Low Positive Predictive Power Research Articles

How well does a wellbeing measure predict psychiatric ‘caseness’ as well as suicide risk and self-harm in adolescents?

Screening for psychiatric disorders may be hampered by traditional measures that increase participant burden and elicit negative responses via denial and social desirability biases. This study examined the utility of a wellbeing measure to identify psychopathology and suicide risk in adolescent participants. 1,579 students from Sydney schools participated in a survey which assessed wellbeing using the Satisfaction With Life Scale (SWLS) as well as psychiatric disorders and suicide risk. Results showed that low scores on the SWLS discriminated adolescents who had experienced a psychiatric condition or suicidality from those not so assigned. Specifically, students with no psychiatric diagnosis yielded a mean SWLS score of 28.0 while for those assigned a diagnosis, mean scores ranged from 19.4–3.0 across the various psychiatric conditions. Students who reported any suicidal ideation yielded a mean SWLS score of 22.7, and those with a current suicidal plan yielded a mean score of 17.7. We derived SWLS cut-off scores for predicting psychiatric caseness and suicidality but established that they had low positive predictive power. The SWLS therefore appears to provide a limited proxy measure of the chance of a psychiatric disorder or psychological distress, and might usefully complement more direct measures of such states.

A Cross-sectional Study on the Self-Efficacy of Pre-service Science and Mathematics Teachers in a Philippine State University

This study investigated the self-efficacy levels of pre-service science and mathematics teachers in a Philippine state university. A total of 172 pre-service science and mathematics teachers served as respondents of the study. Data collection was done through the use of the Science and Mathematics Teaching Efficacy Belief Instrument for Pre-service Teachers. The ANOVA indicated significant difference self-efficacy according to year level such that fourth year pre-service teachers indicated a statistically significant decrease. No significant difference was observed for gender and specialization. As regards to the type of courses as predictors of self-efficacy level, general education courses showed low positive predictive power (β = 0.180) whereas specialization courses and professional education courses showed a negative predictive power of β = -0.198 and β = -0.702 respectively. General education and professional education courses displayed significant predictive power at p < 0.05 whereas specialization courses did not (p=0.151). The overall explanatory power of the regression model was 61.1% (R2 = 0.611, F(3,171) = 90.419, p < 0.001). The 2 implications on the teacher education preparation as well as for future directions are likewise discussed.

Direct behavior rating as a school-based behavior universal screener: Replication across sites

The purpose of this study was to evaluate the utility of Direct Behavior Rating Single Item Scale (DBR–SIS) targets of disruptive, engaged, and respectful behavior within school-based universal screening. Participants included 31 first-, 25 fourth-, and 23 seventh-grade teachers and their 1108 students, sampled from 13 schools across three geographic locations (northeast, southeast, and midwest). Each teacher rated approximately 15 of their students across three measures, including DBR–SIS, the Behavioral and Emotional Screening System (Kamphaus & Reynolds, 2007), and the Student Risk Screening Scale (Drummond, 1994). Moderate to high bivariate correlations and area under the curve statistics supported concurrent validity and diagnostic accuracy of DBR–SIS. Receiver operating characteristic curve analyses indicated that although respectful behavior cut scores recommended for screening remained constant across grade levels, cut scores varied for disruptive behavior and academic engaged behavior. Specific cut scores for first grade included 2 or less for disruptive behavior, 7 or greater for academically engaged behavior, and 9 or greater for respectful behavior. In fourth and seventh grades, cut scores changed to 1 or less for disruptive behavior and 8 or greater for academically engaged behavior, and remained the same for respectful behavior. Findings indicated that disruptive behavior was particularly appropriate for use in screening at first grade, whereas academically engaged behavior was most appropriate at both fourth and seventh grades. Each set of cut scores was associated with acceptable sensitivity (.79–.87), specificity (.71–.82), and negative predictive power (.94–.96), but low positive predictive power (.43–.44). DBR–SIS multiple gating procedures, through which students were only considered at risk overall if they exceeded cut scores on 2 or more DBR–SIS targets, were also determined acceptable in first and seventh grades, as the use of both disruptive behavior and academically engaged behavior in defining risk yielded acceptable conditional probability indices. Overall, the current findings are consistent with previous research, yielding further support for the DBR–SIS as a universal screener. Limitations, implications for practice, and directions for future research are discussed.

