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  • 1
    In: The British Journal of Psychiatry, Royal College of Psychiatrists, Vol. 212, No. 6 ( 2018-06), p. 377-385
    Abstract: Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification. Aims To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics. Method Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit. Results A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97). Conclusions The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated. Declaration of interest Drs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
    Type of Medium: Online Resource
    ISSN: 0007-1250 , 1472-1465
    RVK:
    Language: English
    Publisher: Royal College of Psychiatrists
    Publication Date: 2018
    detail.hit.zdb_id: 2021500-9
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  • 2
    In: Psychological Medicine, Cambridge University Press (CUP), Vol. 50, No. 8 ( 2020-06), p. 1368-1380
    Abstract: Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9. Methods We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy. Results 16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard ( N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies ( N = 27), with similar results for studies that used other types of interviews ( N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01). Conclusions PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
    Type of Medium: Online Resource
    ISSN: 0033-2917 , 1469-8978
    RVK:
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1470300-2
    SSG: 5,2
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  • 3
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 13, No. 1 ( 2023-06-07)
    Abstract: The diagnostic accuracy of a screening tool is often characterized by its sensitivity and specificity. An analysis of these measures must consider their intrinsic correlation. In the context of an individual participant data meta-analysis, heterogeneity is one of the main components of the analysis. When using a random-effects meta-analytic model, prediction regions provide deeper insight into the effect of heterogeneity on the variability of estimated accuracy measures across the entire studied population, not just the average. This study aimed to investigate heterogeneity via prediction regions in an individual participant data meta-analysis of the sensitivity and specificity of the Patient Health Questionnaire-9 for screening to detect major depression. From the total number of studies in the pool, four dates were selected containing roughly 25%, 50%, 75% and 100% of the total number of participants. A bivariate random-effects model was fitted to studies up to and including each of these dates to jointly estimate sensitivity and specificity. Two-dimensional prediction regions were plotted in ROC-space. Subgroup analyses were carried out on sex and age, regardless of the date of the study. The dataset comprised 17,436 participants from 58 primary studies of which 2322 (13.3%) presented cases of major depression. Point estimates of sensitivity and specificity did not differ importantly as more studies were added to the model. However, correlation of the measures increased. As expected, standard errors of the logit pooled TPR and FPR consistently decreased as more studies were used, while standard deviations of the random-effects did not decrease monotonically. Subgroup analysis by sex did not reveal important contributions for observed heterogeneity; however, the shape of the prediction regions differed. Subgroup analysis by age did not reveal meaningful contributions to the heterogeneity and the prediction regions were similar in shape. Prediction intervals and regions reveal previously unseen trends in a dataset. In the context of a meta-analysis of diagnostic test accuracy, prediction regions can display the range of accuracy measures in different populations and settings.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2615211-3
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  • 4
    In: Psychotherapy and Psychosomatics, S. Karger AG, Vol. 89, No. 1 ( 2020), p. 25-37
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9 diagnostic algorithm. Many primary studies publish results for only one approach, and previous meta-analyses of the algorithm approach included only a subset of primary studies that collected data and could have published results. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To use an individual participant data meta-analysis to evaluate the accuracy of two PHQ-9 diagnostic algorithms for detecting major depression and compare accuracy between the algorithms and the standard PHQ-9 cutoff score of ≥10. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, Web of Science (January 1, 2000, to February 7, 2015). Eligible studies that classified current major depression status using a validated diagnostic interview. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Data were included for 54 of 72 identified eligible studies ( 〈 i 〉 n 〈 /i 〉 participants = 16,688, 〈 i 〉 n 〈 /i 〉 cases = 2,091). Among studies that used a semi-structured interview, pooled sensitivity and specificity (95% confidence interval) were 0.57 (0.49, 0.64) and 0.95 (0.94, 0.97) for the original algorithm and 0.61 (0.54, 0.68) and 0.95 (0.93, 0.96) for a modified algorithm. Algorithm sensitivity was 0.22–0.24 lower compared to fully structured interviews and 0.06–0.07 lower compared to the Mini International Neuropsychiatric Interview. Specificity was similar across reference standards. For PHQ-9 cutoff of ≥10 compared to semi-structured interviews, sensitivity and specificity (95% confidence interval) were 0.88 (0.82–0.92) and 0.86 (0.82–0.88). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The cutoff score approach appears to be a better option than a PHQ-9 algorithm for detecting major depression.
