Development and assessment of a brief screening tool for psychosis in dementia.
Ontology highlight
ABSTRACT: Introduction
Hallucinations and delusions (H+D) are common in dementia, but screening for these symptoms-especially in busy clinical practices-is challenging.Methods
Six subject matter experts developed the DRP3™ screen, a novel valid tool to detect H+D in dementia, assessed its content validity through alignment with DRP reference assessments (Scale for the Assessment of Positive Symptoms-Hallucinations + Delusions, Neuropsychiatric Inventory-Questionnaire, International Psychogeriatric Association Criteria), and retrospectively investigated its ability to detect H+D in HARMONY trial (NCT03325556) enrollees.Results
All items from three reference assessments demonstrated significant agreement with the DRP3 screen among raters (P < .0001). Retrospectively applying the DRP3 screen to HARMONY identified all (N = 392) trial enrollees.Discussion
The DRP3 screen, comprising three yes/no questions, is a content-valid tool for detecting H+D in dementia that aligned with current reference assessments and successfully identified trial participants when retrospectively applied to a completed trial. Within busy practice constraints, the DRP3 screen provides a brief tool for sensitive detection of H+D in patients with dementia.
SUBMITTER: Cummings JL
PROVIDER: S-EPMC8650749 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:BackgroundMovement disorders associated with exposure to antipsychotic drugs are common and stigmatising but underdiagnosed.AimsTo develop and evaluate a new clinical procedure, the ScanMove instrument, for the screening of antipsychotic-associated movement disorders for use by mental health nurses.MethodItem selection and content validity assessment for the ScanMove instrument were conducted by a panel of neurologists, psychiatrists and a mental health nurse, who operationalised a 31-item screening procedure. Interrater reliability was measured on ratings for 30 patients with psychosis from ten mental health nurses evaluating video recordings of the procedure. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of 13 mental health nurses for 635 community patients from mental health services with diagnostic judgement of a movement disorder neurologist based on the ScanMove instrument and a reference procedure comprising a selection of commonly used rating scales.ResultsInterreliability analysis showed no systematic difference between raters in their prediction of any antipsychotic-associated movement disorders category. On criterion validity testing, the ScanMove instrument showed good sensitivity for parkinsonism (90%) and hyperkinesia (89%), but not for akathisia (38%), whereas specificity was low for parkinsonism and hyperkinesia, and moderate for akathisia.ConclusionsThe ScanMove instrument demonstrated good feasibility and interrater reliability, and acceptable sensitivity as a mental health nurse-administered screening tool for parkinsonism and hyperkinesia.Declaration of interestNone.
| S-EPMC6171333 | biostudies-literature
Project description:The detection of common mental disorders in humanitarian crisis settings requires a screening tool that is feasible to use as well as sensitive and specific. The Self-Report Questionnaire, developed by the World Health Organization in 1994 to detect presence or absence of common mental health disorders, has frequently been used among conflict-affected and refugee populations. Our goal was to identify a highly predictive and reliable subset of items to serve as a screening tool that can be used in busy, over-crowded, and low-resource primary health care settings to identify women who need mental health attention.We analyzed the responses on a version of the Self-Report Questionnaire expanded to include two suicidality items from 810 displaced women living in refugee camps in Rwanda. Screening items were selected and evaluated for predictive ability using logistic regression in a cross-validation process, sensitivity and specificity using receiver operating characteristic curve analysis, and internal consistency analysis.A five-item screening tool resulted. Those items are "Do you feel unhappy?", Do you feel easily nervous, tense, or worried?", "Have you lost interest in things?", "Do you have trouble thinking clearly?" and "Has the thought of ending your life been on your mind?".The Self-Report Questionnaire-5 may be an important tool for identifying common mental disorders as well as suicide ideation and behaviors when assessing mental health among women in crisis situations. Further evaluation of this tool is warranted.
