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Screening Questionnaire (screening + questionnaire)
Kinds of Screening Questionnaire Selected AbstractsMigraine in Adolescents: Validation of a Screening QuestionnaireHEADACHE, Issue 2 2009Luca Valentinis MD Background., Few studies in adolescents deal with the level of agreement between questionnaire and interview information in relation to headache symptoms. Objective., To evaluate the validity of a self-administered questionnaire on headache for use in epidemiological studies of Italian high school students. Methods., The questionnaire incorporated all items required for diagnosing migraine according to the criteria from the 2004 International Classification of Headache Disorders. The migraine diagnoses obtained from questionnaires were validated against the gold standard diagnoses by a headache specialist. Results., Out of 104 students answering the questionnaires, 93 (89.4%) participated in extensive semi-structured interviews by a neurologist. The chance-corrected agreement rate (kappa) was 0.66, which is considered good. The questionnaire-based migraine diagnosis had a sensitivity of 67.3%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 73.3%. Conclusions., The results indicate that our self-administered questionnaire may be an acceptable instrument in determining the prevalence of migraine sufferers in the northeast Italy adolescent population, useful in identifying subjects with "definite" migraine. [source] Why do primary care doctors diagnose depression when diagnostic criteria are not met?INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2000Michael Höfler Abstract This study examines predictors of false positive depression diagnoses by primary care doctors in a sample of primary care attendees, taking the patients' diagnostic status from a self-report measure (Depression Screening Questionnaire, DSQ) as a yardstick against which to measure doctors' correct and false positive recognition rates. In a nationwide study, primary care patients aged 15,99 in 633 doctors' offices completed a self-report packet that included the DSQ, a questionnaire that assesses depression symptoms on a three-point scale to provide diagnoses of depression according to the criteria of DSM-IV and ICD-10. Doctors completed an evaluation form for each patient seen, reporting the patient's depression status, clinical severity, and treatment choices. Predictor analyses are based on 16,909 patient-doctor records. Covariates examined included depression symptoms, the total DSQ score, number and persistence of depression items endorsed, patient's prior treatment, history of depression, age and gender. According to the DSQ, 11.3% of patients received a diagnosis of ICD-10 depression, 58.9% of which were correctly identified by the doctor as definite threshold, and 26.2% as definite subthreshold cases. However, an additional 11.7% of patients not meeting the minimum DSQ threshold were rated by their doctors as definitely having depression (the false positive rate). Specific DSQ depression items endorsed, a higher DSQ total score, more two-week depression symptoms endorsed, female gender, higher age, and patient's prior treatment were all associated with an elevated rate of false positive diagnoses. The probability of false positive diagnoses was shown to be affected more by doctors ignoring the ,duration of symptoms' criterion than by doctors not following the ,number of symptoms' criterion for an ICD or DSM diagnosis of depression. A model selection procedure revealed that it is sufficient to regress the ,false positive diagnoses' on the DSQ-total score, symptoms of depressed mood, loss of interest, and suicidal ideation; higher age; and patient's prior treatment. Further, the total DSQ score was less important in prediction if there was a prior treatment. The predictive value of this model was quite good, with area under the ROC-curve = 0.86. When primary care doctors use depression screening instruments they are oversensitive to the diagnosis of depression. This is due to not strictly obeying the two weeks duration required by the diagnostic criteria of ICD-10 and DSM-IV. False positive rates are further increased in particular by the doctor's knowledge of a patient's prior treatment history as well as the presence of a few specific depression symptoms. Copyright © 2000 Whurr Publishers Ltd. [source] Older people specific health status and quality of life: a structured review of self-assessed instrumentsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2005Kirstie L. Haywood DPhil Abstract Objectives, To review evidence relating to the measurement properties of older people specific self-assessed, multi-dimensional measures of health status. Design, Systematic literature searches to identify instruments. Pre-defined criteria relating to reliability, validity, responsiveness, precision and acceptability. Results, A total of 46 articles relating to 18 instruments met the inclusion criteria. Most evidence was found for the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ), CARE, Functional Assessment Inventory (FAI) and Quality of Life Profile , Seniors Version (QOLPSV). Most instruments have been evaluated in single studies. Four instruments have evidence of internal consistency and test,retest reliability , LEIPAD, Philadelphia Geriatrics Centre Multilevel Assessment Inventory, Perceived Well-being Scale, Wellness Index (WI). Two instruments lack evidence of reliability , Brief Screening Questionnaire, Geriatric Quality of Life Questionnaire (GQLQ). Older people contributed to the content of the GQLQ, QOLPSV and WI. Most instruments were assessed for validity through comparisons with other instruments, global judgements of health, or clinical and socio-demographic variables. Limited evidence of responsiveness was found for five instruments , GQLQ, OMFAQ, PGCMAI, QOLPSV, Self-Evaluation of Life Scale (SELF). Conclusion, Although most evidence was found for the OMFAQ this was largely for the ADL domain; evidence for reliability and responsiveness is limited. Limited evidence of reliability, validity and responsiveness was found for the PGCMAI, QOLPSV and SELF. The lack of evidence for measurement properties restricts instrument recommendation. Instrument content should be assessed for relevance before application and the concurrent evaluation of specific and widely used generic instruments is recommended. Several instruments, including the BSQ and EASY-Care, were developed recently and further evidence of instrument performance is required. [source] Variations on the CAGE Alcohol Screening Questionnaire: Strengths and Limitations in VA General Medical PatientsALCOHOLISM, Issue 10 2001Katharine A. Bradley Background: Several variations on the CAGE alcohol