Self-administered Screening Tool Research Articles

Validation and reliability of the Malay version of the painDETECT questionnaire (PDQ-M) among patients with neuropathic and nociceptive pain

Background: Neuropathic pain is chronic and debilitating. Early and accurate diagnosis is important for appropriate management. The painDETECT questionnaire (PDQ) is an effective screening tool for presence of neuropathic pain. We tested the validity and reliability of the translated Malay version of PDQ (PDQ-M). Methods: This was a multi-center cross-sectional study conducted over 24 months. The original English version of PDQ was translated into Malay version following international guidelines. Subsequently, patients with chronic pain were administered PDQ-M and Malay version of SF36 at baseline and 2-4 weeks later. The reliability, construct and criterion validity of PDQ-M were evaluated. Clinician diagnoses were used as gold standard for comparison of diagnostic accuracy. Multiple regression analysis was performed to determine correlation between PDQ-M and SF-36 scores. Results: A total of 97 patients were included in the study (53 with neuropathic pain, 44 with nociceptive pain). The EFA of PDQ-M produced three factors which explained 58.3% of the variance. It exhibited fair consistency with Cronbach’s alpha coefficient of 0.719 (for all 9 items) and 0.755 (for 7-item with Likert scale). PDQ-M is reliable with Cronbach’s alpha coefficient of 0.719 and 0.852 for test-retest reliability. A score of ≥17 was the best cut-off value for discriminating between neuropathic and non-neuropathic pain in PDQ-M (79.2% sensitivity, 50.0% specificity). Multiple regression analysis exhibited total PDQ-M score to have significant negative correlation with all components of SF-36 scores except role limitation due to physical health. Conclusions: PDQ-M is a reliable and valid self-administered screening tool for neuropathic pain.

The CAREPAL-8: a short screening tool for multidimensional family caregiver burden in palliative care

BackgroundFamily caregivers of terminally ill and dying people do not only experience varying levels but also different dimensions of caregiver-related strain and burden. The aim of the study was to develop a short multidimensional screening tool for the detection of burden in family caregivers in palliative care.MethodsFamily caregivers of cancer patients newly admitted to specialist inpatient palliative care (N = 232) completed questionnaires on psychological burden, quality of life, social support and need fulfillment. A latent class mixture model was used to identify discrete classes of family caregivers related to their multidimensional caregiver burden. Multinomial logistic regression analyses were performed to identify the most predictive items from a set of established questionnaires.ResultsFour latent classes of family caregivers were identified: Currently stable caregivers (37%), Caregivers with unmet needs (20%), Psychologically burdened caregivers (30%), and High-risk caregivers (13%). Each of these classes describes a different risk profile of multidimensional family caregiver burden, although family caregivers exhibit high levels of distress across all classes. From a set of 48 items, we identified eight items that predicted the class membership best. These items represent the items of the novel multidimensional screening tool: The 8-item Screening Tool for Family Caregiver Burden in Palliative Care (CAREPAL-8). Except for social support, the items maintained fidelity to the conceptualization of multidimensional caregiver burden used in this study. A preliminary classification system was developed, which has yet to be validated.ConclusionsThis study represents the first step in the establishment of a practical, self-administered screening tool that might help healthcare providers to tailor caregiver care according to their burden in daily practice. Brevity of the 8-item tool might facilitate its use in routine clinical care.