    Type of Medium: Online Resource
    ISSN: 0033-3190 , 1423-0348
    RVK:
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1472321-9
    SSG: 5,2
    SSG: 15,3
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  • 5
    In: Psychological Medicine, Cambridge University Press (CUP), Vol. 50, No. 16 ( 2020-12), p. 2816-2816
    Type of Medium: Online Resource
    ISSN: 0033-2917 , 1469-8978
    RVK:
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1470300-2
    SSG: 5,2
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  • 6
    In: Statistical Methods in Medical Research, SAGE Publications, Vol. 29, No. 9 ( 2020-09), p. 2520-2537
    Abstract: Researchers increasingly use meta-analysis to synthesize the results of several studies in order to estimate a common effect. When the outcome variable is continuous, standard meta-analytic approaches assume that the primary studies report the sample mean and standard deviation of the outcome. However, when the outcome is skewed, authors sometimes summarize the data by reporting the sample median and one or both of (i) the minimum and maximum values and (ii) the first and third quartiles, but do not report the mean or standard deviation. To include these studies in meta-analysis, several methods have been developed to estimate the sample mean and standard deviation from the reported summary data. A major limitation of these widely used methods is that they assume that the outcome distribution is normal, which is unlikely to be tenable for studies reporting medians. We propose two novel approaches to estimate the sample mean and standard deviation when data are suspected to be non-normal. Our simulation results and empirical assessments show that the proposed methods often perform better than the existing methods when applied to non-normal data.
    Type of Medium: Online Resource
    ISSN: 0962-2802 , 1477-0334
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2001539-2
    detail.hit.zdb_id: 1136948-6
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  • 7
    In: Bulletin of the American Meteorological Society, American Meteorological Society, Vol. 102, No. 2 ( 2021-02), p. E421-E445
    Abstract: The Chequamegon Heterogeneous Ecosystem Energy-Balance Study Enabled by a High-Density Extensive Array of Detectors 2019 (CHEESEHEAD19) is an ongoing National Science Foundation project based on an intensive field campaign that occurred from June to October 2019. The purpose of the study is to examine how the atmospheric boundary layer (ABL) responds to spatial heterogeneity in surface energy fluxes. One of the main objectives is to test whether lack of energy balance closure measured by eddy covariance (EC) towers is related to mesoscale atmospheric processes. Finally, the project evaluates data-driven methods for scaling surface energy fluxes, with the aim to improve model–data comparison and integration. To address these questions, an extensive suite of ground, tower, profiling, and airborne instrumentation was deployed over a 10 km × 10 km domain of a heterogeneous forest ecosystem in the Chequamegon–Nicolet National Forest in northern Wisconsin, United States, centered on an existing 447-m tower that anchors an AmeriFlux/NOAA supersite (US-PFa/WLEF). The project deployed one of the world’s highest-density networks of above-canopy EC measurements of surface energy fluxes. This tower EC network was coupled with spatial measurements of EC fluxes from aircraft; maps of leaf and canopy properties derived from airborne spectroscopy, ground-based measurements of plant productivity, phenology, and physiology; and atmospheric profiles of wind, water vapor, and temperature using radar, sodar, lidar, microwave radiometers, infrared interferometers, and radiosondes. These observations are being used with large-eddy simulation and scaling experiments to better understand submesoscale processes and improve formulations of subgrid-scale processes in numerical weather and climate models.