screening questionnaire have been recommended. This report evaluates modifications and additions to the CAGE. Methods: Alcohol screening questionnaires were evaluated in male VA general medicine patients (n= 227; mean age, 65.8). Mailed questionnaires included two scoring options for the CAGE (standard and last-year time frames), questions about quantity and frequency of drinking, two questions about episodic heavy drinking, and the question "Have you ever had a drinking problem?" Main analyses compared alcohol screening questions, at various cut-points, to a gold standard of hazardous drinking during the past year (,14 drinks/week or ,5 drinks on an occasion) and/or DSM-III-R alcohol abuse or dependence, based on standardized interviews. Results: The CAGE questionnaire with a past-year time frame was much less sensitive (0.57 vs. 0.77) but more specific (0.82 vs. 0.59) than the standard CAGE for detecting hazardous drinking during the past year and/or DSM-III-R alcohol abuse or dependence. An eight-item questionnaire that included the standard CAGE was most sensitive (0.92) but had low specificity (0.50). A single question about the frequency of drinking ,6 drinks on an occasion, included in the eight-item questionnaire, was both relatively sensitive (0.77) and specific (0.83). Conclusion: The CAGE questionnaire with a past-year time frame was an insensitive alcohol-screening test. An eight-item augmented version of the standard CAGE was the most sensitive. A question about the frequency of drinking ,6 drinks on an occasion performed better than the standard CAGE, which made it the optimal brief screening test for at-risk drinking. [source] Pediatric primary care to help prevent child maltreatment: the Safe Environment for Every Kid (SEEK) modelCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2009Richard Reading Pediatric primary care to help prevent child maltreatment: the Safe Environment for Every Kid (SEEK) model . DubowitzH., FeigelmanS., LaneW. & KimJ. ( 2009 ) Pediatrics , 123 , 858 , 864 . DOI: 10.1542/peds.2008-1376 . Context Effective strategies for preventing child maltreatment are needed. Few primary care-based programmes have been developed, and most have not been well evaluated. Objective Our goal was to evaluate the efficacy of the Safe Environment for Every Kid (SEEK) model of pediatric primary care in reducing the occurrence of child maltreatment. Methods A randomized trial was conducted from June 2002 to November 2005 in a university-based resident continuity clinic in Baltimore, Maryland. The study population consisted of English-speaking parents of children (0,5 years) brought in for child health supervision. Of the 1118 participants approached, 729 agreed to participate, and 558 of them completed the study protocol. Resident continuity clinics were cluster randomized by day of the week to the model (intervention) or standard care (control) groups. Model care consisted of (1) residents who received special training; (2) the Parent Screening Questionnaire; and (3) a social worker. Risk factors for child maltreatment were identified and addressed by the resident physician and/or social worker. Standard care involved routine pediatric primary care. A subset of the clinic population was sampled for the evaluation. Child maltreatment was measured in three ways: (1) child protective services reports using state agency data; (2) medical chart documentation of possible abuse or neglect; and (3) parental report of harsh punishment via the Parent-Child Conflict Tactics scale. Results Model care resulted in significantly lower rates of child maltreatment in all the outcome measures: fewer child protective services reports, fewer instances of possible medical neglect documented as treatment non-adherence, fewer children with delayed immunizations and less harsh punishment reported by parents. One-tailed testing was conducted in accordance with the study hypothesis. Conclusions The SEEK model of pediatric primary care seems promising as a practical strategy for helping prevent child maltreatment. Replication and additional evaluation of the model are recommended. [source] Brief screening questionnaires to identify problem drinking during pregnancy: a systematic reviewADDICTION, Issue 4 2010Ethel Burns ABSTRACT Aims Although prenatal screening for problem drinking during pregnancy has been recommended, guidance on screening instruments is lacking. We investigated the sensitivity, specificity and predictive value of brief alcohol screening questionnaires to identify problem drinking in pregnant women. Methods Electronic databases from their inception to June 2008 were searched, as well as reference lists of eligible papers and related review papers. We sought cohort or cross-sectional studies that compared one or more brief alcohol screening questionnaire(s) with reference criteria obtained using structured interviews to detect ,at-risk' drinking, alcohol abuse or dependency in pregnant women receiving prenatal care. Results Five studies (6724 participants) were included. In total, seven instruments were evaluated: TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), T-ACE [Take (number of drinks), Annoyed, Cut down, Eye-opener], CAGE (Cut down, Annoyed, Guilt, Eye-opener], NET (Normal drinker, Eye-opener, Tolerance), AUDIT (Alcohol Use Disorder Identification Test), AUDIT-C (AUDIT-consumption) and SMAST (Short Michigan Alcohol Screening Test). Study quality was generally good, but lack of blinding was a common weakness. For risk drinking sensitivity was highest for T-ACE (69-88%), TWEAK (71,91%) and AUDIT-C (95%), with high specificity (71,89%, 73,83% and 85%, respectively). CAGE and SMAST performed poorly. Sensitivity of AUDIT-C at score ,3 was high for past year alcohol dependence (100%) or alcohol use disorder (96%) with moderate specificity (71% each). For life-time alcohol dependency the AUDIT at score ,8 performed poorly. Conclusion T-ACE, TWEAK and AUDIT-C show promise for screening for risk drinking, and AUDIT-C may also be useful for identifying alcohol dependency or abuse. However, their performance as stand-alone tools is uncertain, and further evaluation of questionnaires for prenatal alcohol use is warranted. [source] Reactivity to alcohol assessment measures: an experimental testADDICTION, Issue 8 2009Scott T. Walters ABSTRACT Aims Previous research has suggested that alcohol screening and assessment may affect drinking. Design This study was a randomized test of reactivity to alcohol assessment questionnaires among a group of heavy drinking college students. Setting and participants A total of 147 university students completed a screening questionnaire and were randomized to either immediate assessment or delayed assessment. The immediate assessment group completed