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Are existing self-ratings of acute manic symptoms in adults reliable and valid?-A systematic review.Bipolar Disorders Sep 2020Depression research historically uses both self- and clinician ratings of symptoms with significant and substantial correlations. It is often assumed that manic patients...
BACKGROUND
Depression research historically uses both self- and clinician ratings of symptoms with significant and substantial correlations. It is often assumed that manic patients lack insight and cannot accurately report their symptoms. This delayed the development of self-rating scales for mania, but several scales now exist and are used in research. Our objective is to systematically review the literature to identify existing self-ratings of symptoms of (hypo)mania and to evaluate their psychometric properties.
METHODS
PubMed, Web of Knowledge, and Ovid were searched up until June 2018 using the keywords: "(hypo)mania," "self-report," and "mood disorder" to identify papers which included data on the validity and reliability of self-rating scales for (hypo)mania in samples including patients with bipolar disorder.
RESULTS
We identified 55 papers reporting on 16 different self-rating scales claiming to assess (hypo)manic symptoms or states. This included single item scales, but also some with over 40 items. Three of the scales, the Internal State Scale (ISS), Altman Self-Rating Mania Scale (ASRM), and Self-Report Manic Inventory (SRMI), provided data about reliability and/or validity in more than three independent studies. Validity was mostly assessed by comparing group means from individuals in different mood states and sometimes by correlation to clinician ratings of mania.
CONCLUSIONS
ASRM, ISS, and SRMI are promising self-rating tools for (hypo)mania to be used in clinical contexts. Future studies are, however, needed to further validate these measures; for example, their associations between each other and sensitivity to change, especially if they are meant to be outcome measures in studies.
Topics: Adult; Bipolar Disorder; Female; Humans; Male; Middle Aged; Mood Disorders; Psychiatric Status Rating Scales; Psychometrics; Reproducibility of Results; Self Report
PubMed: 32232950
DOI: 10.1111/bdi.12906 -
International Journal of Medical... Apr 2022Wearable activity trackers are gaining traction in medical research, providing both real-time and remote monitoring of physical fitness. Activity trackers offer an... (Review)
Review
BACKGROUND
Wearable activity trackers are gaining traction in medical research, providing both real-time and remote monitoring of physical fitness. Activity trackers offer an excellent source of personalized physical activity data from patients, as well as healthy individuals, that would provide insights into healthcare analytics and user-feedback on health status. In addition, these activity trackers would also allow researchers to monitor symptom severity and assist clinicians in providing their patients a more holistic care. Despite the promise of wearable device technology, there is still a lack of standardization in the medical literature regarding the analysis and reporting of adherence, validity and physical activity data generated by these activity trackers.
OBJECTIVE
We performed a systematic review to identify the activity tracker-derived measures and evaluate the relations of reported adherence, validity, and physical activity types across currently available literature.
METHODS
The searches were performed using Pubmed and Embase databases. Studies enrolling at least 1,000 human subjects regardless of health or disease status, using activity trackers of any brand used to track step count, distance, heart rate, energy expenditure or activity intensity, were included. Studies have been published between 2009 to March 2021, with editorials, systematic reviews, meta-analysis, grey literature, validation studies, study protocols and studies using smartphone trackers being excluded. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
RESULTS
A total of 27 studies met the eligibility criteria and were included in the review, with a total of 514,418 and 1,186,530 subjects recruited in observational and interventional studies, respectively. Apart from ActiGraph (n = 11, 41%), Fitbit (n = 4, 15%) and Axivity (n = 3, 11%) were found to be the most commonly used activity trackers in both types of studies. The wear duration of activity trackers ranged from 1 day to 59 months, with 1 week being the most common length (n = 16, 59%). The most frequently collected physical activity measure was activity intensity (n = 21, 78%), followed by step count (n = 9, 33%) and energy expenditure (n = 2, 7%). Most studies defined a valid day as wear-time of at least 10 h within 1 day (n = 10, 37%), and a valid interval as a week with at least 3 valid days (n = 8, 30%).
CONCLUSIONS
This systematic review reveals the diverse analysis and reporting of activity tracker data in the medical literature. Future studies will need to evaluate the feasibility on adopting minimum reporting thresholds of data generated by wearable activity trackers.