An Examination of the Validity of the Behavioral and Emotional Screening System in a Rural Elementary School

The purpose of the current study was to evaluate a screening instrument. The sample contained 496 elementary children from the rural southeast. Properties of the Teacher, Parent, and Student Forms of the Behavioral and Emotional Screening System were examined. Results indicated that all forms had high levels of internal consistency. There were low to moderate correlations between the Teacher Form and reading, behavior, and attendance variables. The Parent Form was significantly correlated with attendance and reading. The Student Forms were significantly correlated with office discipline referrals, attendance, and reading. The Teacher Form identified 28% of students as being at-risk (elevated or extremely elevated), followed by 20% and 32% on the Parent and Student Forms, respectively. The risk groups were significantly different in terms of attendance, behavior, and achievement. However, interrater agreement regarding risk status across different raters was low. All forms demonstrated low positive predictive power and low to moderate sensitivity relative to an outcome of office discipline referrals but did show reasonably strong negative predictive power and specificity. Future directions for research are presented.

Transient elastography as a predictor of oesophageal varices, a comparison with other non invasive markers

IntroductionSurveillance for varices is recommended for cirrhotic patients, with endoscopy the gold standard investigation. The authors sought to establish the utility of transient elastography (TE) in predicting the presence of...

Mental Health Disorders, Psychological Distress, and Suicidality in a Diverse Sample of Lesbian, Gay, Bisexual, and Transgender Youths

We examined associations of race/ethnicity, gender, and sexual orientation with mental disorders among lesbian, gay, bisexual, and transgender (LGBT) youths. We assessed mental disorders by administering a structured diagnostic interview to a community sample of 246 LGBT youths aged 16 to 20 years. Participants also completed the Brief Symptom Inventory 18 (BSI 18). One third of participants met criteria for any mental disorder, 17% for conduct disorder, 15% for major depression, and 9% for posttraumatic stress disorder. Anorexia and bulimia were rare. Lifetime suicide attempts were frequent (31%) but less so in the prior 12 months (7%). Few racial/ethnic and gender differences were statistically significant. Bisexually identified youths had lower prevalences of every diagnosis. The BSI 18 had high negative predictive power (90%) and low positive predictive power (25%) for major depression. LGBT youths had higher prevalences of mental disorder diagnoses than youths in national samples, but were similar to representative samples of urban, racial/ethnic minority youths. Suicide behaviors were similar to those among representative youth samples in the same geographic area. Questionnaires measuring psychological distress may overestimate depression prevalence among this population.

Distribution and conservation of the coastal population of the black-headed dwarf chameleon Bradypodion melanocephalum in KwaZulu-Natal

The coastal population of the black-headed dwarf chameleon Bradypodion melanocephalum in KwaZulu-Natal appears to be centred on the eThekwini Municipal Area, which is experiencing rapid urban development. This population occurs in few statutory protected areas, all of which are small. In order to conserve successfully the coastal population in KwaZulu-Natal, knowledge of its geographic range and location of potentially suitable habitat is required. Bradypodion melanocephalum was until recently known mainly from Durban, with isolated records from areas to the north and south. A cartographic model was used to estimate the distribution of the coastal population in KwaZulu-Natal. The model predictions were ground-truthed, and the model was found to have a positive predictive power of 0.57 and a negative predictive power of 0.84. The relatively low positive predictive power of the model appeared related to habitat management that is not appropriate for the conservation of B. melanocephalum. The geographic range was then estimated using a Maxent model to predict climate suitability while at the same time taking cognizance of a dispersal barrier, the output of which was further refined in a geographic information system to exclude areas of unsuitable landcover. The variables included in the final model were mean daily minimum temperature of the coldest month and mean daily maximum relative humidity of the coldest month. Both these variables relate to dew formation in the dry winter period, and dew appears to be a critical water source for B. melanocephalum during winter. The Maxent model estimates greater probabilities of occurrence towards the coast, where rapid urbanisation is occurring. This urbanisation is one of the threats to the survival of the coastal population of Bradypodion melanocephalum. The utility of translocation of B. melanocephalum to areas that will not be developed within a development site in comparison to translocation ofT-site as mitigation to ensure the conservation of the coastal population in rapidly urbanizing areas needs to be investigated further.

Psychometric Properties of the Texas Primary Reading Inventory for Early Reading Screening in Kindergarten

This study investigated the psychometric properties of the kindergarten Texas Primary Reading Inventory (TPRI; Texas Education Agency and the University of Texas System, 2004—2006) Mid-Year screeners with a sample of 180 students. The TPRI screeners were designed to determine which students are not at risk for later reading failure. Results indicated adequate internal consistency reliability and concurrent and predictive validity for screening purposes. Classification validity analyses indicated low false negative rates and high negative predictive power but substantial false positive rates and low positive predictive power. The TPRI Mid-Year screeners were found to be adequate instruments for identifying students who are unlikely in need of further assessment. Recommendations are provided for using the TPRI within a response-to-intervention or other prevention-based service delivery model.