a set of drinking questionnaires at baseline, 3, 6 and 12 months, while the delayed assessment group completed questionnaires only at 12 months. Measurements Primary outcomes included overall volume of drinking, risky drinking and use of risk reduction behaviors. Findings We found a significant effect of assessment on measures of risky drinking and risk reduction behaviors, but not on overall volume of drinking. Specifically, at 12 months, participants who had previously completed drinking assessments had a lower peak blood alcohol concentration (BAC) (d = ,0.373), were more likely to report a low score on the Alcohol Use Disorders Identification Test (AUDIT; odds ratio = 2.55) and tended to use more strategies to moderate their alcohol consumption (d = 0.352). Risk reduction behaviors that were affected tended to be those that limited alcohol consumption, rather than those that minimized consequences. Conclusions These results may have implications for the development of brief interventions. [source] Randomized controlled trial of the effects of completing the Alcohol Use Disorders Identification Test questionnaire on self-reported hazardous drinkingADDICTION, Issue 2 2008Jim McCambridge ABSTRACT Aims The direct effects of screening on drinking behaviour have not previously been evaluated experimentally. We tested whether screening reduces self-reported hazardous drinking in comparison with a non-screened control group. Design Two-arm randomized controlled trial (RCT), with both groups blinded to the true nature of the study. Setting and participants A total of 421 university students aged 18,24 years, recruited in five London student unions. Interventions Both groups completed a brief pen-and-paper general health and socio-demographic questionnaire, which for the experimental group also included the 10-item Alcohol Use Disorders Identification Test (AUDIT) screening questionnaire. Measurements The primary outcome was the between-group difference in AUDIT score at 2,3-month follow-up. Eight secondary outcomes comprised other aspects of hazardous drinking, including dedicated measures of alcohol consumption, problems and dependence. Findings A statistically significant effect size of 0.23 (0.01,0.45) was detected on the designated primary outcome. The marginal nature of the statistical significance of this effect was apparent in additional analyses with covariates. Statistically significant differences were also obtained in three of eight secondary outcomes, and the observed effect sizes were not dissimilar to the known effects of brief interventions. Conclusions It is unclear to what extent these findings represent the effects of screening alone, a Hawthorne effect in which drinking behaviour has changed in response to monitoring, or whether they indicate reporting bias. These possibilities have important implications both for the dissemination of screening as an intervention in its own right and for behavioural intervention trials methodology. [source] Epilepsy as a Consequence of Cerebral Malaria in Area in Which Malaria Is Endemic in Mali, West AfricaEPILEPSIA, Issue 5 2006Edgard Brice Ngoungou Summary:,Purpose: Cerebral malaria (CM) is suspected to be a potential cause of epilepsy in tropical areas, but little information is available. The purpose of this study was to evaluate the role of CM in epilepsy among children in Mali. Methods: An exposed,nonexposed study was performed to identify children who had epilepsy after malaria in the 0- to 15-year age group. The exposure factor was CM defined according to World Health Organization (WHO) criteria, and the nonexposure factor was symptomatic malaria without the characteristics of CM (NCM). All the children underwent a screening questionnaire and were examined by a medical physician. After the screening phase, a specialist in neuropediatrics examined the children suspected to have epilepsy. EEG and computed tomography (CT) scans were performed in some of these patients. Results: In total, 101 subjects who had had CM and 222 who had had NCM were included. Fifty-four children (CM, 34; NCM, 20) were suspected to have epilepsy, and six were confirmed (CM, five; NCM, one). The incidence rate was 17.0 per 1000 person-years in the CM group and 1.8 per 1000 person-year in the NCM group; thus the relative risk (RR) was 9.4 [95% confidence interval (CI), 1.3,80.3; p = 0.02]. After adjustment on age and duration of follow-up, the RR was 14.3 (95% CI, 1.6,132.0; p = 0.01). Conclusions: The risk of sequelar epilepsy is significantly higher in the CM group compared with the NCM group. A reevaluation of this cohort should be carried out later to search for temporal epilepsy that appeared after age 10 years. [source] Quantitation of non-motor symptoms in Parkinson's diseaseEUROPEAN JOURNAL OF NEUROLOGY, Issue 2008K. Ray Chaudhuri Background:, Disabling non-motor symptoms (NMS) associated with Parkinson's disease (PD), such as dementia and loss of balance, do not respond well to levodopa therapy and can lead to eventual death in patients with the disease. In 2006, a multidisciplinary group of experts and patient representatives developed an NMS screening questionnaire (NMSQuest) and a unified Non-Motor Symptoms Scale (NMSS) to address the need for simple identification and comprehensive assessment of NMS in patients with PD. Methods and Results:, An international pilot study of 96 healthy controls and 123 patients with various stages of treated and untreated PD was conducted to demonstrate that the NMSQuest is a feasible, valid, and accepted tool. Conclusion:, The majority of patients and caregivers felt that the questionnaire was clear and relevant to their daily lives. Data from 242 PD patients with no dementia were analysed in a pilot study on the clinimetric validation of NMSS. Similar to the NMSQuest study, the NMSS study revealed a significant correlation between progression of PD and increasing NMS burden. These studies suggest that the NMSQuest accurately detects the NMS, and that the NMSS closely correlates with quality of life for PD patients. [source] Predicting developmental deficiencies at the age of four based on data from the first seven months of life,INFANT MENTAL HEALTH JOURNAL, Issue 6 2008Anne Margrethe Rostad The study examines very young children with the aim of identifying precursors of developmental problems during the first 7 months of age. Information from screening and observations in the birth clinic, in the first level of health care, and from parents was collected on five different occasions. The information that was included concerning the child and family was defined as either optimal or nonoptimal. At the age of 4 years, a clinical group was identified (11.1% of the total population). Logistic regression analyses were performed to