A novel olfactory sorting task

BackgroundThis study aimed to develop a simple self-administered screening tool for odor memory, which allowed users to self-test their olfactory function repeatedly even at home.MethodsOne hundred and ten participants were recruited (30 men, age = 50.1 ± 9.9 years; 80 women, age = 47.1 ± 11.5 years); half of them were heathy volunteers, the other half were patients with olfactory dysfunction. Fifty-one healthy participants volunteered for a retest within an interval of a maximum of 14 days. Olfactory function was assessed using the extended Sniffin’ Sticks test (SST) comprising tests for odor threshold, identification, and discrimination. All participants received the Novel Olfactory Sorting Task (NOST) which is based on the sorting of 12 matching pairs of odors involving olfactory and cognitive functions. After that, all participants rated questions related to their test performance and the practicability of the test.ResultsConsistent with the previous literature, significant effects of age were found. Results showed an acceptable test-retest reliability and a satisfactory validity of the NOST. The NOST score not only had positive correlations with SST, but also was capable of differentiating severe hyposmia/anosmia from normosmia by the score of 5.5 (sensitivity of 76.2%, specificity of 77.6%).ConclusionThe present study showed the good reliability, validity, and possible clinical usefulness of the NOST. As a self-performed screening test, it can be comprehended and conducted easily, which may provide a quick and simple approach to obtaining a global estimation of olfactory and cognitive functions.

Developing a Mental Health Screening Questionnaire in an Asian Children's Hospital Emergency Setting.

Mental health concerns among adolescents are increasingly prevalent, yet underrecognized. Adolescents with psychological distress often present to the emergency department (ED) with somatic symptoms. Due to inadequate time for rapport building and lack of familiarity of ED clinicians with psychosocial evaluation, these concerns often get missed. We describe the development and implementation of the Youth Well Being (YWB) questionnaire, a self-administered psychosocial screening tool that aims to overcome the communication barriers to psychosocial evaluation. A multidisciplinary team used a Delphi-like approach to develop the questionnaire, using the home, education, activities/peers, drugs/alcohol, suicidality, emotions/behavior, discharge resources (HEADS-ED) questionnaire as the main reference. Modifications were made based on panel members' clinical experience and adapted to suit local sociocultural context. The YWB questionnaire is administered to adolescents aged 10 to 19 years presenting to the KK Women's and Children's Hospital ED with possible psychosomatic symptoms and behavioral or mental health issues. Positive findings prompt further targeted face-to-face interviews by the clinicians to facilitate appropriate psychosocial referral. The 9 domains in the YWB questionnaire explore potential psychosocial difficulties that affect the adolescent's well-being and aim to uncover potential issues that could account for the adolescent's symptoms. We discuss the rationale behind the questions and response options in the YWB questionnaire. The YWB questionnaire is the first initiative in Singapore to enable efficient psychosocial screening of at-risk adolescents in the ED. This communication tool can potentially be used in other health care settings to enable early recognition and intervention for adolescents distressed by psychosocial problems.

Translation and validation of menopause quick 6 (MQ6) into the Malay language

BackgroundInquiring conservative Asian women about their menopausal symptoms is often challenging in crowded primary healthcare clinics. Furthermore, the subject matter is culturally sensitive to most Malaysian women. Hence, the translation of MQ6 into Malay is crucial to enable self-administration, eliminating the necessity for interviewers and mitigating potential respondent shyness.MethodsThe Menopause Quick 6 (MQ6) questionnaire was translated into the Malay language with an addition of an item, henceforth termed MQ6 (M). Forward and backward translation was performed. Face and content validity were conducted. MQ6 (M) was self-administered to 400 women aged between 40 and 60 attending six primary healthcare clinics in Malaysia. To ascertain the reliability for MQ6 (M), corrected Item-Total Correlation, Squared Multiple Correlation, Cronbach’s Alpha if the Item is Deleted, and Kuder-Richardson Reliability Coefficients (KR20). Exploratory factor analysis was done to determine its’ construct validity.ResultsThe outcome of the validation was satisfactory. By the Lawshe method, the content validity ratios ranged from 0.6 to 1.0 and the content validity index was 0.914. The Internal consistency for MQ6(M) Cronbach’s alpha was 0.711 while Kuder-Richardson Reliability Coefficients KR20 was 0.676. Factor loading of all four items is above 0.70, indicating a well-defined structure. Whereas factor loading for three items fell within the range of 0.50–0.69 indicating a practically significant threshold for a new questionnaire.ConclusionMQ6 (M) has acceptable reliability and construct validity to be considered as a self-administered screening tool in primary care clinics in Malaysia.