| S-EPMC4912842 | biostudies-other
Project description:OBJECTIVE:This study evaluated the psychometric properties of the Korean Anxiety Screening Assessment (K-ANX) developed for screening anxiety disorders. METHODS:Data from 613 participants were analyzed. The K-ANX was evaluated for reliability using Cronbach's alpha, item-total correlation, and test information curve, and for validity using focus group interviews, factor analysis, correlational analysis, and item characteristics based on item response theory (IRT). The diagnostic sensitivity and specificity of the K-ANX were compared with those of the Beck Anxiety Inventory (BAI) and Generalized Anxiety Disorder 7-item scale (GAD-7). RESULTS:The K-ANX showed excellent internal consistency (?=0.97) and item-total coefficients (0.92-0.97), and a one-factor structure was suggested. All items were highly correlated with the total scores of the BAI, GAD-7, and Penn State Worry Questionnaire. IRT analysis indicated the K-ANX was most informative as a screening tool for anxiety disorders at the range between 0.8 and 1.6 (i.e., top 21.2 to 5.5 percentiles). Higher sensitivity (0.795) and specificity (0.937) for identifying anxiety disorders were observed in the K-ANX compared to the BAI and GAD-7. CONCLUSION:The K-ANX is a reliable and valid measure to screen anxiety disorders in a Korean sample, with greater sensitivity and specificity than current measures of anxiety symptoms.
| S-EPMC6258999 | biostudies-other
Project description:In this study, we examined the preliminary concurrent validity of a brief version of the Prodromal Questionnaire (PQ-B), a self-report screening measure for psychosis risk syndromes. Adolescents and young adults (N=141) who presented consecutively for clinical assessment to one of two early psychosis research clinics at the University of California, San Francisco and UC Los Angeles completed the PQ-B and the Structured Interview for Prodromal Syndromes (SIPS) at intake. Endorsement of three or more positive symptoms on the PQ-B differentiated between those with prodromal syndrome and psychotic syndrome diagnoses on the SIPS versus those with no SIPS diagnoses with 89% sensitivity, 58% specificity, and a positive Likelihood Ratio of 2.12. A Distress Score measuring the distress or impairment associated with endorsed positive symptoms increased the specificity to 68%, while retaining similar sensitivity of 88%. Agreement was very similar when participants with psychotic syndromes were excluded from the analyses. These results suggest that the PQ-B may be used as an effective, efficient self-report screen for prodromal psychosis syndromes when followed by diagnostic interview, in a two-stage evaluation process in help-seeking populations.
| S-EPMC3113633 | biostudies-literature
Project description:PURPOSE:Develop and establish the content validity of the Behavioral Assessment Screening Tool (BAST?), a self-reported measure of behavioral and emotional symptoms after traumatic brain injury. METHODS:This was an assessment development study, including two focus groups of individuals with traumatic brain injury (n?=?11) and their family members (n?=?10) and an expert panel evaluation of content validity by experts in traumatic brain injury rehabilitation (n?=?7). We developed and assessed the Content Validity Index of the BAST?. RESULTS:The BAST? initial items (n?=?77) corresponded with an established conceptual model of behavioral dysregulation after traumatic brain injury. After expert panel evaluation and focus group feedback, the final BAST? included 66 items (60 primary, 6 branching logic) rated on a three-level ordinal scale (Never, Sometimes, Always) with reference to the past two weeks, and an Environmental Context checklist including recent major life events (n?=?23) and four open-ended questions about environmental factors. The BAST? had a high Content Validity Index of 89.3%. CONCLUSION:The BAST? is a theoretically grounded, multidimensional self-reported assessment of behavioral dysregulation after traumatic brain injury, with good content validity. Future translation into mobile health modalities could improve effectiveness and efficiency of long-term symptom monitoring post-traumatic brain injury. Future work will establish and validate the factor structure, internal consistency reliabilities and other validities of the BAST. Implications for Rehabilitation Behavioral problems after traumatic brain injury is one of the strongest contributing factors to poor mood and community integration outcomes after injury. Behavior is complex and multidimensional, making it a challenge to measure and to monitor long term. The Behavioral Assessment Screening Tool (BAST) is a patient-oriented outcome assessment developed in collaboration with individuals with traumatic brain injury, their care partners, and experts in the field of traumatic brain injury rehabilitation to be relevant and accessible for adults with traumatic brain injuries. The BAST is a long-term monitoring and screening tool for community-dwelling adults with traumatic brain injuries, to improve identification and management of behavioral and emotional sequelae.
