Good Screening Properties Research Articles

Development and Validation of Hospital Mental Health Screen to Detect Psychiatric Morbidity in Medically Ill Patients in India

Background: Psychiatric morbidities often go unnoticed in medically ill patients. It is essential to screen patients with medical morbidity so that they can be referred to psychiatrists for early interventions in general hospitals in India. There is a potential lacuna in terms of the availability of a scale that can aptly identify psychiatric symptoms in medically ill patients beyond depression or anxiety, especially in low-resource settings like India. Aim: The aim was to detect psychiatric morbidity in medically ill patients in India. Methodology: Items were generated using deductive and inductive approaches. Item-Content Validity Index (I-CVI) and Scale-Content Validity Index/Universal Agreement (S-CVI/UA) were computed by involving eight subject matter specialists. The tool was circulated to 397 medically ill patients for computing The exploratory factor analysis (EFA). Domain-wise reliability using Cronbach’s alpha was calculated for six factors. The concurrent criterion validity of the Hospital Mental Health Screen (HMHS) tool was calculated by the receiver operating curve (ROC) against the gold standard of any psychiatric morbidity diagnosed by two psychiatrists in 397 medically ill patients. We used IBM SPSS version 23. Results: Initially, 34 items were generated. At the I-CVI threshold of 79%, seven items were discarded. The S-CVI/UA of the scale was 85.1%. The Kaiser–Meier–Olkin Measure of Sampling Adequacy (KMO MSA) was found to be 0.916. At a factor loading threshold of 0.4 and an eigenvalue above 1, a six-factor structure was extracted using principal component analysis and varimax rotation. Domain-wise reliability was computed, which was between 0.657 and 0.840. The final tool consisted of 27 Likert items (0 = never to 4 = always). Using the ROC curve at the 19.5 threshold, 91.4% of the positive outcomes were correctly classified and 9.5% of the adverse outcomes were expected to be incorrectly identified by the HMHS screening tool. Conclusion: HMHS is a valid and reliable tool with good screening properties, designed especially for the Indian setting. This scale can assist in identifying psychiatric morbidity in medically ill patients in low-resource settings. There is further scope for performing confirmatory factor analysis (CFA) to reinforce the factor structure of HMHS.

Density functional applications of jellium with a local gap model correlation energy functional.

We develop a realistic density functional approximation for the local gap, which is based on a semilocal indicator that shows good screening properties. The local band model has remarkable density scaling behaviors and works properly for the helium isoelectronic series for the atoms of the Periodic Table, as well as for the non-relativistic noble atom series (up to 2022 e-). Due to these desirable properties, we implement the local gap model in the jellium-with-gap correlation energy, developing the local-density-approximation-with-gap correlation functional (named LDAg) that correctly gives correlation energies of atoms comparable with the LDA ones but shows an improvement for ionization potential of atoms and molecules. Thus, LDAg seems to be an interesting and useful tool in density functional theory.

Characteristics and Assessment of Frailty as Risk Factor of Therapy-Related Acute Toxicities and Delayed Overall Treatment Time in Elderly Patients Treating with External Beam Radiation Therapy at Indonesia Top Referral Hospital