Yubi-Wakka Test for Sarcopenia Screening in the Community: Comparative Agreement, Diagnostic Performance and Validity with Calf Circumference Measurements.

Screening tools such as calf circumference (CC) and Yubi-wakka (finger-ring) test have been recognized as effective tools by Asian Working Group for Sarcopenia 2019 (AWGS'19) for sarcopenia screening but their comparative agreement, diagnostic performance and validity are unclear. This study aims to determine: (i)agreement between calf and finger-ring circumference, (ii)diagnostic performance for low muscle mass and AWGS'19 sarcopenia diagnosis, (iii)correlation with muscle mass, strength, and physical performance, and (iv)association with frailty, life space mobility and physical activity. We studied 187 healthy community-dwelling older adults (mean age=66.8+7.0years) from the GERILABS-2 study. CC was measured via (i) both calves in sitting and standing positions, and (ii) Yubi-wakka test by encircling the thickest part of the non-dominant calf with index fingers and thumbs of both hands. We performed Cohen's kappa to check for agreement, area under receiver operating characteristic curve (AUC) to compare diagnostic performance, partial correlations adjusted for age and gender to compare convergent validity, and logistic regression to determine predictive validity for outcome measures. Sarcopenia prevalence was 24.0% (AWGS'19). Yubi-wakka identified 16.6% of participants as screen-positive ("smaller"), showing moderate agreement only with non-dominant sitting CC measurements (k=0.421,p<0.001) and having lower diagnostic performance in determining low muscle mass (AUC=0.591 vs 0.855-0.870,p<0.001; sensitivity=57.1% vs 75.5-90.8%; specificity=58.4% vs 70.8-80.9%) and sarcopenia diagnosis (AUC=0.581 vs 0.788-0.818,p<0.001; sensitivity=55.6% vs 57.5-71.8%; specificity=74.4% vs 75.6-88.9%) compared to CC measurements. Yubi-wakka correlated significantly with muscle mass, grip strength and knee extension but not physical performance. When adjusted for age, gender and hypertension, Yubi-wakka was significantly associated with frailty (OR=3.96,95%CI:1.09-14.38), life space mobility (OR=2.38,95%CI:1.08-5.24) and physical activity (OR=2.50,95%CI:1.07-5.86). Yubi-wakka provides a self-administered, low-cost and practicable community screening tool for sarcopenia. Our study affirmed the convergent and predictive validity of Yubi-wakka, albeit with lower sensitivity and specificity in diagnostic performance compared to CC measurements.

Pilot development of diagnostic tools for lower limb apophyseal injuries in children and adolescents.

Lower limb apophyseal injuries commonly occur in children and adolescents with unknown incidence and prevalence. These conditions are considered benign, but impact children and adolescents quality of life and can lead to sport withdrawal at a crucial time. The primary aim of this research was to develop self-administered tools for two of the most common apophyseal injuries. The secondary aim was to test the sensitivity and specificity of the tools. Study 1 used a three round online Delphi panel (n = 8), with expert consensus supported by robust literature. This panel developed a self-administered screening tool for calcaneal (Sever's disease) and tibial tuberosity (Osgood-Schlatter's disease) apophysitis. Study 2 tested the sensitivity and specificity of these developed tools with parents and children (n = 63) with concurrent clinical examination by a health professional. An initial sample size for Study 2 was set at 155 children however this was impacted by COVID-19 and recruitment was halted. Both tools had excellent diagnostic accuracy with an area under the curve of 83% (95% confidence interval = 0.70 to 0.95) for the posterior heel (calcaneal apophysitis) tool and 93% (95% confidence interval = 0.80 to 1.00) for the anterior of knee (tibial tuberosity apophysitis) tool using the pilot data from the 63 children. These tools may also enhance opportunities for clinicians and health service providers with pre-clinical screening to reduce wait list time and encourage low cost, self-administered management where indicated. These findings may enable large epidemiological studies to identify populations and calculate incidence and prevalence of these conditions using self report.