    Type of Medium: Online Resource
    ISSN: 0003-0007 , 1520-0477
    Language: Unknown
    Publisher: American Meteorological Society
    Publication Date: 2021
    detail.hit.zdb_id: 2029396-3
    detail.hit.zdb_id: 419957-1
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  • 8
    In: Ocean Science, Copernicus GmbH, Vol. 19, No. 3 ( 2023-06-15), p. 837-856
    Abstract: Abstract. Warming of the Arctic due to climate change means the Arctic Ocean is now free from ice for longer, as sea ice melts earlier and refreezes later. Yet, it remains unclear how this extended ice-free period will impact carbon dioxide (CO2) fluxes due to scarcity of surface ocean CO2 measurements. Baseline measurements are urgently needed to understand spatial and temporal air–sea CO2 flux variability in the changing Arctic Ocean. There is also uncertainty as to whether the previous basin-wide surveys are representative of the many smaller bays and inlets that make up the Canadian Arctic Archipelago (CAA). By using a research vessel that is based in the remote Inuit community of Ikaluqtuutiak (Cambridge Bay, Nunavut), we have been able to reliably survey pCO2 shortly after ice melt and access previously unsampled bays and inlets in the nearby region. Here we present 4 years of consecutive summertime pCO2 measurements collected in the Kitikmeot Sea in the southern CAA. Overall, we found that this region is a sink for atmospheric CO2 in August (average of all calculated fluxes over the four cruises was −4.64 mmol m−2 d−1), but the magnitude of this sink varies substantially between years and locations (average calculated fluxes of +3.58, −2.96, −16.79 and −0.57 mmol m−2 d−1 during the 2016, 2017, 2018 and 2019 cruises, respectively). Surface ocean pCO2 varied by up to 156 µatm between years, highlighting the importance of repeat observations in this region, as this high interannual variability would not have been captured by sparse and infrequent measurements. We find that the surface ocean pCO2 value at the time of ice melt is extremely important in constraining the magnitude of the air–sea CO2 flux throughout the ice-free season. However, further constraining the air–sea CO2 flux in the Kitikmeot Sea will require a better understanding of how pCO2 changes outside of the summer season. Surface ocean pCO2 measurements made in small bays and inlets of the Kitikmeot Sea were ∼ 20–40 µatm lower than in the main channels. Surface ocean pCO2 measurements made close in time to ice breakup (i.e. within 2 weeks) were ∼ 50 µatm lower than measurements made 〉 4 weeks after breakup. As previous basin-wide surveys of the CAA have focused on the deep shipping channels and rarely measure close to the ice breakup date, we hypothesize that there may be an observational bias in previous studies, leading to an underestimate of the CO2 sink in the CAA. These high-resolution measurements constitute an important new baseline for gaining a better understanding of the role this region plays in the uptake of atmospheric CO2.
    Type of Medium: Online Resource
    ISSN: 1812-0792
    Language: English
    Publisher: Copernicus GmbH
    Publication Date: 2023
    detail.hit.zdb_id: 2183769-7
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  • 9
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2021
    In:  BMC Public Health Vol. 21, No. 1 ( 2021-12)
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: In Australia, it is projected that one in four individuals will be at the nominal retirement age of 65 or over by 2056; this effect is expected to be especially pronounced in rural areas. Previous findings on the effects of retirement on wellbeing have been mixed. The present study explores the effects of employment and retirement on health and wellbeing among a sample of rural Australians. Methods Australian Rural Mental Health Study participants who were aged 45 or over ( N  = 2013) were included in a series of analyses to compare the health and wellbeing of individuals with differing employment and retirement circumstances. Self-reported outcome variables included perceived physical health and everyday functioning, financial wellbeing, mental health, relationships, and satisfaction with life. Results Across the outcomes, participants who were employed or retired generally reported better health and wellbeing than those not in the workforce. Retired participants rated more highly than employed participants on mental health, relationships, and satisfaction with life. There was also a short-term benefit for perceived financial status for retired participants compared to employed participants, but this effect diminished over time. Conclusions While retirement is a significant life transition that may affect multiple facets of an individual’s life, the direction and magnitude of these effects vary depending on the retirement context, namely the pre-retirement and concurrent circumstances within which an individual is retiring. Personal perceptions of status changes may also contribute to an individual’s wellbeing more so than objective factors such as income. Policies that promote rural work/retirement opportunities and diversity and address rural disadvantage are needed.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041338-5
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  • 10
    Online Resource
    Online Resource
    American Geophysical Union (AGU) ; 2022
    In:  Journal of Geophysical Research: Biogeosciences Vol. 127, No. 10 ( 2022-10)
    In: Journal of Geophysical Research: Biogeosciences, American Geophysical Union (AGU), Vol. 127, No. 10 ( 2022-10)
    Abstract: Scaling in space and time is an essential foundation for understanding land‐atmosphere interactions A series of papers in this collection demonstrate scale‐related advances in a number of areas Coordination of research across disciplines is needed
    Type of Medium: Online Resource
    ISSN: 2169-8953 , 2169-8961
    Language: English
    Publisher: American Geophysical Union (AGU)
    Publication Date: 2022
    detail.hit.zdb_id: 3094167-2
    detail.hit.zdb_id: 2220777-6
    SSG: 16,13
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