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Medicina (Kaunas, Lithuania) May 2021Sensitivity, which denotes the proportion of subjects correctly given a positive assignment out of all subjects who are actually positive for the outcome, indicates how... (Review)
Review
Sensitivity, which denotes the proportion of subjects correctly given a positive assignment out of all subjects who are actually positive for the outcome, indicates how well a test can classify subjects who truly have the outcome of interest. Specificity, which denotes the proportion of subjects correctly given a negative assignment out of all subjects who are actually negative for the outcome, indicates how well a test can classify subjects who truly do not have the outcome of interest. Positive predictive value reflects the proportion of subjects with a positive test result who truly have the outcome of interest. Negative predictive value reflects the proportion of subjects with a negative test result who truly do not have the outcome of interest. Sensitivity and specificity are inversely related, wherein one increases as the other decreases, but are generally considered stable for a given test, whereas positive and negative predictive values do inherently vary with pre-test probability (e.g., changes in population disease prevalence). This article will further detail the concepts of sensitivity, specificity, and predictive values using a recent real-world example from the medical literature.
Topics: Biomedical Research; Humans; Predictive Value of Tests; Prevalence; Sensitivity and Specificity
PubMed: 34065637
DOI: 10.3390/medicina57050503 -
Morbidity and Mortality Weekly Report.... Mar 2020Autism spectrum disorder (ASD).
PROBLEM/CONDITION
Autism spectrum disorder (ASD).
PERIOD COVERED
2016.
DESCRIPTION OF SYSTEM
The Autism and Developmental Disabilities Monitoring (ADDM) Network is an active surveillance program that provides estimates of the prevalence of ASD among children aged 8 years whose parents or guardians live in 11 ADDM Network sites in the United States (Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin). Surveillance is conducted in two phases. The first phase involves review and abstraction of comprehensive evaluations that were completed by medical and educational service providers in the community. In the second phase, experienced clinicians who systematically review all abstracted information determine ASD case status. The case definition is based on ASD criteria described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
RESULTS
For 2016, across all 11 sites, ASD prevalence was 18.5 per 1,000 (one in 54) children aged 8 years, and ASD was 4.3 times as prevalent among boys as among girls. ASD prevalence varied by site, ranging from 13.1 (Colorado) to 31.4 (New Jersey). Prevalence estimates were approximately identical for non-Hispanic white (white), non-Hispanic black (black), and Asian/Pacific Islander children (18.5, 18.3, and 17.9, respectively) but lower for Hispanic children (15.4). Among children with ASD for whom data on intellectual or cognitive functioning were available, 33% were classified as having intellectual disability (intelligence quotient [IQ] ≤70); this percentage was higher among girls than boys (39% versus 32%) and among black and Hispanic than white children (47%, 36%, and 27%, respectively) [corrected]. Black children with ASD were less likely to have a first evaluation by age 36 months than were white children with ASD (40% versus 45%). The overall median age at earliest known ASD diagnosis (51 months) was similar by sex and racial and ethnic groups; however, black children with IQ ≤70 had a later median age at ASD diagnosis than white children with IQ ≤70 (48 months versus 42 months).
INTERPRETATION
The prevalence of ASD varied considerably across sites and was higher than previous estimates since 2014. Although no overall difference in ASD prevalence between black and white children aged 8 years was observed, the disparities for black children persisted in early evaluation and diagnosis of ASD. Hispanic children also continue to be identified as having ASD less frequently than white or black children.
PUBLIC HEALTH ACTION
These findings highlight the variability in the evaluation and detection of ASD across communities and between sociodemographic groups. Continued efforts are needed for early and equitable identification of ASD and timely enrollment in services.
Topics: Autism Spectrum Disorder; Child; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Male; Population Surveillance; Prevalence; United States
PubMed: 32214087
DOI: 10.15585/mmwr.ss6904a1 -
Harefuah Sep 2019Excoriation (Skin-Picking) disorder is a clinically recognized condition which was recently included in the Diagnostic and Statistical manual of the American Psychiatric... (Review)
Review
Excoriation (Skin-Picking) disorder is a clinically recognized condition which was recently included in the Diagnostic and Statistical manual of the American Psychiatric Association (DSM) - fifth edition, as OCD (obsessive compulsive disorder) related disorder. The disorder's official status has been achieved due to its high frequency and unique clinical picture involving both mental and physical impairment. In this article, we would like to present a concise review of the literature together with an illustrative case. Epidemiological surveys show a prevalence of 3% to 5% for the general population, with heterogeneous gender and age distribution. In recent years the disorder has been categorized under the family of BFRB's (Body Focused Repetitive Behaviours). However, there are some elements associated with movement suppression and tic disorders, as well as disorders belonging to obsessive-compulsive spectrum. The treatment of this disorder may be pharmacological and/or psychological. There is some evidence for the benefit of some SSRI (Selective Serotonin Reuptake Inhibitors) agents as well as for N-Acetyl-Cysteine. Various psychological treatments have been investigated and some of them have proven to be effective. These include cognitive behavioural protocols, some of which have been developed specifically for this disorder.