Lifetime Experience of Childhood Abuse and Neglect Among High School Students at Debre Tabor Town, South Gondar Zone, Northwest Ethiopia: An Institution-Based Cross-Sectional Study.

Childhood abuse and neglect is defined as any intentional harm or mistreatment of a child that results in actual or potential harm to the child's health, survival and development. It has been linked to an increased risk of a wide range of serious short- and long-term medical and mental health problems. Although it is a complex societal issue, it receives limited research attention in the area. To assess lifetime prevalence of childhood abuse and neglect among high school students in Debre Tabor town, south Gondar Zone, Northwest Ethiopia, 2022. A cross-sectional study design was used to assess 423 high school students, chosen through a systematic sampling technique. Data were collected using a pre-tested, structured and self-administered international child abuse screening tool, child version (ICAST-C). The effect of independent variables on the outcome variable was explored using logistic regression analyses. The level of significances were determined using an odds ratio with a 95% confidence interval. Of the 423 study participants, 84.4% had lifetime experience of childhood abuse and neglect. Being female (AOR=4.5, 95% CI: 2.38, 8.60), parental marital status (AOR=5.4, 95% CI: 1.07, 27.3), illiteracy of father (AOR=1.65, 95% CI: 4.5, 6.03), birth order (AOR=4.5, 95% CI: 1.57, 13.0), open family discussion of sexual matters (AOR=0.37, 95% CI:1.74, 7.86), and watching pornography (AOR=0.08, 95% CI: 0.02, 0.40) were significantly associated with lifetime experience of childhood abuse and neglect. Lifetime experience of childhood abuse and neglect was high as compared with previous studies. Being female, parental marital status, illiterate fathers, watching pornography, and open family discussion of sexual matters were predictors of childhood abuse and neglect. Dealing with this issue should be considered an integral component of high school students' care, including parental education and respite care.

Medication risk checklist for older adults (LOTTA) – development and validation of a self-assessment tool

Background Patient safety strategies highlight patients’ own active involvement in ensuring medication safety. A prerequisite for involving patients in their medication therapy is having tools that can assist them in ensuring safe medicine use. Older home-dwelling adults with multiple medications are at high risk for medication-related problems, yet only a few age-specific patient self-administered medication risk screening tools exist. This study aimed to develop, validate, and assess the feasibility of a self-administered medication risk checklist for home-dwelling older adults ≥65 years. Materials and methods The draft checklist was formed based on a validated practical nurse-administered Drug Related Problem Risk Assessment Tool supplemented with findings from two systematic literature reviews. The content validity of the draft checklist was determined by a three-round Delphi survey with a panel of 19 experts in geriatric care and pharmacotherapy. An agreement of ≥80% was required. A feasibility assessment (i.e. understandability of the items, fill-out time of the checklist) of the content-validated checklist was conducted among older adults ≥65 years (n = 87) visiting community pharmacies (n = 4). Data were analysed using qualitative content analysis. Results The final validated and feasibility-tested Medication Risk Checklist (LOTTA) for home-dwelling older adults consists of eight items screening the highest priority systemic risks (three items), potentially drug-induced symptoms (one item), adherence, and self-management problems (four items). The checklist proved feasible for self-administration, the mean fill-out time being 6.1 min. Conclusions A wide range of potential medication risks related to the medication use process can be identified by patient self-assessment. Screening tools such as LOTTA can enhance early detection of potential medication risks and risk communication between older adults and their healthcare providers. A wider and more integrated use of the checklist could be facilitated by making it electronically available as part of the patient information systems.

Measurement invariance of the Center for Epidemiologic Studies Scale-Depression within and across six diverse intervention trials.