Topics: Biomedical Research; Exercise; Fitness Trackers; Heart Rate; Humans; Wearable Electronic Devices
PubMed: 35121356
DOI: 10.1016/j.ijmedinf.2022.104696 -
Arthritis Care & Research Sep 2013To evaluate the quality of the methods and reporting of published studies that validate administrative database algorithms for rheumatic disease case ascertainment. (Review)
Review
OBJECTIVE
To evaluate the quality of the methods and reporting of published studies that validate administrative database algorithms for rheumatic disease case ascertainment.
METHODS
We systematically searched MEDLINE, Embase, and the reference lists of articles published from 1980 to 2011. We included studies that validated administrative data algorithms for rheumatic disease case ascertainment using medical record or patient-reported diagnoses as the reference standard. Each study was evaluated using published standards for the reporting and quality assessment of diagnostic accuracy, which informed the development of a methodologic framework to help critically appraise and guide research in this area.
RESULTS
Twenty-three studies met the inclusion criteria. Administrative database algorithms to identify cases were most frequently validated against diagnoses in medical records (83%). Almost two-thirds of the studies (61%) used diagnosis codes in administrative data to identify potential cases and then reviewed medical records to confirm the diagnoses. The remaining studies did the reverse, identifying patients using a reference standard and then testing algorithms to identify cases in administrative data. Many authors (61%) described the patient population, but few (26%) reported key measures of diagnostic accuracy (sensitivity, specificity, and positive and negative predictive values). Only one-third of studies reported disease prevalence in the validation study sample.
CONCLUSION
The methods used in administrative data validation studies of rheumatic diseases are highly variable. Few studies reported key measures of diagnostic accuracy despite their importance for drawing conclusions about the validity of administrative database algorithms. We developed a methodologic framework and recommendations for validation study conduct and reporting.
Topics: Databases, Factual; Humans; Medical Records; Rheumatic Diseases; Validation Studies as Topic
PubMed: 23436765
DOI: 10.1002/acr.21993 -
Frontiers in Public Health 2021This work aims to systematically identify, describe, and appraise all prognostic models for cervical cancer and provide a reference for clinical practice and future...
This work aims to systematically identify, describe, and appraise all prognostic models for cervical cancer and provide a reference for clinical practice and future research. We systematically searched PubMed, EMBASE, and Cochrane library databases up to December 2020 and included studies developing, validating, or updating a prognostic model for cervical cancer. Two reviewers extracted information based on the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modeling Studies checklist and assessed the risk of bias using the Prediction model Risk Of Bias ASsessment Tool. Fifty-six eligible articles were identified, describing the development of 77 prognostic models and 27 external validation efforts. The 77 prognostic models focused on three types of cervical cancer patients at different stages, i.e., patients with early-stage cervical cancer ( = 29; 38%), patients with locally advanced cervical cancer ( = 27; 35%), and all-stage cervical cancer patients ( = 21; 27%). Among the 77 models, the most frequently used predictors were lymph node status ( = 57; 74%), the International Federation of Gynecology and Obstetrics stage ( = 42; 55%), histological types ( = 38; 49%), and tumor size ( = 37; 48%). The number of models that applied internal validation, presented a full equation, and assessed model calibration was 52 (68%), 16 (21%), and 45 (58%), respectively. Twenty-four models were externally validated, among which three were validated twice. None of the models were assessed with an overall low risk of bias. The Prediction Model of Failure in Locally Advanced Cervical Cancer model was externally validated twice, with acceptable performance, and seemed to be the most reliable. Methodological details including internal validation, sample size, and handling of missing data need to be emphasized on, and external validation is needed to facilitate the application and generalization of models for cervical cancer.
Topics: Female; Humans; Pregnancy; Bias; Prognosis; Uterine Cervical Neoplasms
PubMed: 34026714
DOI: 10.3389/fpubh.2021.654454 -
Health Technology Assessment... 2012Although the vast majority of children with acute infections are managed at home, this is one of the most common problems encountered in children attending emergency... (Review)
Review
BACKGROUND
Although the vast majority of children with acute infections are managed at home, this is one of the most common problems encountered in children attending emergency departments (EDs) and primary care. Distinguishing children with serious infection from those with minor or self-limiting infection is difficult. This can result in misdiagnosis of children with serious infections, which results in a poorer health outcome, or a tendency to refer or admit children as a precaution; thus, inappropriately utilising secondary-care resources.