| S-EPMC6198322 | biostudies-literature
Project description:BACKGROUND:Loss and grief are experienced by caregivers of persons with dementia (PWD), relating to the ambiguous loss of PWD even when they are still alive and the anticipation of future loss related to their physical death. Such experience of caregiver grief is not easily recognized in clinical practice, despite its association with adverse effects such as caregiver burden, caregiver depression and caregivers' desire to place the PWD in nursing homes. We constructed a simple screening tool - based on factors associated with caregiver grief - to identify caregivers with high grief. METHODS:Spouses or children of community-dwelling PWD (n?=?403) completed self-administered questionnaires containing a well-established grief scale and information related to the caregiver and PWD. We split the study sample into two - the derivation sample (n?=?300) was used to identify factors associated with grief (using logistic regression) and derive a simple tool based on the number of identified factors; the validation sample (n?=?103) evaluated the performance of the tool using the receiver-operating-characteristic-curve-analysis (ROC). RESULTS:Four key factors were identified by the multivariable regression - more severe dementia (odds ratio, OR 6.9), behavioral problems in PWD (OR 5.0), spousal caregivers (OR 6.0) and daily caregiving (OR 3.0). The screening tool (based on the number of key factors) had an area under ROC of 0.77. At the optimal cut-off of ?2 key factors, the tool had a sensitivity of 0.91 and a specificity of 0.42. CONCLUSIONS:The identified factors are consistent with current understanding on caregiver grief. They can be easily integrated into the workflow of routine services to screen for caregivers who are more likely to benefit from further grief-related assessment.
| S-EPMC6391777 | biostudies-literature
Project description:ObjectiveTo develop a short, patient-administered screening tool that will allow for earlier assessment of prescription opioid dependence (often referred to as addiction) in primary care settings.Design and settingCross-sectional analysis (N = 1,134) from the two-year time point of the Pain and Opioids IN Treatment (POINT) cohort was used in the scale development.SubjectsParticipants who completed two-year interviews in the POINT study, a prospective cohort study that followed people with chronic noncancer pain over a five-year period, and who were prescribed strong opioids for a minimum of six weeks at baseline.MethodsAn advisory committee provided advice on wording and content for screening in primary care settings. Univariate logistic regression identified individual items that were significantly associated with meeting ICD-11 criteria for prescription opioid dependence. Exploratory and confirmatory factor analysis (EFA and CFA) were conducted, and items were reduced to identify a small item set that were discriminative and shared a simple underlying structure.ResultsSixty-four variables associated with ICD-11 criteria for prescription opioid dependence were initially identified. Four rounds of EFA were performed, resulting in five items remaining. CFA identified two possible four-item combinations, with the final combination chosen based on greater item endorsement and the results of goodness-of-fit indices.ConclusionsAddressing prescription opioid dependence is an important part of the global public health challenge surrounding rising opioid-related harm. This study addresses an important initial requisite step to develop a brief screening tool. Further studies are required to validate the tool in clinical settings.
| S-EPMC8204889 | biostudies-literature
Project description:To develop and evaluate a short version of the 10/66 dementia diagnostic schedule for use in low-income and middle-income countries.Split-half analysis for algorithm development and testing; cross-evaluation of short-schedule and standard-schedule algorithms in 12 community surveys.(1) The 10/66 pilot sample data set of people aged 60 years and over in 25 international centres each recruiting the following samples: (a) dementia; (b) depression, no dementia; (c) no dementia, high education and (d) no dementia, low education. (2) Cross-sectional surveys of people aged 65 years or more from 12 urban and rural sites in 8 countries (Cuba, Dominican Republic, Peru, Mexico, Venezuela, India, China and Puerto Rico).In the 10/66 pilot samples, the algorithm for the short schedule was developed in 1218 participants and tested in 1211 randomly selected participants; it was evaluated against the algorithm for the standard 10/66 schedule in 16 536 survey participants.The short diagnostic schedule was derived from the Community Screening Instrument for Dementia, the CERAD 10-word list recall task and the Euro-D depression screen; it was evaluated against clinically assigned groups in the pilot data and against the standard schedule (using the Geriatric Mental State (GMS) rather than Euro-D) in the surveys.In the pilot test sample, the short-schedule algorithm ascertained dementia with 94.2% sensitivity. Specificities were 80.2% in depression, 96.6% in the high-education group and 92.7% in the low-education group. In survey samples, it coincided with standard algorithm dementia classifications with over 95% accuracy in most sites. Estimated dementia prevalences in the survey samples were not consistently higher or lower using the short compared to standard schedule.For epidemiological studies of dementia in low-income and middle-income settings where the GMS interview (and/or interviewer training required) is not feasible, the short 10/66 schedule and algorithm provide an alternative with acceptable levels of performance.