detect risk factors. Twenty-one precursors were used to create a screening questionnaire that provided useful information (sensitivity = 56.1%, specificity = 98.8%) for predicting developmental problems of the children. The contribution of sociodemographic data was significant; medical information was less significant. The highest prediction rate surprisingly was found in the moderate clinical subgroup (62.1%), compared to the group with more severe problems that had a slightly lower rate (46.7%). The conclusion of the study is that it is possible to detect infants in need of early intervention using a continuous process of observation and screening. [source] Screening for depression and anxiety: correlates of non-response and cohort attrition in the Netherlands Study of Depression and Anxiety (NESDA)INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2009Willem Jan Van Der Veen Abstract A major problem in the analysis of attrition of cohorts in studies on mental health problems is that data on those who do not participate at the outset of a study are largely unavailable. It is not known how underlying psychopathology affects the first stages of screening where non-response and selectivity are usually highest. This article presents results of one of the centres of the Netherlands Study of Depression and Anxiety (NESDA), a longitudinal study aimed at describing the long-term course and consequences of depression and anxiety disorders. The aim is to describe the different ways of attrition during the first NESDA-wave in a cohort of patients aged 18,65 years of the Registration Network Groningen and to analyse whether attrition is related to gender, age and psychopathology as recorded in general practice. The attrition of the study cohort (n = 8475) was highest during the first stages, eventually leading to a population of 169 patients only who participated in the full NESDA-programme. Probabilities of transition from one stage of the screening process to the next were regressed on selected background variables using binary logistic regression. Correlates of participation were being female and being older (>40). Psychopathology was an important variable in the formation of the initial sample cohort, but only had a weak influence on patient response to the screening questionnaire. Study design factors had a stronger impact on the changing composition of the cohort at each screening stage compared to patient factors. Copyright © 2009 John Wiley & Sons, Ltd. [source] Estimation of psycholeptic and psychoanaleptic medicine use in an adult general population sample using the Anatomical Therapeutic Chemical classificationINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2008U. John Abstract Little is known about psycholeptic and psychoanaleptic medicine (PM) use in the general population. This study presents prevalence data about PM use. The sample included 4310 individuals aged 20,79 from a general population health examination in a northern German area (participation proportion: 68.8%; Study of Health in Pomerania, SHIP). Medicines taken during the past seven days were assessed from the medicine packages or self-reports and classified according to the Anatomical Therapeutic Chemical (ATC) classification developed by the World Health Organization. In total, 6.3% of the sample reported PM intake, 8.7% of the women and 4.7% of the men. During the past 12 months prior to the health examination, 49.2% of the individuals with PM use consulted a general practitioner but not a neurologist or a psychiatrist. Among the study participants with PM use, 88.8% had one or more mental disorders during lifetime according to a screening questionnaire. It is concluded that considerable proportions of individuals with current PM use exist although lower than may be expected on the basis of the number of individuals with mental disorder in the general population. Copyright © 2008 John Wiley & Sons, Ltd. [source] Menopausal symptom perception and severity: results from a screening questionnaireJOURNAL OF CLINICAL NURSING, Issue 7 2008FAANP, Judith A Berg PhD Background., Although it is widely acknowledged women experience symptoms during their transition from reproductive to postreproductive stage, there is inconsistency as to the prevalence of symptoms as well as their severity ratings. Aim and objectives., The purpose of this study was to describe symptom perception and severity in mid-life women volunteering for an intervention study for menopause symptom management. Design., A cross-sectional descriptive design was used to provide data on presenting symptoms in a sample of women negotiating the menopausal transition. Methods., A community-based sample of Caucasian women aged 43,55 years was recruited from national nursing media, local media and a variety of local community sources. A screening questionnaire was administered to determine qualification for study entry based upon symptom severity scores from the questionnaire. This report includes results from the screening questionnaire. Results., One hundred and sixty-five women were screened to obtain 110 qualified participants with mean age of 49·3 SD 3·04 years who were 4·7 SD 7 months past their last menstrual period. Sleep difficulties, forgetfulness and irritability were perceived by the highest number of women while sleep difficulties, night sweats, irritability and forgetfulness were rated the most severe. Conclusions., Findings from this study expand understanding of the menopause symptom experience, because few reports include symptom severity reports. All aspects of the symptom experience are necessary to develop appropriate interventions and to evaluate them. Relevance to clinical practice., Providing education about menopause symptoms is central to nursing practice of mid-life women. Therefore, nurses must keep abreast of current knowledge to prepare women for their transition to postreproductive phase or to reassure women who are surprised to find hot flashes are not the only symptoms encountered. [source] Variations on the CAGE Alcohol Screening Questionnaire: Strengths and Limitations in VA General Medical PatientsALCOHOLISM, Issue 10 2001Katharine A. Bradley Background: Several variations on the CAGE alcohol screening questionnaire have been recommended. This report evaluates modifications and additions to the CAGE. Methods: Alcohol screening questionnaires were evaluated in male VA general medicine patients (n= 227; mean age, 65.8). Mailed questionnaires included two scoring options for the CAGE (standard and last-year time frames), questions about quantity and frequency of drinking, two questions about episodic heavy drinking, and the question "Have you ever had a drinking problem?" Main analyses compared alcohol screening questions, at various