OBJECTIVES
We systematically identified clinical features and laboratory tests which identify serious infection in children attending the ED and primary care. We also identified clinical prediction rules and validated those using existing data sets.
DATA SOURCES
We searched MEDLINE, Medion, EMBASE, Cumulative Index to Nursing and Allied Health Literature and Database of Abstracts of Reviews of Effects in October 2008, with an update in June 2009, using search terms that included terms related to five components: serious infections, children, clinical history and examination, laboratory tests and ambulatory care settings. We also searched references of included studies, clinical content experts, and relevant National Institute for Health and Clinical Excellence guidelines to identify relevant studies. There were no language restrictions. Studies were eligible for inclusion if they were based in ambulatory settings in economically developed countries.
REVIEW METHODS
Literature searching, selection and data extraction were carried out by two reviewers. We assessed quality using the quality assessment of diagnostic accuracy studies (QUADAS) instrument, and used spectrum bias and validity of the reference standard as exclusion criteria. We calculated the positive likelihood ratio (LR+) and negative likelihood ratio (LR-) of each feature along with the pre- and post-test probabilities of the outcome. Meta-analysis was performed using the bivariate method when appropriate. We externally validated clinical prediction rules identified from the systematic review using existing data from children attending ED or primary care.
RESULTS
We identified 1939 articles, of which 35 were selected for inclusion in the review. There was only a single study from primary care; all others were performed in the ED. The quality of the included studies was modest. We also identified seven data sets (11,045 children) to use for external validation. The most useful clinical features for ruling in serious infection was parental or clinician overall concern that the illness was different from previous illnesses or that something was wrong. In low- or intermediate-prevalence settings, the presence of fever had some diagnostic value. Additional red flag features included cyanosis, poor peripheral circulation, rapid breathing, crackles on auscultation, diminished breath sounds, meningeal irritation, petechial rash, decreased consciousness and seizures. Procalcitonin (LR+ 1.75-2.96, LR- 0.08-0.35) and C-reactive protein (LR+ 2.53-3.79, LR- 0.25-0.61) were superior to white cell counts. The best performing clinical prediction rule was a five-stage decision tree rule, consisting of the physician's gut feeling, dyspnoea, temperature ≥ 40 °C, diarrhoea and age. It was able to decrease the likelihood of serious infections substantially, but on validation it provided good ruling out value only in low-to-intermediate-prevalence settings (LR- 0.11-0.28). We also identified and validated the Yale Observation Scale and prediction rules for pneumonia, meningitis and gastroenteritis.
LIMITATIONS
Only a single study was identified from primary-care settings, therefore results may lack generalisability.
CONCLUSIONS
Several clinical features are useful to increase or decrease the probability that a child has a serious infection. None is sufficient on its own to substantially raise or lower the risk of serious infection. Some are highly specific ('red flags'), so when present should prompt a more thorough or repeated assessment. C-reactive protein and procalcitonin demonstrate similar diagnostic characteristics and are both superior to white cell counts. However, even in children with a serious infection, red flags will occur infrequently, and their absence does not lower the risk. The diagnostic gap is currently filled by using clinical 'gut feeling' and diagnostic safety-netting, which are still not well defined. Although two prediction rules for serious infection and one for meningitis provided some diagnostic value, we do not recommend widespread implementation at this time. Future research is needed to identify predictors of serious infection in children in primary-care settings, to validate prediction rules more widely, and determine the added value of blood tests in primary-care settings.
FUNDING
The National Institute for Health Research Health Technology Assessment programme.
Topics: C-Reactive Protein; Child; Child Welfare; Confidence Intervals; Critical Care; Diagnostic Tests, Routine; Emergency Service, Hospital; Female; Humans; Laboratories; Male; Patient Care; Pediatrics; Predictive Value of Tests; Triage; United Kingdom
PubMed: 22452986
DOI: 10.3310/hta16150 -
Survey of Ophthalmology 2020Cataract is a common cause of reversible blindness. Visual acuity alone is not enough to assess appropriateness for surgery, prioritization, and outcomes. Catquest-9SF...