Depression, a major contributor to the global burden of disease, is an outcome of interest in clinical trials. Researchers and clinicians note that depression often presents differently across cultures, posing challenges in the accurate measurement of depressive symptoms across populations. A commonly used self-administered screening tool to measure depressive symptoms, the Center for Epidemiologic Studies Scale-Depression (CES-D), has been translated into dozens of languages and used in thousands of studies, yet gaps remain in our understanding of its factor structure and invariance across studies and over time in the context of interventions. In this secondary analysis, we sampled six recent trials from lower- and middle-income countries to (a) establish the factor structure of the CES-D, (b) assess measurement invariance of the CES-D across treatment versus control arms and over time, (c) examine cross-study invariance, and (d) identify items that may be driving potential noninvariance. We performed exploratory/confirmatory factor analysis to establish the factor structure of the CES-D within each trial and used multiple group confirmatory analysis to assess within-study cross-arm/cross-time and cross-study invariance. After removal of positive affect items, a unidimensional model performed equivalently over time and across arms within trials, but exhibited noninvariance across trials, supporting prior literature describing differences in factor structure of the scale across populations. While our findings suggest that the CES-D without positive affect items is a valid measure of depressive symptoms within trials in our sample, caution is warranted in interpreting the findings of meta-analyses and multisite/multicountry studies using the CES-D as an outcome measure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Psychometric properties and factor structure of the diabetes eatıng problem survey- revised (DEPS-R) among adults with type 1 diabetes mellitus

Background and objectiveAlthough many studies on the Diabetes Eating Problem Survey–Revised (DEPS-R) in adolescents with type 1 diabetes mellitus (T1D), the number of studies validating this questionnaire in adults with T1D is limited. Therefore, this study aimed to examine the factor structure of the Turkish version of the DEPS-R in adults with T1D and internal consistency and construct validity.MethodsA total of 100 patients with T1D, ages 18–50 years, completed the DEPS-R and EDE-Q. In addition to tests of validity, confirmatory factor analysis was conducted to investigate the factor structure of the 6-item Turkish version of DEPS-R.ResultsThe Cronbach’s alpha coefficient of the DEPS-R Turkish version was 0.77, suggesting good internal consistency. The median (IQ) DEPS-R score was 15.0 (13.0) among all participants. DEPS-R score was significantly correlated with BMI (r = 0.210; p < 0.05) and EDE-Q (r = 0.586; p < 0.01). There was no correlation between the HbA1c values of participants and neither EDE-Q nor DEPS-R scores. The confirmatory factor analysis results show that the three-factor model was a good fit.ConclusionA short, self-administered diabetes-specific screening tool for disordered eating behavior is recommended be used routinely in the clinical care of adults with T1D, and Turkish version of DEPS-R has acceptable internal consistency and construct validity in adults with T1D.Level of evidenceLevel V, descriptive study.Clinicaltrials.gov registration number NCT05346679/ 21.04.2022 (retrospectively registered)

Validation of the self-administered Montreal Cognitive Assessment (MoCA) XpressO: A self-administered digital cognitive screening tool for the adult population in the general public

Validation of the self-administered Montreal Cognitive Assessment (MoCA) XpressO: A self-administered digital cognitive screening tool for the adult population in the general public

Validation of the self-administered Montreal Cognitive Assessment (MoCA) XpressO: A self-administered digital cognitive screening tool for the adult population in the general public

Validation of the self-administered Montreal Cognitive Assessment (MoCA) XpressO: A self-administered digital cognitive screening tool for the adult population in the general public

Digital handwriting characteristics for dysgraphia detection using artificial neural network

Despite all of the technical advancements in writing and text editing with keyboards on numerous devices, writing with a pen remains a fundamental ability in modern human existence. Handwriting disabilities are referred to as dysgraphia. Nonetheless, how well they are taught to write in school, 10-30% of children never attain a respectable level of handwriting. Early identification is critical because it can help children avoid difficulties in their behavioral and academic development. On blank papers attached to digital tablets, 280 individuals were asked to complete the concise evaluation scale for children’s handwriting (BHK), with 218 having typical handwriting and 62 having dysgraphia. In addition to their age and BHK quality and speed scores, 12 variables identifying digital handwriting across several domains (static, kinematic, pressure, and tilt) were collected. In this paper, we provided a rapid and automated dysgraphia classification approach using an artificial neural network (ANN) model. Using digital handwriting traits as an input to the ANN approach, the prediction findings were encouraging and very accurate, reaching 96% accuracy, and they could lead to the development of a new self-administered dysgraphia screening tool.