Topics: Diagnostic and Statistical Manual of Mental Disorders; Humans; Obsessive-Compulsive Disorder; Prevalence; Self-Injurious Behavior; Selective Serotonin Reuptake Inhibitors
PubMed: 31507114
DOI: No ID Found -
Clinical and Investigative Medicine.... Jun 2022Disease prevalence estimates from population-based administrative databases are often biased due to measurement (misclassification) errors. The purpose of this article... (Review)
Review
PURPOSE
Disease prevalence estimates from population-based administrative databases are often biased due to measurement (misclassification) errors. The purpose of this article is to review the methodology for estimating disease prevalence in administrative data, with a focus on bias correction.
SOURCE
Several approaches to bias correction in administrative data were reviewed and application of these methods was demonstrated using an example from the literature: physician claims and hospitalization data were employed to estimate diabetes prevalence in Ontario, Canada.
FINDINGS
Misclassification bias in prevalence estimates from administrative data can be reduced by developing and selecting an optimal algorithm for case identification, applying a bias correction formula, or using statistical modelling. An algorithm for which sensitivity equals positive predictive value provides an unbiased estimate of prevalence. Bias reduction methods generally require information about the measurement properties of the algorithm, such as sensitivity, specificity, or predictive value. These properties depend on disease type, prevalence, algorithm definition (including the observation window), and may vary by population and time. Prevalence estimates can be improved by applying multivariable disease prediction models.
CONCLUSION
Frequency of a positive case identification algorithm in administrative data is generally not equivalent to disease prevalence. Although prevalence estimates can be corrected for bias using known measurement properties of the algorithm, these properties may be difficult to estimate accurately; therefore, disease prevalence estimates based on administrative data must be treated with caution.
Topics: Databases, Factual; Diabetes Mellitus; Hospitalization; Humans; Ontario; Predictive Value of Tests; Prevalence
PubMed: 35752980
DOI: 10.25011/cim.v45i2.38100 -
European Journal of Medical Research Jul 2023Blood urea nitrogen (BUN) was an important biomarker for the development and prognosis of many diseases. Numerous studies had demonstrated that BUN had a strong...
Blood urea nitrogen (BUN) was an important biomarker for the development and prognosis of many diseases. Numerous studies had demonstrated that BUN had a strong relationship with long-term mortality, survival and the prevalence of some diseases. The diagnosis and treatment, prognosis and long-term survival rate of cancer were the focus of clinical research at present. However, the relationship between BUN level and cancer prevalence was not clear. To investigate the relationship between BUN level and cancer prevalence, we performed a statistical analysis of population data from the National Health and Nutrition Examination Survey (NHANES) database. The results of the study showed that BUN level were positively correlated with cancer prevalence, and the correlation was more pronounced in breast cancer.
Topics: Humans; Female; Blood Urea Nitrogen; Nutrition Surveys; Breast Neoplasms; Prevalence
PubMed: 37393332
DOI: 10.1186/s40001-023-01186-4 -
Der Nervenarzt Sep 2018Grief is a natural response to the loss of a loved one and its intensity usually lessens over time. Approximately 10% of bereaved persons, however, experience...
Grief is a natural response to the loss of a loved one and its intensity usually lessens over time. Approximately 10% of bereaved persons, however, experience persistent symptoms resulting in the development of a prolonged grief disorder (PGD). A PGD shows a distinct symptom cluster and is considered for inclusion as a diagnosis in the upcoming revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11). It is distinct from other mental disorders but symptoms overlap, especially with major depression and posttraumatic stress disorder. In addition to diagnostic criteria and differential diagnosis, the following article also describes prevalence rates, comorbidities, risk factors as well as treatment options for PGD.
Topics: Bereavement; Humans; International Classification of Diseases; Mental Disorders; Prevalence; Time Factors
PubMed: 30116835
DOI: 10.1007/s00115-018-0577-2 -
The Journal of Nervous and Mental... Mar 2023Since the implementation of "two-child policy" in China, the prevalence and influencing factors of postpartum depression (PPD) between women at first childbirth and...
Since the implementation of "two-child policy" in China, the prevalence and influencing factors of postpartum depression (PPD) between women at first childbirth and second childbirth remains unclear. We aimed to compare the prevalence and the influencing factors of PPD between the two groups. Postpartum women were recruited at their 6-week postpartum checkups and invited to complete questionnaires. The prevalence rate of PPD was 42.1%. There was no statistical difference found regarding the prevalence of PPD and the total score on the Edinburgh Postnatal Depression Scale between the two groups. The median of the item "self-injury" was significantly higher among women at first childbirth. Women with gestational diabetes in pregnancy, antenatal anxiety and depression, abortion, having babies getting sick occasionally, and deteriorated relationships with partner in pregnancy had much higher risks for PPD. Both primiparous and secundiparous had a high prevalence of PPD. It provides scientific evidence for clinical preventive and nursing care for PPD.