cut-points, to a gold standard of hazardous drinking during the past year (,14 drinks/week or ,5 drinks on an occasion) and/or DSM-III-R alcohol abuse or dependence, based on standardized interviews. Results: The CAGE questionnaire with a past-year time frame was much less sensitive (0.57 vs. 0.77) but more specific (0.82 vs. 0.59) than the standard CAGE for detecting hazardous drinking during the past year and/or DSM-III-R alcohol abuse or dependence. An eight-item questionnaire that included the standard CAGE was most sensitive (0.92) but had low specificity (0.50). A single question about the frequency of drinking ,6 drinks on an occasion, included in the eight-item questionnaire, was both relatively sensitive (0.77) and specific (0.83). Conclusion: The CAGE questionnaire with a past-year time frame was an insensitive alcohol-screening test. An eight-item augmented version of the standard CAGE was the most sensitive. A question about the frequency of drinking ,6 drinks on an occasion performed better than the standard CAGE, which made it the optimal brief screening test for at-risk drinking. [source] Reliability and Validity of the Alcohol Use Disorders Identification Test (AUDIT) Imbedded Within a General Health Risk Screening Questionnaire: Results of a Survey in 332 Primary Care PatientsALCOHOLISM, Issue 5 2000Jean-Bernard Daeppen Background: Self-administered, general health risk screening questionnaires that are administered while patients wait in the doctor's office may be a reasonable and timesaving approach to address the requirements of preventive medicine in a typical 10-min medical visit. The psychometric characteristics of the Alcohol Use Disorders Identification Test (AUDIT) incorporated within a health questionnaire (H-AUDIT) have not been examined. Methods: The reliability and validity of the self-administered AUDIT were compared between the H-AUDIT and the AUDIT used as a single scale (S-AUDIT) in 332 primary care patients. Results: No major demographic or alcohol use characteristics were found between the 166 subjects who completed the H-AUDIT and the 166 individuals who completed the S-AUDIT. The test-retest reliability of the 166 subjects who completed the H-AUDIT [estimated by Spearman correlation coefficient at a 6-week interval (0.88), internal consistency (total correlation coefficients for all items ranged from 0.38 to 0.69; Cronbach , index 0.85), and the sensitivity and specificity of the H-AUDIT were used to identify at-risk drinkers' areas under receiver operating characteristic (0.77) and alcohol-dependent subjects' areas under receiver operating characteristic (0.89)] was similar to the same measurements obtained with the 166 individuals who completed the S-AUDIT. Conclusions: The AUDIT incorporated in a health risk screening questionnaire is a reliable and valid self-administered instrument to identify at-risk drinkers and alcohol-dependent individuals in primary care settings. [source] Unawareness and undertreatment of asthma: follow-up in a different geographic area in DenmarkALLERGY, Issue 8 2009V. Backer Background:, Early detection and treatment of asthma is important to minimize morbidity and healthcare costs. The objective of this study was to investigate asthma awareness and management in a western society. Methods:, In a random sample of 10 400 subjects aged 14,44 years, 686 (6.6%) reported symptoms of asthma in a standardized screening questionnaire. All 686 were evaluated by respiratory specialists and diagnosed by history, symptoms, lung function tests, bronchial challenges and allergy testing. Of these 686 participants, 69 (10%) had asthma alone, 205 (30%) had rhinitis alone and 217 (32%) had both asthma and rhinitis; 195 (28%) had nonasthmatic respiratory reports. Results:, Awareness of asthma was found among 163 (57%) of the 286 asthmatics, and 204 (95%) had doctor-diagnosed rhinitis as well. In a multivariate regression analysis, comorbidity with rhinitis (, = 0.489, P < 0.001), smoking (, = ,0.116, P < 0.01), doctor-diagnosed bronchitis (, = 0.086, P < 0.05), and earlier emergency visits at hospital (, = 0.147, P < 0.001) was significantly associated with awareness. A difference in awareness was found between those who had asthma and rhinitis (62.2%) and those who had asthma alone (40.6%) (P < 0.01). Inhaled corticosteroids (ICS) were used by 27% of those with asthma, including 12% who used both ICS and long-acting beta-agonist. Conclusions:, More than half of the persons with asthma were aware of their disorder; and the awareness was more likely in those with comorbidity of rhinitis. In general, asthma management was inadequate. [source] Self-rated health status in spinocerebellar ataxia,Results from a European multicenter study,MOVEMENT DISORDERS, Issue 5 2010Tanja Schmitz-Hübsch MD Abstract Patient-based measures of subjective health status are increasingly used as outcome measures in interventional trials. We aimed to determine the variability and predictors of subjective health ratings in a possible target group for future interventions: the spinocerebellar ataxias (SCAs). A consecutive sample of 526 patients with otherwise unexplained progressive ataxia and genetic diagnoses of SCA1 (117), SCA2 (163), SCA3 (139), and SCA6 (107) were enrolled at 18 European referral centers. Subjective health status was assessed with a generic measure of health related quality of life, the EQ-5D (Euroqol) questionnaire. In addition, we performed a neurological examination and a screening questionnaire for affective disorders (patient health questionnaire). Patient-reported health status was compromised in patients of all genotypes (EQ-5D visual analogue scale (EQ-VAS) mean 61.45 ± 20.8). Specifically, problems were reported in the dimensions of mobility (86.9% of patients), usual activities (68%), pain/discomfort (49.4%), depression/anxiety (46.4%), and self care (38.2%). Multivariate analysis revealed three independent predictors of subjective health status: ataxia severity, extent of noncerebellar involvement, and the presence of depressive syndrome. This model explained 30.5% of EQ-VAS variance in the whole sample and might be extrapolated to other SCA genotypes. © 2010 Movement Disorder Society [source] Treating Pain Patients at Risk: Evaluation of a Screening Tool in Opioid-Treated Pain Patients With and Without AddictionPAIN MEDICINE, Issue 2 2003FACP, Robert Friedman MD ABSTRACT Patients receiving opioid treatment for chronic pain, many of whom were hospitalized with medical complications of substance abuse, were asked to complete a screening questionnaire to help validate a simple self-administered survey. Questions relating to tobacco abuse and prior treatment for drug and alcohol abuse distinguished patients with addiction and pain from opioid-treated