Ventricular Late Potentials and Degree of Reperfusion of the Infarct-Related Artery

Background: Patency of the infarct-related artery is known to be a powerful determinant of the prognosis after AMI. Most studies have reported a lower incidence of late potentials from patients treated with thrombolytic agents than patients not so treated. The purpose of this study was to evaluate the use of ventricular late potentials in the first week after AM1 to differentiate patients according to the TIMI flow in the infarct-related artery. Material and Methods: In 106 patients with AMI, we recorded three determinations of late potentials with filters of 25, 40, and 80-250 Hz, at 24, 72, and 144 hours after the onset of symptoms. Classification was based on the angiography study: group I with TIM1 0-1 and group I1 with TIMI 2-3. Results: We found a low positive predictive power in TIMI 0-1 (around 50%) for all records and filters. The negative predictive value was high (72%-93%) and increased with time from the AM1 and frequency of the filter. The most sensitive filter was 80-250 Hz and the most specific was 25-250 Hz. The duration of the QRSf and LAS40 was longer and the RAMS were lower in the patients with diminished TIMI flow. Conclusion: The absence of late potentials is associated with a better TIMI flow in the artery.

Measuring cognitive impairment in substance abusers with psychiatric comorbidity using the screening test for the Luria‐Nebraska neuropsychological battery: Comments regarding positive predictive power and diagnostic prevalence

The present study examined the diagnostic accuracy of the Screening Test for the Luria‐Nebraska Neuropsychological Battery (ST‐LNNB). Specifically, the ability of the ST‐LNNB to detect cognitive impairment versus nonimpairment among psychiatrically involved substance abusers was assessed. In light of the fact that cognitive impairment is relatively common within this population and given the paucity of research on the ST‐LNNB, such data would be instrumental in clarifying the conditions under which the ST‐LNNB validly assesses cognitive impairment. Subjects consisted of 183 male and 89 female substance abusing inpatients with psychiatric comorbidity residing in a private psychiatric hospital. Level of cognitive functioning was assessed by the Shipley Institute of Living Scale (SILS), with ion Quotients less than or equal to 90 denoting cognitive impairment. Results indicated that under conditions of low to moderate diagnostic prevalence (less than about .45), the ST‐LNNB evidenced low positive predictive power (PPP) when the recommended cutoff score of 8 was utilized. In order for the ST‐LNNB to demonstrate acceptable levels of PPP (i.e., .85 and .90), prevalences of impairment of .467 and .636 were necessary. Our data also suggested that the maximum PPP value for the ST‐LNNB may be limited. These results should be of interest to mental health professionals who currently use the ST‐LNNB and to clinicians who are considering incorporating brief cognitive screening instruments, such as the ST‐LNNB, into their assessment batteries.

940-73 Predictive Value for Major Arrhythmic Events of Ventricular Arrhythmias Detected in the Subacute Phase of a Fibrinolysed Myocardial Infarction. An Analysis of the GISSI-2 Data Base

The relationship between ventricular arrhythmias (VA) in the subacute phase of a myocardial infarction and subsequent major arrhythmic events (MAE) was mainly defined in the prefibrinolytic era, We examined the large population of patients enrolled in the GISSI-2 study in order to evaluate the significance and predictive power for MAE (sustained ventricular tachycardia -SVT-and sudden death -SD-) of VA detected by Holter monitoring during the subacute phase of a fibrinolysed acute myocardial infarction (AMI). Of the 12,381 pts. enrolled in the GISSI-2 study, an Holter monitoring was available in 8,676 and a six month follow-up was completed in 7,713. During the follow-up 84 pts. died suddenly and 26 experienced one or more SVT. The relationship between VA and MAE was evaluated by odds ratio (OR) and their 95% confidence intervals. OR for MAE was 4.5 (2.7–7.5) if the Holter showed > 10 ventricular ectopic beats per hour; 2.3 (1.5–3.7) if couplets were present; 3.3 (1.5–7.0) if nonsustained ventricular tachycardias (NSVT) were noticed; 3.0 12.0–4.5) if any complex VA was detected. A multivariate analysis (Cox modell including the major prognostic determinants confirmed the independent prognostic value of VA in the Holter recording except for NSVT. Any arrhythmic parameter had a very low positive predictive power (from 2.4 to 3.0%). In conclusion, our data show that VA still have, in the fibrinolytic era, a prognostic significance for MAE, but the predictive power is very low and is therefore mandatory to add other variables to identify the pts. more at risk.