BACKGROUND: Older patients are at a higher risk of being frail. Frailty implies that even a minor stressor can have major negative implications on physical, psychological domains. Geriatric-8 (G-8) screening tool shows good screening properties for identifying vulnerable elderly patients with cancer. AIM: We, therefore, decided to investigate the utility of G-8 associated with acute toxicity and prolonged overall treatment time (OTT) in elderly cancer patients treated with radiotherapy (RT). MATERIALS AND METHODS: A prospective observational cohort study is performed. Eligible subjects are patients aged ≥60 years and were referred for curative or palliative RT. We use the G-8 questionnaire for consecutive patients before starting RT. We recorded acute toxicity and OTT and identified potential predictors. RESULTS: A total of 52 consecutive geriatric patients were included with an average age of 67 years. Of all those subjects, 21% had head-and-neck cancers, 29% gynecology cancers, 23% breast cancers, and 27% other cancers. According to the G-8, 65% of the patients were potentially frail. Toxicity Grade ≥3 was observed among 32% of subjects who were potentially frail according to the G-8 and 0% of the subject who was fit (p = 0.007). Prolonged OTT was observed in 61.8% of potentially frail and 27.8% of the subjects who were fit (p = 0.020). On multivariate analysis, only chemoradiation was strongly associated with acute toxicity Grade ≥3 odds ratio 11.1 (95% confidence interval 1.4–83.6; p = 0.019). CONCLUSION: The utility of G-8 in daily practice seems to be limited. Only concurrent chemoradiation was associated with acute toxicity. Future prospective studies should investigate whether the G-8 is a good predictor for other relevant clinical outcomes and survival in our local settings.

Influence of electric fields on metal self-diffusion barriers and its consequences on dendrite growth in batteries.

Based on the results of periodic density functional theory calculations, we have recently proposed that the height of self-diffusion barriers can serve as a descriptor for dendrite growth in batteries [M. Jäckle et al., Energy Environ. Sci. 11, 3400 (2018)]. However, in the determination of the self-diffusion barriers, the electrochemical environment has not been taken into account. Still, due to the presence of electrical double layers at electrode/electrolyte interfaces, strong electric fields can be present close to the interfacial region. In a first step toward including the electrochemical environment, we have calculated barriers for terrace-diffusion on lithium, magnesium, and silver surfaces and across-step self-diffusion on lithium in the presence of electric fields. Whereas the electric field effect is more pronounced on a stepped surface than on flat terraces, overall we find a negligible influence of electric fields on self-diffusion barriers which we explain by the good screening properties of metals.

The DETection of Arthritis in Inflammatory boweL diseases (DETAIL) questionnaire: development and preliminary testing of a new tool to screen patients with inflammatory bowel disease for the presence of spondyloarthritis.

To develop and to test in a preliminary way a new self-administered screening tool, called DETection of Arthritis in Inflammatory boweL diseases (DETAIL) questionnaire, in patients suffering from inflammatory bowel disease (IBD) not previously diagnosed as having a spondyloarthritis (SpA). DETAIL questionnaire was realized through the interrogation of 95 experts. They were asked to rate the importance of a list of items, derived from a review of the referral models of SpA, to detect the SpA manifestations in IBD patients. The six top-rated items composed the questionnaire, tested in IBD patients not already diagnosed having a SpA. One-hundred and twenty-eight patients were tested with the DETAIL questionnaire in the gastroenterology setting. After the rheumatologic assessment, in 21 (16.4%) subjects was diagnosed a SpA according to the Assessment of SpondyloArthritis international Society (ASAS) classification criteria. Of the six items of the DETAIL questionnaire, the best positive likelihood ratio (LR+) was found in item 2 (LR+ 3.82), exploring dactylitis, and in item 6 (LR+ 3.82) and item 5 (LR+ 3.40), two questions exploring inflammatory low back pain. Enthesitis (item 3-LR+ 2.87) and peripheral synovitis (item 1 - LR+ 2.81) gave similar results, while item 4, exploring the duration of low back pain, resulted in the worst performance (LR+ 1.99). Three of the six items answered in affirmative way gave a post-test probability ≥ 75%. The presence of a fibromyalgia represents a major confounder. The DETAIL questionnaire showed good screening properties that need to be confirmed in broader cohorts.