| S-EPMC4885443 | biostudies-other
Project description:Background/objectivesBriefer measures of symptoms and functional limitations may reduce assessment burden and facilitate monitoring populations of persons with dementia (PWD).DesignProspective follow-up study.SettingUniversity-based dementia care management program.Participants1,091 PWD.MeasurementsWe assessed cognition (Mini Mental State Examination (MMSE)-11 tasks), neuropsychiatric symptom severity (Neuropsychiatric Inventory Questionnaire Severity Scale (NPIQ-S)-12 items), and functional ability (Activities of Daily Living (ADL)-6 items; Functional Activities Questionnaire (FAQ)-10 items). Item response theory was used to select subsets of items by identifying low item discrimination (<1.50), poor item fit (χ2 ), local dependence (LD), and with difficulty similar to other items. We estimated correlations between original and shorter scales and compared their associations with mortality. We added two symptoms (trouble swallowing, coughing when eating) reflecting late-stage dementia complications, created a multi-dimensional dementia assessment composite, and examined its association with mortality.ResultsFive MMSE tasks were eliminated: two with low discrimination, two with difficulty similar to other items, and one with poor fit. The remaining tasks were correlated with the full MMSE at r = 0.82. We retained three ADLs that were correlated with the total ADL set at r = 0.95 and kept five FAQ items that were not LD (correlation with full FAQ, r = 0.97). Associations with mortality were similar between the longer and shorter scales. A higher score on the composite (range 0-100) indicates worse dementia impact and was associated with mortality (hazard ratio (HR) per scale point: 1.03 (1.02-1.04)).ConclusionThese brief assessments and dementia composite may reduce administration time while preserving validity.
| S-EPMC8269957 | biostudies-literature
Project description:Study objectivesWe evaluated the performance of the Insomnia Severity Index-3 (ISI-3) as a short screening tool to identify clinically significant insomnia derived from the 7-item ISI in an older primary care population.MethodsWe used results from two surveys including the 7-item ISI: Sample 1 (n = 3197) and Sample 2 (n = 247) individuals aged ≥60 years with a diagnosis of osteoarthritis from electronic health records. The 7 items were: difficulty falling asleep, difficulty staying asleep, waking too early, sleep satisfaction, sleep interference with daytime functioning, noticeability of sleep problems by others, and worry about sleep. The ISI-3 included items with highest item-total correlations to the 7-item ISI from Sample 1. A 7-item ISI score ≥15 was defined as clinically significant insomnia and served as the primary criterion for the ISI-3. We derived operating characteristics to determine the diagnostic accuracy and cut-points to maximize sensitivity and specificity for both samples.ResultsThe items with the highest item-total correlations were: sleep dissatisfaction, sleep interference with daily functioning, and worry about sleep problems (r = 0.78-0.81); while difficulty falling asleep, difficulty staying asleep, waking too early and noticeability of sleep problems by others showed lower correlations (r = 0.60-0.74). The ISI-3 achieved high discriminant validity in identifying insomnia (AUC = 0.97-0.98). An ISI-3 score of ≥7 maximized sensitivity (0.94-0.97) and specificity (0.88-0.91) with kappa = 0.68-0.71, 89.1-91.5% agreement.ConclusionsThe ISI-3 can effectively screen for insomnia to trigger a more thorough diagnostic evaluation including the 7-item ISI for research or clinical purposes. Future validation studies are needed in other community and clinical populations.Clinical trialThis manuscript describes secondary analyses of data two National Institutes on Aging-funded clinical trials (ClinicalTrials.gov identifier: NCT01142349, NCT02946957).
| S-EPMC8141095 | biostudies-literature