Topics: Pregnancy; Female; Humans; Depression, Postpartum; Prevalence; Postpartum Period; Anxiety; Anxiety Disorders; Risk Factors
PubMed: 36108287
DOI: 10.1097/NMD.0000000000001591 -
FP Essentials Aug 2020Personality disorders (PDs) have a prevalence of approximately 9% in the United States. Patients with these disorders frequently are encountered in the family medicine...
Personality disorders (PDs) have a prevalence of approximately 9% in the United States. Patients with these disorders frequently are encountered in the family medicine setting. It is thought that a combination of unknown genetic factors and life experiences, particularly adverse childhood experiences, contribute to PD development. The diagnosis of patients with PD is complex and should be performed by a psychiatry or psychology subspecialist. The (Fifth Edition) () divides the 10 PDs into three clusters based on descriptive commonalities. Individuals with cluster A PDs often are described as odd or eccentric. Individuals with cluster B PDs often appear dramatic and emotional and exhibit erratic behavior. Individuals with cluster C PDs often appear anxious and fearful. Family physicians should be able to recognize patients with characteristics suggestive of PDs who should be considered for screening. Management consists mainly of psychotherapy. Use of pharmacotherapy is recommended in some specific situations. Patients with PDs can have significant disabilities, medical comorbidities, and high rates of health care use. They have a higher incidence of sleep disorders, chronic pain, chronic health conditions, and obesity than patients in the general population.
Topics: Child; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Humans; Personality Disorders; Prevalence; United States
PubMed: 32757561
DOI: No ID Found -
Journal of Affective Disorders May 2021Prolonged grief is a disorder (PGD) characterized by severe and disabling grief reactions for an extended period of time after the loss of a significant person. ICD-11...
BACKGROUND
Prolonged grief is a disorder (PGD) characterized by severe and disabling grief reactions for an extended period of time after the loss of a significant person. ICD-11 and DSM-5-TR differ substantially in individual criteria.
OBJECTIVE
Estimation of the respective prevalence of PGD and PGD and the frequency with which single symptoms of prolonged grief occur in the general population.
METHODS
Out of a representative sample of the German general population (N=2498), n = 914 reported a significant loss and prolonged grief symptoms based on the extended version of the self-reported Prolonged Grief Disorder-13+9 (PG13+9). Sociodemographic and loss-related characteristics were collected.
RESULTS
The probable prevalence of PGD was 1.5% and that of PGD was 1.2% in the general sample. Among bereaved persons (n=914), the prevalence of developing PGD was 4.2% and that of PGD was 3.3%. Diagnostic agreement between the two criteria-sets was very high and did not increase after heightening the accessory symptom threshold for PGD. Difficulties accepting the loss was the most frequent single symptom (14-25%) and grief-related impairment was common (10-16%). Over 60% of participants with a probable PGD diagnosis utilized health care services.
LIMITATIONS
Results are based on self-reported data. The PG13+9 was not designed to assess grief symptoms according to ICD-11 and DSM-5-TR diagnostic criteria.
CONCLUSIONS
Prolonged grief according to ICD-11 and DSM-5-TR is a notable disorder in the general population. Among bereaved persons, single symptoms of prolonged grief are relatively frequent and cause substantial degrees of impairment.
Topics: Bereavement; Diagnostic and Statistical Manual of Mental Disorders; Grief; Humans; International Classification of Diseases; Prevalence
PubMed: 33812243
DOI: 10.1016/j.jad.2021.03.058 -
Current Opinion in Psychology Jun 2018Multiple studies have reported community prevalence rates of personality disorders (PDs), but these studies differed in terms of diagnostic criteria, assessment... (Meta-Analysis)
Meta-Analysis Review
Multiple studies have reported community prevalence rates of personality disorders (PDs), but these studies differed in terms of diagnostic criteria, assessment instruments, communities sampled, and size, producing widely ranging estimates. We take a meta-analytic approach to characterizing PD community prevalence rates by comparing results from two reviews that pooled previous studies. Overall, particular PD rates are low in community samples, but the presence of any PD is relatively high, with approximately one person in seven experiencing personality psychopathology. High congruence of prevalence estimates, but low rank-order agreement of rates, was observed. We discuss how the presence of PD is associated with socio-demographic correlates such as gender, race/ethnicity, and age and highlight areas for further study.
Topics: Demography; Diagnostic and Statistical Manual of Mental Disorders; Ethnicity; Humans; Personality Assessment; Personality Disorders; Prevalence
PubMed: 28961462
DOI: 10.1016/j.copsyc.2017.09.001