Validation of self-reported hearing loss among adult Croatians: the performance of the Hearing Self-Assessment Questionnaire against audiometric evaluation

Objective: The aim of this study was to validate the performance of a self-assessment hearing loss screening tool for adults against audiometric evaluation. Different audiological measurements were compared with the results of a 10-item Likert-type questionnaire named the Hearing Self-Assessment Questionnaire (HSAQ) to investigate its psychometric characteristics. Design: Participants underwent audiological evaluation and completed the HSAQ. The screening performance of the HSAQ was evaluated against three definitions of hearing loss: better-ear mean pure-tone thresholds >25 dBHL at 500–2000 Hz, 500–4000 Hz and 1000–4000 Hz. Study sample: The study enrolled 112 participants aged between 24 and 88 years (mean age 56.24 years, ±12.92). Results: The HSAQ had high Cronbach's alpha and intraclass correlation coefficients and showed construct, concurrent and discriminant validity. Its screening characteristics proved very good or excellent, depending on the definition of hearing loss. Receiver operating characteristic curve analysis showed excellent accuracy of the HSAQ in the identification of better-ear high-frequency hearing loss and better-ear speech-frequency hearing loss, with respect to different cut-off points. Conclusions: Given the ease with which it is administered and its good screening properties, the HSAQ can be useful in deciding whether adult clients should be referred to audiological evaluation due to reasonable suspicion of hypoacusis.

Impurity screening behavior of the high-field side scrape-off layer in near-double-null configurations: prospect for mitigating plasma–material interactions on RF actuators and first-wall components

The impurity screening response of the high-field side (HFS) scrape-off layer (SOL) to localized nitrogen injection is investigated on Alcator C-Mod for magnetic equilibria spanning lower-single-null, double-null and upper-single-null configurations under otherwise identical plasma conditions. L-mode, EDA H-mode and I-mode discharges are investigated. HFS impurity screening is found to depend on magnetic flux balance and the direction of B × B relative to the most active divertor. Impurity ‘plume’ emission patterns indicate that both parallel and perpendicular (E × B) flows in the SOL contribute to the ‘flushing’ of impurities towards the active divertor, thereby affecting the overall impurity screening behavior. Despite the fact that the HFS SOL is extremely narrow in near-double-null configurations, this SOL is able to screen locally injected nitrogen at least as effectively as the low-field side (LFS) SOL—up to a factor of 10 more effective, depending on specific plasma conditions and whether the magnetic geometry produces parallel flows that work with or against E × B flows. For situations in which the E × B drift of the impurity ions opposes parallel flow toward the primary divertor, HFS impurity screening is found to be least effective. When E × B drifts assist parallel flow toward the primary divertor, HFS impurity screening is found to be very effective. These data support the idea of placing RF actuators and close-fitting wall components on the HFS of the tokamak. With this configuration, near-double-null magnetic topologies may be used for active control of plasma parameters at the antenna/plasma interface for optimal RF coupling, mitigate the generation of local impurities from plasma–material interactions and, taking advantage of favorable plasma flows and good screening properties of the HFS SOL, further minimize the impact of wall-born impurity sources on the plasma core.

Revisión de estudios de la Escala de Ansiedad y Depresión Hospitalaria (HAD) en muestras españolas.

<em>Introduction:</em><strong> </strong>The Hospital Anxiety and Depression Scale (HADS, Zigmond and Snaith, 1983) has become a popular clinical instrument designed to assess anxiety and depression. Evidence of HADS’ good screening properties applied to several samples has been found. HADS seems to be as good screening properties as other tools. Different studies in Spanish sample tested its psychometric properties, including also their cut-offs points, specificity and sensitivity. Our <em>aim </em>is to unify the results of studies in Spanish population specifying guidelines regarding their applicability and interpretation of their cut-off points. <em>Material and method</em>: bibliographic review. <em>Results:</em><strong> </strong>15 articles were selected, a) HADS confirms its optimal psychometric properties in different groups, b) HADS shows some variability in proposed cut-off points for different groups, c) A number of items shown weak factor loading and item-test. <em>Discussion:</em> These items should be reconsidered for new proposals of a shortened final scale. We suggest attending at distress total scale.