Cataract is a common cause of reversible blindness. Visual acuity alone is not enough to assess appropriateness for surgery, prioritization, and outcomes. Catquest-9SF questionnaire evaluates patients' self-assessed visual function as related to daily tasks. We summarize and assess the validity of Catquest-9SF as a patient-reported outcome questionnaire to determine its suitability for clinical use. Thirteen studies with sample sizes ranging 102-10,886 (total n = 15,289) undertaken from 2009 to 2018 were included. Catquest-9SF showed unidimensionality, ordered response thresholds, and acceptable precision in all studies. Nine studies had significant mistargeting (range 0.66 to -2.04); the tasks being easy relative to the respondent ability in most studies. Two studies had misfitting items. We conclude Catquest-9SF is a valid and reliable tool to measure visual function in patients with cataract in various populations. Because results can be population specific, it is recommended that Catquest-9SF be validated in a new population before it is incorporated in routine practice.
Topics: Cataract; Cataract Extraction; Global Health; Humans; Incidence; Patient Reported Outcome Measures; Quality of Life; Visual Acuity
PubMed: 31862206
DOI: 10.1016/j.survophthal.2019.12.002 -
COPD Dec 2020Selecting valid and reliable PA assessments in chronic obstructive pulmonary disease (COPD) is crucial to ensure that the information obtained is accurate, valuable, and...
Selecting valid and reliable PA assessments in chronic obstructive pulmonary disease (COPD) is crucial to ensure that the information obtained is accurate, valuable, and meaningful. The purpose of this systematic review was to compare the validity and reliability among PA assessments in COPD. An electronic database search of PubMed and CINAHL was completed in December 2019 using MeSH terms on physical activity, COPD, validation, and questionnaires. Transparency in reporting was assessed with the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist while methodological quality was assessed with the modified Quality Appraisal tool for Reliability studies (QAREL) for reliability studies and the Quality Appraisal of Validity Studies (QAVALS) for validity studies. The search yielded fifteen different measures. The Stanford 7-day recall (PAR) demonstrated the strongest correlations with SenseWear Armband on energy expenditure ( = 0.83; < 0.001) and moderate correlations for time spent in activity over 3 METs ( = 0.54, < 0.001). The Multimedia Activity Recall (MARCA) also demonstrated moderate to good correlations with both SenseWear and Actigraph GT3X + accelerometers ( = 0.66-0.74). Assisted and computerized PRO measures (PAR and MARCA) and hybrid measures (C-PPAC and D-PPAC) demonstrate better psychometric properties as compared to other subjective measures and may be considered for quantification of PA in COPD. However, observations drawn from single validation studies limit strength of recommendations and further research is needed to replicate the findings.
Topics: Exercise; Humans; Pulmonary Disease, Chronic Obstructive; Reproducibility of Results; Self Report
PubMed: 33054418
DOI: 10.1080/15412555.2020.1830963 -
Sports Medicine - Open Oct 2022In intermittent team and racquet sports, metabolic loads are rarely investigated as they are difficult to examine, e.g., by portable metabolic carts and lactate...
BACKGROUND
In intermittent team and racquet sports, metabolic loads are rarely investigated as they are difficult to examine, e.g., by portable metabolic carts and lactate measures. However, determining the instantaneous metabolic power of intermittent running from acceleration and speed data is possible. Recently, this potential has gained more interest in research and practice due to the development of player tracking technologies that allow easy access to the required data. The aim of this review was to systematically investigate the validity and point out the evidence of this new approach for estimating metabolic loads in intermittent sports. To provide an in-depth understanding of this approach and its validity, the fundamental aspects of the underlying concept were also considered.
METHODS
PubMed®, Cochrane Library, Web of Science™, and BISp-surf databases were included in the search conducted on March 1, 2021. Studies assessing physiological and methodological validation as well as conceptual studies of the metabolic power approach in intermittent sports players without diseases or injuries were deemed eligible. The quality assessment was implemented using a modified 12-item version of the Downs and Black checklist. Additionally, a best-evidence synthesis of the validation studies was performed to clarify the direction and strength of the evidence.