chronic pain patients. [source] Characteristics of participants with self-reported hemochromatosis or iron overload at HEIRS study initial screeningAMERICAN JOURNAL OF HEMATOLOGY, Issue 2 2008James C. Barton There are few descriptions of young adults with self-reported hemochromatosis or iron overload (H/IO). We analyzed initial screening data in 7,343 HEmochromatosis and IRon Overload Screening (HEIRS) Study participants ages 25,29 years, including race/ethnicity and health information; transferrin saturation (TS) and ferritin (SF) measurements; and HFE C282Y and H63D genotypes. We used denaturing high-pressure liquid chromatography and sequencing to detect mutations in HJV, TFR2, HAMP, SLC40A1, and FTL. Fifty-one participants reported previous H/IO; 23 (45%) reported medical conditions associated with H/IO. Prevalences of reports of arthritis, diabetes, liver disease or liver cancer, heart failure, fertility problems or impotence, and blood relatives with H/IO were significantly greater in participants with previous H/IO reports than in those without. Only 7.8% of the 51 participants with previous H/IO reports had elevated TS; 13.7% had elevated SF. Only one participant had C282Y homozygosity. Three participants aged 25,29 years were heterozygous for potentially deleterious mutations in HFE2, TFR2, and HAMP promoter, respectively. Prevalences of self-reported conditions, screening iron phenotypes, and C282Y homozygosity were similar in 1,165 participants aged 30 years or greater who reported previous H/IO. We conclude that persons who report previous H/IO diagnoses in screening programs are unlikely to have H/IO phenotypes or genotypes. Previous H/IO reports in some participants could be explained by treatment that induced iron depletion before initial screening, misdiagnosis, or participant misunderstanding of their physician or the initial screening questionnaire. Am. J. Hematol., 2008. © 2007 Wiley-Liss, Inc. [source] Association of Extraesophageal Reflux Disease and Sinonasal Symptoms: Prevalence and Impact on Quality of Life,THE LARYNGOSCOPE, Issue 12 2007Thomas R. Pasic MD Abstract Objectives: The purpose of this study was to investigate the prevalence of extraesophageal reflux disease symptoms and their association with sinonasal disorders within a general sample of adults in our community and to determine how these conditions affect perception of general health, sinus-related quality of life (QOL), and perception of reflux and digestive function. Study Design/Methods: A community-dwelling sample of 1,878 adults completed symptom and QOL surveys in a two-stage prospective design: an initial screening questionnaire (n = 1,878) and disease-specific (sinus and reflux/digestion) and general health-related QOL instruments (n = 1,073). Demographic and response data were summarized and analyzed for prevalence and correlations among data sets. Results: Sinonasal symptoms were reported in 71% of subjects who completed the initial screening questionnaire, and reflux-related symptoms were reported by 59% of respondents. The co-occurrence of sinonasal and reflux symptoms was reported by 45% of respondents. Subjects with both sinonasal and reflux symptoms scored significantly worse on the disease-specific and general physical and mental QOL scales than subjects with only reflux or sinonasal symptoms or no symptoms. Conclusions: Symptoms associated with inflammatory sinonasal disorders and gastroesophageal reflux disease are common in the general U.S. adult population and co-occur in the same individuals to a greater degree than can be attributed to chance alone. Co-occurrence was found to be associated with significant declines in both disease-specific and general physical and mental QOL. This finding has implications with regard to pathogenesis and treatment of these disorders. [source] Validation of a pre-anaesthetic screening questionnaireANAESTHESIA, Issue 9 2003W. G. Hilditch Summary We developed a screening questionnaire to be used by nurses to decide which patients should see an anaesthetist for further evaluation before the day of surgery. Our objective was to measure the accuracy of responses to the questionnaire. Agreement between questionnaire responses and the anaesthetist's assessment was assessed. For questions with a prevalence of 5 to 95%, the Kappa coefficient was used; percentage agreement was used for all other questions. Criterion validity was excellent/good for all questions with a prevalence between 5 and 95%, except for the question ,Do you have kidney disease?' For questions with prevalence <,5%, all demonstrated adequate criterion validity except the questions ,Has anyone in your family had a problem following an anaesthetic?' and ,If you have been put to sleep for an operation were there any anaesthetic problems?' Therefore, it is reasonable for nurses to use this questionnaire to determine which patients an anaesthetist should see before the day of surgery. [source] Coffee consumption and risk of rheumatoid arthritisARTHRITIS & RHEUMATISM, Issue 11 2003Elizabeth W. Karlson Objective Recent reports have suggested an association between consumption of coffee or decaffeinated coffee and the risk of rheumatoid arthritis (RA), although data are sparse and somewhat inconsistent. Furthermore, existing studies measured dietary exposures and potential confounders only at baseline and did not consider possible changes in diet or lifestyle over the followup period. We studied whether coffee, decaffeinated coffee, total coffee, tea, or overall caffeine consumption was associated with the risk of RA, using the Nurses' Health Study, a longitudinal cohort study of 121,701 women. Methods Information on beverage consumption was assessed with a food frequency questionnaire (FFQ) that was completed every 4 years, from baseline in 1980 through 1998. Among the 83,124 women who completed the FFQ at baseline, the diagnosis of incident RA (between 1980 and 2000) was confirmed in 480 women by a connective tissue disease screening questionnaire and medical record review for American College of Rheumatology criteria. Relationships between intake of various beverages and the risk of RA were assessed in age-adjusted models and in multivariate Cox proportional hazards models including the cumulative average intake of each beverage during the followup period, adjusted for numerous potential confounders. In addition, for direct comparisons with prior reports, multivariate analyses were repeated using only baseline beverage information. Results We did not find a significant association between decaffeinated coffee consumption of ,4 cups/day (compared with no decaffeinated coffee consumption) and subsequent risk of incident RA, in either an adjusted multivariate model (relative risk [RR] 1.1, 95% confidence