ASSERT – The Autism Symptom SElf-ReporT for adolescents and adults: Bifactor analysis and validation in a large adolescent population

With a view to developing a brief screening instrument for autism symptoms in a general population of adolescents, seven items from the Asperger syndrome (and high-functioning autism) diagnostic interview were adapted for use as self-report in an online questionnaire for youths aged 16-19 years (N=10,220). The selected items target lack of social understanding (4 items) and rigid and repetitive behavior and interests (RRBI; 3 items). Factor analyses were performed, and the seven items were also validated against self-reported ASD diagnosis. Best statistical model fit was found for a bifactor model with one general factor and two domain specific factors tied to social difficulties and RRBI. Both the general and the domain specific factors were associated with self-reported ASD diagnoses. The scale (referred to as the Autism Symptom SElf-ReporT for Adolescents and Adults--ASSERT) had good screening properties with a receiver operating curve-area under the curve (ROC-AUC) of 0.87 and a diagnostic odds ratio (DOR) of 15.8. Applying a modified scoring of the scale further improved the screening properties leading to a ROC-AUC of 0.89 and a DOR of 24.9. The ASSERT holds promise as a brief self-report screen for autism symptoms in adolescents, and further studies should explore its usefulness for adults.

Accuracy of the G-8 geriatric-oncology screening tool for identifying vulnerable elderly patients with cancer according to tumour site: The ELCAPA-02 study

G-8 screening tool showed good screening properties for identifying vulnerable elderly patients with cancer who would benefit from a comprehensive geriatric assessment (CGA). We investigated whether tumour site and metastatic status affected its accuracy. Cross-sectional analysis of a prospective cohort study. Geriatric-oncology clinics of two teaching hospitals in the urban area of Paris. Patients aged 70 or over (n = 518) with breast ( n= 113), colorectal (n = 108), urinary-tract (n = 89), upper gastrointestinal/liver (n = 85), prostate (n = 69), or other cancers (n = 54). Reference standard for diagnosing vulnerability was the presence of at least one abnormal test among the Activities of Daily Living (ADLs), Instrumental ADL, Mini-Mental State Examination, Mini Nutritional Assessment, Cumulative Illness Rating Scale-Geriatrics, Timed Get-Up-and-Go, and Mini-Geriatric Depression Scale. Sensitivity, specificity and likelihood ratios of G-8 scores ≤ 14 were compared according to tumour site and patient characteristics. Median age was 80; 48.2% had metastases. Prevalence of vulnerability and abnormal G-8 score was 84.2% (95% confidence interval [95% CI], 81-87.3) and 79.5% (95% CI, 76-83). The G-8 was 86.9% sensitive (95% CI, 83.4-89.9) and 59.8% specific (95% CI, 48.3-70.4). G-8 performance varied significantly (all p values < 0.001) across tumour sites (sensitivity, 65.2% in prostate cancer to 95.1% in upper gastrointestinal/liver cancer; and specificity, 23.1% in colorectal cancer to 95.7% in prostate cancer) and metastatic status (sensitivity and specificity, 93.8% and 53.3% in patients with metastases vs. 79.5% and 63.3% in those without, respectively). Differences remained significant after adjustment on age and performance status. These G-8 accuracy variations across tumour sites should be considered when using G-8 to identify elderly patients with cancer who could benefit from CGA.

Counter-ions at single charged wall: Sum rules

For inhomogeneous classical Coulomb fluids in thermal equilibrium, like the jellium or the two-component Coulomb gas, there exists a variety of exact sum rules which relate the particle one-body and two-body densities. The necessary condition for these sum rules is that the Coulomb fluid possesses good screening properties, i.e. the particle correlation functions or the averaged charge inhomogeneity, say close to a wall, exhibit a short-range (usually exponential) decay. In this work, we study equilibrium statistical mechanics of an electric double layer with counter-ions only, i.e. a globally neutral system of equally charged point-like particles in the vicinity of a plain hard wall carrying a fixed uniform surface charge density of opposite sign. At large distances from the wall, the one-body and two-body counter-ion densities go to zero slowly according to the inverse-power law. In spite of the absence of screening, all known sum rules are shown to hold for two exactly solvable cases of the present system: in the weak-coupling Poisson-Boltzmann limit (in any spatial dimension larger than one) and at a special free-fermion coupling constant in two dimensions. This fact indicates an extended validity of the sum rules and provides a consistency check for reasonable theoretical approaches.