RESULTS
Of 947 studies that were identified, 31 met the eligibility criteria of which 7 were physiological, 13 methodological validation, and 11 conceptual studies. Gold standards for validating the metabolic power approach were predominantly oxygen uptake with 6 and traditional running speed analysis with 8 studies for physiological and methodological validation, respectively. The best-evidence synthesis showed conflicting to strong and moderate to strong evidence for physiological and methodological validity of the approach, respectively. The conceptual studies revealed several modifications regarding the approach that need to be considered. Otherwise, incorrect implementation can occur.
CONCLUSIONS
Evidence of the physiological validity of the metabolic power approach ranged from conflicting to strong. However, this should be treated with caution as the validation studies were often partially implemented incorrectly as shown by the underlying concept studies. Moreover, strong evidence indicated that the approach is valid from a methodological perspective. Future studies must consider what the metabolic power approach can and cannot actually display.
PubMed: 36282365
DOI: 10.1186/s40798-022-00525-9 -
Current Obesity Reports Dec 2022Overweight and obesity are associated to health prognosis. Therefore, body composition assessment is an important health outcome, especially in adult population. We... (Review)
Review
PURPOSE OF REVIEW
Overweight and obesity are associated to health prognosis. Therefore, body composition assessment is an important health outcome, especially in adult population. We analyzed the criterion-related validity of existing field-based methods and equations for body composition estimation in adults aged 19-64 years.
RECENT FINDINGS
One hundred studies met inclusion criteria. The field-based methods, waist circumference (WC), body adiposity index (BAI), and body mass index (BMI) are valid to indicate body adiposity. Likewise, several equations, including the classical Durnin/Womersley equation, Jackson/Pollock equation (males), and Jackson, Pollock, and Ward equation (females), are valid to estimate total body fat mass or body fat percentage. Anthropometric field methods can provide a simple, quick, and easy informative indicators of adiposity in adults. Classical equations, such as Durnin/Womersley equation, Jackson/Pollock equation, and Jackson, Pollock, and Ward equation, are still valid to estimate total body fat mass or body fat percentage in adult population. When choosing estimation equations, specific population characteristics, such as age, weight status, or race ethnicity, should be taken into account. (Trial Registration: Registered on PROSPERO (CRD42020194272)).
Topics: Humans; Body Composition; Young Adult; Adult; Middle Aged; Body Mass Index; Adiposity; Waist Circumference; Reference Values; Overweight; Obesity
PubMed: 36369621
DOI: 10.1007/s13679-022-00488-8 -
Clinical Nutrition ESPEN Dec 2022Accurate dietary assessment is an essential component for nutrition care planning and monitoring. The visual estimation method (VEM) of dietary assessment is routinely... (Review)
Review
BACKGROUND
Accurate dietary assessment is an essential component for nutrition care planning and monitoring. The visual estimation method (VEM) of dietary assessment is routinely used in hospitals around the world. Therefore, clarity regarding its validity is imperative.
AIM
To conduct a systematic literature review to evaluate the validity of the VEM to assess food consumption and energy and protein intake in the hospital setting.
METHODS
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and checklist. Full-text manuscripts, published in English between January 2000 and September 2021, were searched using five electronic databases. A further manual search of reference lists was conducted.
RESULTS
14 studies evaluating the validity of 12 different VEMs were included. 12 studies used various point-scales (0-100%), three with pre-determined nutrient estimates assigned to each intake level, and nine without. Two studies used modern technology. Results indicate that the VEM can achieve validity at the group level, but support at the individual level was limited. No one method of visual estimation appeared to be more valid than another; however, training of raters appears to be important.
CONCLUSION
The VEM shows potential as a valid tool for dietary monitoring in hospitals. Further high-quality research is required to establish the effects of meal and rater characteristics on validity at the group and individual levels. Furthermore, to reflect current modes of implementation more fully, research is needed to evaluate the validity of the VEM when operated via food-service software suites.
Topics: Humans; Diet Records; Meals; Diet; Hospitals; Eating
PubMed: 36513469
DOI: 10.1016/j.clnesp.2022.09.011