Exploring the Patient Health Questionnaire-15 as a screening tool for wellness in law enforcement

ABSTRACT Law enforcement officers globally face unique stressors and heightened morbidity compared to the general population. This study emerged as part of an initiative to provide data needed to design policies and programs that address the stressors faced by officers and to investigate how these factors may affect officer performance. As part of this initiative, a nationally representative cohort of officers (n = 2,867, mean age 41) answered questions regarding their physical and mental health. Measurements at one time point included the Patient Health Questionnaire-15 (PHQ-15) to query somatic symptoms and additional wellness measures assessing sleep and exhaustion, stress, mental health, and suicidality. We identified strong and significant associations between the PHQ-15 in the expected directions with all five wellness measures. Significant associations indicate that the PHQ-15, when used as a self-administered screening tool, will increase awareness of physical and mental symptoms in officers that might otherwise go unnoticed.

A mobile application using automatic speech analysis for classifying Alzheimer's disease and mild cognitive impairment

Speech and language disturbances have been observed from the early stages of Alzheimer's disease (AD), including mild cognitive impairment (MCI), and speech analysis has been expected to help as a screening tool for early detection of AD and MCI. However, the questions of whether and how automatic speech analysis, including speech recognition by a self-administered tool, can be used for such detection remain largely unexplored. In this study, we performed automatic analysis of speech data collected via a mobile application from 114 older participants during cognitive tasks. The goal was to classify AD, MCI, and cognitively normal (CN) groups by using speech features characterizing acoustic, prosodic, and linguistic aspects. First, we evaluated how accurately linguistic features could be automatically extracted from transcriptions generated by automatic speech recognition (ASR), and we found that the features were highly correlated (r = 0.92) with those extracted from manual transcriptions. Then, a machine-learning speech classifier using these features achieved 78.6% accuracy for classifying AD, MCI, and CN through nested cross-validation (AD versus CN: 91.2% accuracy; MCI versus CN: 87.6% accuracy). Our results suggest the utility and validity of using a mobile application with automatic speech analysis as a self-administered screening tool for early detection of AD and MCI.

Posttraumatic stress, visual working memory, and visual imagery in military personnel

Posttraumatic stress disorder (PTSD) is characterized by disruptions to cognitive functioning. Two studies were conducted to examine the relevance of military-related PTSD to two cognitive functions – visual working memory and visual imagery. Participants were military personnel who reported their PTSD diagnosis history and completed a self-administered screening tool for PTSD, the PTSD Checklist – Military Version. In Study 1, 138 personnel also completed a memory span task and a 2-back task using colored words in which Stroop interference was introduced via the semantic content of the words. In Study 2, a separate group of 211 personnel completed measures of perceived imagery vividness and spontaneous use of visual imagery. Interference effects on working memory in PTSD-diagnosed military personnel were not replicated. However, ANCOVA and structural equation modelling revealed that PTSD-intrusions were associated with poorer working memory whereas PTSD-arousal was associated with spontaneous use of visual imagery. We interpret these results as evidence that intrusive flashbacks disrupt working memory performance not by limiting memory capacity nor by interfering directly with memory functions such as inhibition, but by adding internal noise in the form of task-irrelevant memories and emotions. Visual imagery appears to be unrelated to these flashbacks but with arousal symptoms of PTSD, perhaps in the form of flashforwards about feared/anticipated threats.