A validation of the Cannabis Abuse Screening Test (CAST) using a latent class analysis of the DSM‐IV among adolescents

This paper explored the latent class structure of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (assessed with the Munich Composite International Diagnostic Interview). Secondly, the screening properties of the Cannabis Abuse Screening Test (CAST) in adolescents were assessed with classical test theory using the latent class structure as empirical gold standard. The sample comprised 3266 French cannabis users aged 17 to 19 from the general population. Three latent classes of cannabis users were identified reflecting a continuum of problem severity: non-symptomatic, moderate and severe. Gender-specific analyses showed the best model fit, although results were almost identical in the total sample. The latent classes were good predictors of daily cannabis use, number of joints per day and age of first experimentation. The CAST showed good screening properties for the moderate/severe class (area under receiver operating characteristic curve > 0.85) and very good for the severe class (0.90). It was more sensitive for boys, more specific for girls. Although structural equivalence across gender was rejected, results suggest small gender differences in the latent structure of the DSM-IV. The performance of the CAST in screening for the latent class structure was good and superior to those obtained with the classical DSM-IV diagnoses.

Screening older cancer patients: first evaluation of the G-8 geriatric screening tool

Development of a geriatric screening tool is necessary to identify elderly cancer patients who would benefit from comprehensive geriatric assessment (CGA). We develop and evaluate the G-8 screening tool against various reference tests. Analyses were based on 364 cancer patients aged>70 years scheduled to receive first-line chemotherapy included in a multicenter prospective study. The G-8 consists of seven items from the Mini Nutritional Assessment (MNA) questionnaire and age. Our primary reference test is based on a set of seven CGA scales: Activities Daily Living (ADL), Instrumental ADL, MNA, Mini-Mental State Exam, Geriatric Depression Scale, Cumulative Illness Rating Scale-Geriatrics, and Timed Get Up and Go. We considered the presence of at least one questionnaire with an impaired score as an abnormal reference exam. Additional reference exams are also discussed. The prevalence of being at risk varied from 60% to 94% according to the various definitions of the reference test. When considering the primary reference test, a cut-off value of 14 for the G-8 tool provided a good sensitivity estimate (85%) without deteriorating the specificity excessively (65%). The G-8 shows good screening properties for identifying elderly cancer patients who could benefit from CGA.

Validation of the Autism Spectrum Screening Questionnaire in a Total Population Sample

There is a lack of instruments validated for screening of autism spectrum disorders (ASD) in general populations and primary care settings. The Autism Spectrum Screening Questionnaire (ASSQ) has previously been shown to have good screening properties in clinical settings. We used the ASSQ to screen a total population of 7-9 year-olds (N = 9430) for ASD in the Bergen Child Study. Parents and teachers filled in the ASSQ, and high-scorers were invited for clinical assessment, along with a large group of screen negative children. We found that the ASSQ was well suited as a general population screen. Combining parent and teacher ASSQ and using cut-off score of > or =17 provided the most efficient screen with sensitivity of 0.91 and specificity of 0.86.

Screening Adults for Asperger Syndrome Using the AQ: A Preliminary Study of its Diagnostic Validity in Clinical Practice

The Autism Spectrum Quotient (AQ) has been developed to measure the degree to which an adult with normal intelligence has autistic traits. In this paper it is evaluated for its potential as a screening questionnaire in clinical practice on one hundred consecutive referrals to a diagnostic clinic for adults suspected of having Asperger Syndrome or high functioning autism (AS/HFA). The results indicate that it has good discriminative validity and good screening properties at a threshold score of 26. The implications of these results are discussed.