interval [95% CI] 0.5,2.2) or a multivariate model using only baseline reports of decaffeinated coffee consumption (RR 1.0, 95% CI 0.6,1.7). Similarly, there was no relationship between cumulative caffeinated coffee consumption and RA risk (RR 1.1, 95% CI 0.8,1.6 for ,4 cups per day versus none) or between tea consumption and RA risk (RR 1.1, 95% CI 0.7,1.8 for >3 cups/day versus none). Total coffee and total caffeine consumption were also not associated with the risk of RA. Conclusion In this large, prospective study, we find little evidence of an association between coffee, decaffeinated coffee, or tea consumption and the risk of RA among women. [source] Enuresis in childhood, and urinary and fecal incontinence in adult life: do they share a common cause?BJU INTERNATIONAL, Issue 7 2005Ayse Gurbuz OBJECTIVE To investigate whether there is any association between urinary or fecal incontinence and childhood bedwetting, and given such a relationship, to detect which type of urinary incontinence (UI) is associated with childhood bedwetting. PATIENTS AND METHODS In all, 1021 patients who were admitted to the outpatient gynaecology clinics of the authors' institution for an annual gynaecological examination were included in this descriptive clinical study. A simple multi-choice screening questionnaire was used to collect data for analysis. RESULTS There was a history of bedwetting in childhood in 181 (21.1%) of women without and in 48 (29.6%) of those with UI; the difference was significant (chi-square, P < 0.05). Women with stress UI had significantly higher rates of enuresis in childhood (35.4%) than those without UI (21.1%; P = 0.003). Of women who had a history of bedwetting in childhood, 12.2% had stress UI, but only 6.4% of those with no such history had stress UI. Fecal incontinence was significantly more common in women with a history of bedwetting in childhood (P < 0.05). CONCLUSION A history of childhood bedwetting seems to increase the risk of having UI, stress UI and fecal incontinence. Being aware of this association may provide an opportunity to avoid exposing these women to additional risk factors for these condition. [source] The efficacy of voice therapy in patients after treatment for early glottic carcinomaCANCER, Issue 1 2006Christine D. L. van Gogh M.D. Abstract BACKGROUND After treatment for early glottic carcinoma, a considerable number of patients end up with voice problems that interfere with daily life activities. The objective of this randomized and controlled study was to assess the efficacy of voice therapy in these patients. METHODS Of 177 patients, 6,120 months after treatment for early glottic carcinoma, 70 patients (40%) suffered from voice impairment based on a 5-item screening questionnaire. Approximately 60% of those 70 patients were not interested in participating in the current study. Twenty-three patients who were willing to participate were assigned randomly either to a voice therapy group (n = 12 patients) or to a control group (n = 11 patients). Multidimensional voice analyses (the self-reported Voice Handicap Index [VHI], acoustic and perceptual voice quality analysis, videolaryngostroboscopy, and the Voice Range Profile) were conducted twice: before and after voice therapy or with 3 months in between for the control group. RESULTS Statistical analyses of the difference in scores (postmeasurement minus premeasurement) showed significant voice improvement after voice therapy on the total VHI score, percent jitter, and noise-to-harmonics ratio in the voice signal and on the perceptual rating of vocal fry. CONCLUSIONS Voice therapy proved to be effective in patients who had voice problems after treatment for early glottic carcinoma. Improvement not only was noticed by the patients (VHI) but also was confirmed by objective voice parameters. Cancer 2006. © 2005 American Cancer Society. [source] Prevalence of Parkinson's disease in a Chinese populationACTA NEUROLOGICA SCANDINAVICA, Issue 3 2004J. Woo Background , Ethnic differences in the prevalence of Parkinson's disease have been observed, but may be due to differences in screening instruments and diagnostic criteria. Aims , To compare the prevalence of Parkinson's disease in Hong Kong Chinese and Australians in Sydney. Methods , A door-to-door community survey in the Hong Kong Chinese population was carried out using a two-staged procedure (screening questionnaire followed by physical examination), which had been validated for use in the community in a survey among Australians, to determine the prevalence in Chinese and to compare with that in Australians. Results , A total of 1080 households were contacted, the non-response rate was 27%. The prevalence among those aged 55 years in the community and above was 0.5%, and 0.186% for the overall population assuming no subjects were below 55 years. These figures are lower than the 3.6% for Australians, aged >55 years. Conclusion , There appears to be a difference in prevalence of Parkinson's disease between Hong Kong Chinese and Australians in Sydney. Such differences may be due to documented differences in prevalence of genetic polymorphisms associated with Parkinson's disease between Chinese and Australians, or to differences in environmental factors. [source] A randomised controlled trial of clinics in secondary schools for adolescents with asthmaCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2004Cliona Ni Bhrolchain Aim To test the hypothesis that delivery of a programme of asthma care in nurse-led clinics in school would improve access to care and health outcomes compared with care in general practice. Methods Pupils at four secondary schools in Bristol, North Somerset and South Gloucestershire, UK, were included in the randomized controlled trial. Another two schools were included to control for any cross-contamination between school clinic attenders and general practice attenders in the trial schools. Pupils in trial schools were randomly assigned to receive an invitation for an asthma review at school or in general practice. Schools were stratified for deprivation and covered rural, urban and suburban populations. Pupils with asthma were identified using a screening questionnaire and then cross-referenced with practice prescribing records. Four school nurses with additional specialist asthma training ran the school clinics weekly. Consultations concentrated on the needs and interests of adolescents and followed national guidelines for treatment changes. Reviews were arranged at 1 and 6 months, with an additional 3-month review if needed. The pupil's GP was kept informed. General practice care was according to the practice's usual treatment protocols. Primary outcomes were the proportion of pupils who had had an asthma review in 6 months, health-related quality of life and level of symptoms. Secondary outcomes were pupil knowledge and attitude to asthma, inhaler technique, the proportion taking inhaled steroids daily, school absence due to asthma, PEFR and pupil preference for the setting of care. Sample size was calculated to have an 80% chance of showing an increase from 40% to 60% having a review in 6 months and half a standard deviation improvement on the quality of life measure. Analysis was on an intention to treat basis. Results School clinic pupils were more likely to attend (91% vs. 51%). However, symptom control or quality of life were no better. School clinic pupils knew more about asthma, had a more positive attitude and better inhaler technique. Absence and PEFR showed no difference. 