Web-based autism screening using facial images and convolutional neural network

Developmental disabilities such as autism spectrum disorder (ASD) affect a person’s ability to interact socially, and communicate effectively and also cause behavioral issues. Children with ASD cannot be cured but they might benefit from early intervention to enhance their cognitive abilities, favorite their growth , and affect their lives and families in a positive way. Multiple standard ASD screening tools are used such as the autism diagnostic observational schedule (ADOS) and the autism diagnostic interview (ADI), which are known to be lengthy and challenging without specialist training to administrate and score. The process of ASD assessment can be time-consuming and costly, and the growing number of autistic cases worldwide indicates an urgent need for a quick, simple, and dependable self-administered autism screening tool that may be used if a child displays some of the common signs of autism, and to ensure whether or not he should seek professional full ASD diagnosis. According to a number of studies, ASD individuals exhibit facial phenotypes that are distinct from those of normally developing children. Furthermore, convolutional neural networks (CNN) have mostly found utility in image classification applications due to their high classification accuracy. Using facial images, a dense convolutional network (Densenet) model, and cloud-based advantages, in this paper we proposed a practical, fast, and easy-to-use ASD online screening approach. Easily available through the internet via the link “https://asd-detector.herokuapp.com/”, our suggested web-based screening instrument may be a practical and trustworthy tool for practitioners in their ASD diagnostic procedures with a 98 percent testing dataset classification accuracy.

The effectiveness of corrective exercises on the KOJI AWARENESS score and activity-related pain intensity

The KOJI AWARENESS� screening test is a self-administered screening tool for assessment of mobility, stability, and strength. It provides corrective exercises corresponding to the individual's answers to the KOJI AWARENESS� test questions. However, there is no evidence of the effectiveness of corrective exercises in improving KOJI AWARENESS� screening test scores and activity-related pain.Twenty-six healthy subjects (11 female and 15 male ; age 20?50 years) were selected for participation. In a controlled laboratory setting, subjects were administered the KOJI AWARENESS� test and were provided with individualized exercise programs based on the results of this first test. KOJI AWARENESS� results were checked on the first day immediately after the first exercise session, and then again after the two-week program. Pain intensity was also assessed during daily training using a numerical rating scale.Compared to pre-intervention, KOJI AWARENESS� scores were significantly higher immediately after the first corrective exercise session and after 2 weeks of intervention (p<0.001). Moreover, pain intensity was significantly lower after 2 weeks of intervention (p<0.001).Individualized KOJI AWARENESS� corrective exercises were effective immediately on the first day and also after the two-week program in improving the KOJI AWARENESS� score and reducing pain intensity during daily training. J. Med. Invest. 70 : 208-212, February, 2023.

A simple and rapid focal seizure screening tool in resource-limited setting

Background &amp; Objective: A substantial proportion of patients were managed by general clinicians in resource-limited settings. Therefore, we aim to develop a simple and rapid focal seizure screening tool that can assist non-neurologists in seizure classification. Methods: We conducted a self-administered qualitative questionnaire study on seizure manifestation developed based on the validated comprehensive questionnaires by Reutens et al. for clinical diagnosis of seizures. Logistic regression analyses were conducted to determine the features of seizure which form the items of a focal seizure screening tool. A receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal cut-off score. Results: Among the 199 subjects, 145 (73%) had focal seizures. Three categories of symptoms, i.e., (i) aura (fear, déjà vu, and epigastric aura), (ii) unilateral motor phenomena, and (iii) oral automatism, are significantly associated with the diagnosis of focal seizure. The logistic regression model containing these 3 items / features was statistically significant, χ2 (3, N=199) = 22.93, p&lt;0.001, and correctly classified 71.4% of cases. A focal seizure screening tool was developed by assigning a score of 1 to each category of symptoms. The area under the curve of ROC curve is 0.706 (95% CI: 0.629-0.783), p&lt;0.001. A score of ≥2 is the most optimal cut-off with a sensitivity of 50.3%, specificity of 85.2%, positive predictive value (PPV) of 91.0%, and negative predictive value (NPV) of 41.8%. Conclusion: A simple and rapid self-administered focal seizure screening tool was established with high specificity and PPV.