Insulin-like growth factor-I and its binding protein-3 in serum: are they good screening properties for the diagnosis of growth hormone deficiency?

Serum insulin-like growth factor-I and insulin-like growth factor binding protein-3 are simply-determined screening analytes if growth hormone deficiency is suspected. The analysis of growth hormone secretion using standardised stimulation tests and secretion profiles is complicated and expensive in comparison. In retrospect, we have examined the value of insulin-like growth factor-I and its binding protein-3 for the diagnostic clarification of patients with short stature (n = 117). In 39/117 patients growth hormone secretion was investigated as ward patients. Growth hormone deficiency was diagnosed in 10 patients, for 16 patients the diagnosis was neurosecretory dysfunction. For all patients (n = 7) with lowered insulin-like growth factor binding protein-3 and insulin-like growth factor-I values (insulin-like growth factor binding protein-3 < 5th percentile, insulin-like growth factor-I < 10th percentile) a growth hormone disorder was proven. Conversely, however, only 3/10 patients with classical growth hormone deficiency (n = 3) showed a lowering of both analytes. 8/10 patients with classical growth hormone deficiency and 8/16 patients with neurosecretory dysfunction had at least one lowered value. Two patients showed normal values for insulin-like growth factor-I and insulin-like growth factor binding protein-3 despite biochemically proven growth hormone deficiency. The combined determination of insulin-like growth factor-I and insulin-like growth factor binding protein-3 can provide valuable help during preliminary diagnosis of patients of short stature, indicating a disturbance of the growth hormone secretion if the values are lowered. Normal values do not, however, exclude the possibility of a growth hormone deficiency. Inpatient endocrinological testing is indispensible if growth hormone deficiency is suspected.

Personality traits and disorders among psychiatric outpatients and normal subjects on the basis of the SCID screen questionnaire

SCID screen questionnaire – a self-report instrument for axis-H diagnoses – was distributed to 65 psychiatric outpatients and 133 normal subjects. In addition, independent clinical DSM-III-R diagnoses were made in the patients. When cut-off was adjusted in the SCID screen, specificity was 64% and sensitivity 86%, with a Pearson's correlation coefficient of 0.52 (p<0.001). The results from the SCID screen were analysed in two different ways – a dimensional approach estimating the proportion of criteria fulfilled and a traditional categoric approach estimating the prevalence of different personality disorders. All cluster-A disorders and obsessive compulsive personality disorder were more frequent among male than female patients. When analysed dimensionally, no sex differences were identified among patients or normal subjects. Among patients 62% had at least one and 46% multiple axis-II diagnoses, avoidant being the most prevalent. Among normal subjects narcissistic and obsessive compulsive personality disorders were most frequent for males and histrionic and borderline for females. The SCID screen showed good screening properties and also turned out to be promising as sole diagnostic instrument for axis-II disorders. It could easily be administered in an epidemiologic research setting. By rating and displaying every single criterion, the SCID screen also records potentially valuable “subthreshold” personality traits.

Dipole and current fluctuations in the quantum one-component plasma at equilibrium

By an analysis of the current and dipole mean square fluctuations per unit volume for a quantum mechanical jellium in thermal equilibrium at temperature beta -1, the authors give a new proof of the sum rule integral dx mod x mod 2S(x)=3/4(h(cross) omega p/ pi ) coth( beta h(cross) omega p/2) for the second moment of the charge-charge correlation function S(x), where omega p is the plasma frequency. No use is made of perturbation theories. The proof relies on correlation inequalities and sum rules which are valid in phases of charged systems having good screening properties. Up to second order in Planck's constant, the current-current correlations have a non-integrable spatial decay even when the corresponding classical state shows Debye screening.