63% who attended school clinics preferred this model but, taking both groups together, just over half would prefer to attend their GP for follow-up. Cost of care (including practice, school clinic, hospital and medication) was £32.10 at school, £19.80 at the trial practices and £18.00 at control practices. Conclusions Previous evaluations of nurse-led asthma clinics in practice have also failed to show improvements in outcomes, though process measures do improve. This may be due to the need for nurses to refer patients to doctors for changes in medication, rather than doing this themselves. Some weaknesses in study design that may have affected outcome, but the essential conclusion is that nurse-led asthma clinics in school are not cost effective. The study does suggest that such clinics can reach a high proportion of adolescents, but for asthma at least this does not result in any measurable improvement in outcome. [source] Brief screening questionnaires to identify problem drinking during pregnancy: a systematic reviewADDICTION, Issue 4 2010Ethel Burns ABSTRACT Aims Although prenatal screening for problem drinking during pregnancy has been recommended, guidance on screening instruments is lacking. We investigated the sensitivity, specificity and predictive value of brief alcohol screening questionnaires to identify problem drinking in pregnant women. Methods Electronic databases from their inception to June 2008 were searched, as well as reference lists of eligible papers and related review papers. We sought cohort or cross-sectional studies that compared one or more brief alcohol screening questionnaire(s) with reference criteria obtained using structured interviews to detect ,at-risk' drinking, alcohol abuse or dependency in pregnant women receiving prenatal care. Results Five studies (6724 participants) were included. In total, seven instruments were evaluated: TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), T-ACE [Take (number of drinks), Annoyed, Cut down, Eye-opener], CAGE (Cut down, Annoyed, Guilt, Eye-opener], NET (Normal drinker, Eye-opener, Tolerance), AUDIT (Alcohol Use Disorder Identification Test), AUDIT-C (AUDIT-consumption) and SMAST (Short Michigan Alcohol Screening Test). Study quality was generally good, but lack of blinding was a common weakness. For risk drinking sensitivity was highest for T-ACE (69-88%), TWEAK (71,91%) and AUDIT-C (95%), with high specificity (71,89%, 73,83% and 85%, respectively). CAGE and SMAST performed poorly. Sensitivity of AUDIT-C at score ,3 was high for past year alcohol dependence (100%) or alcohol use disorder (96%) with moderate specificity (71% each). For life-time alcohol dependency the AUDIT at score ,8 performed poorly. Conclusion T-ACE, TWEAK and AUDIT-C show promise for screening for risk drinking, and AUDIT-C may also be useful for identifying alcohol dependency or abuse. However, their performance as stand-alone tools is uncertain, and further evaluation of questionnaires for prenatal alcohol use is warranted. [source] Evaluating screening questionnaires using receiver Operating Characteristic (ROC) curves from two-phase (double) samplesINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2000Giulia Bisoffi Abstract The characteristics of psychiatric screening tests (for example, sensitivity, specificity, and AUC , the area under an ROC curve) are frequently assessed using data arising from two-phase samples. Too often, however, the statistical methods that are used are incorrect. They do not appropriately account for the sampling design. Valid methods for the estimate of sensitivity, specificity and, in particular, the AUC, together with its standard error, are discussed in detail and a Stata macro for the implementation of these methods is provided. Simple weighting procedures are used to correct for verification biases arising from the two-phase design, together with bootstrap or jackknife sampling for the calculation of valid standard errors. Copyright © 2000 Whurr Publishers Ltd. [source] Cost-Effectiveness of Screening for Unhealthy Alcohol Use with %Carbohydrate Deficient Transferrin: Results From a Literature-Based Decision Analytic Computer ModelALCOHOLISM, Issue 8 2009Alok Kapoor Background:, The %carbohydrate deficient transferrin (%CDT) test offers objective evidence of unhealthy alcohol use but its cost-effectiveness in primary care conditions is unknown. Methods:, Using a decision tree and Markov model, we performed a literature-based cost-effectiveness analysis of 4 strategies for detecting unhealthy alcohol use in adult primary care patients: (i) Questionnaire Only, using a validated 3-item alcohol questionnaire; (ii) %CDT Only; (iii) Questionnaire followed by %CDT (Questionnaire-%CDT) if the questionnaire is negative; and (iv) No Screening. For those patients screening positive, clinicians performed more detailed assessment to characterize unhealthy use and determine therapy. We estimated costs using Medicare reimbursement and the Medical Expenditure Panel Survey. We determined sensitivity, specificity, prevalence of disease, and mortality from the medical literature. In the base case, we calculated the incremental cost-effectiveness ratio (ICER) in 2006 dollars per quality-adjusted life year ($/QALY) for a 50-year-old cohort. Results:, In the base case, the ICER for the Questionnaire-%CDT strategy was $15,500/QALY compared with the Questionnaire Only strategy. Other strategies were dominated. When the prevalence of unhealthy alcohol use exceeded 15% and screening age was <60 years, the Questionnaire-%CDT strategy costs less than $50,000/QALY compared to the Questionnaire Only strategy. Conclusions:, Adding %CDT to questionnaire-based screening for unhealthy alcohol use was cost-effective in our literature-based decision analytic model set in typical primary care conditions. Screening with %CDT should be considered for adults up to the age of 60 when the prevalence of unhealthy alcohol use is 15% or more and screening questionnaires are negative. [source] | |||||||||||||