appropriate to capture responses to dynamic attributes in views with respect to restoration, provided that semantic adaptations and further validations are set in place. This study highlights the need for more validation studies to increase the robustness of self-report instruments and outlines a theoretical approach to achieve this scope.