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Depression and Anxiety Mar 2014Despite being one of the leading causes of disability worldwide, fewer than 10% of depressed individuals in low-resource settings have access to treatment. Mounting... (Review)
Review
BACKGROUND
Despite being one of the leading causes of disability worldwide, fewer than 10% of depressed individuals in low-resource settings have access to treatment. Mounting evidence suggests that nonspecialist workers are capable of providing counseling and case management at the community level. They often use brief psychiatric screening instruments as clinical tools to identify cases and monitor symptoms over time. In order for such tools to be used in diverse settings, they must demonstrate adequate reliability and validity in addition to cross-cultural relevance. To be used to guide routine care they also need to be flexibly adapted and sensitive to change. The goal of this paper is to assess the cross-cultural validity of brief psychiatric screening instruments in sub-Saharan Africa, identify best practices, and discuss implications for clinical management and scale-up of mental health treatment in resource-poor settings.
METHOD
Systematic review of studies assessing the validity of screening instruments for depression, anxiety, and mental distress in sub-Saharan Africa using Medline and PsycINFO.
RESULTS
Sixty-five studies from 16 countries assessing the validity of brief screening instruments for depression, anxiety, and/or mental distress.
CONCLUSIONS
Despite evidence of underlying universality in the experience of depression and anxiety in sub-Saharan Africa, differences in the salience, manifestation, and expression of symptoms suggest the need for the local adaptation of instruments. Rapid ethnographic assessment has emerged as a promising, low-cost, and efficient strategy for doing so.
Topics: Africa South of the Sahara; Anxiety Disorders; Depressive Disorder; Humans; Mass Screening; Psychiatric Status Rating Scales; Psychometrics
PubMed: 23780834
DOI: 10.1002/da.22142 -
International Journal of Clinical... Feb 2021Background Tobacco use is a leading preventable cause of morbidity and mortality globally. Clinical practice guidelines for the treatment of tobacco use dependence are...
Background Tobacco use is a leading preventable cause of morbidity and mortality globally. Clinical practice guidelines for the treatment of tobacco use dependence are of varied scope and quality, making it challenging for users to select and apply recommendations. Objective The study objective is to identify and critically appraise the quality of existing clinical practice guidelines for tobacco cessation. Setting The study occurred between collaborative academic institutions located in Qatar and New Zealand. Methods A systematic literature search was performed for the period 2006-2018 through the following databases: PubMed, EMBASE, CINAHL, ISI Web of Science, Scopus, National Guideline Clearing House, Campbell Library, Health System Evidence, Joanna Briggs Institute Evidence-Based Practice Database, Academic Search Complete, ProQuest, PROSPERO, and Google Scholar. Relevant professional societies' and health agencies' websites were also searched. Two reviewers independently extracted and assessed guidelines' quality using Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Main outcome measure Standardized domain scores according to the AGREE II instrument. Results 7741 hits were identified. After removing duplicates and screening, 24 guidelines were included. Highest guideline quality was for National Institute for Health and Care Excellence (NICE) guideline with an overall ranking score of 87.56% and least quality was for Japanese Circulation Society Joint Working Group with an overall score of 29.34%. Domain 4 of AGREE II (clarity of presentation) had the highest average quality score (70.95%), while the lowest average quality scores were for Domain 2 (Rigour of Development) (50.21%) and Domain 5 (Applicability) (45.05%). Conclusion Seven guidelines were judged to be of high quality (overall score of ≥ 70%). Future guidelines for tobacco dependence treatment should use rigorous methods of development and provide applicable recommendations.
Topics: Databases, Factual; Humans; Mass Screening; New Zealand; Practice Guidelines as Topic; Qatar; Smoking Cessation; Tobacco Use Disorder
PubMed: 32897449
DOI: 10.1007/s11096-020-01110-4 -
The Medical Journal of Malaysia Dec 2010A systematic review on the effectiveness and cost-effectiveness of school scoliosis screening programme was carried out. A total of 248 relevant titles were identified,... (Review)
Review
A systematic review on the effectiveness and cost-effectiveness of school scoliosis screening programme was carried out. A total of 248 relevant titles were identified, 117 abstracts were screened and 28 articles were included in the results. There was fair level of evidence to suggest that school scoliosis screening programme is safe, contributed to early detection and reduction of surgery. There was also evidence to suggest that school-based scoliosis screening programme is cost-effective. Based on the above review, screening for scoliosis among school children is recommended only for high risk group such as girls at twelve years of age.
Topics: Adolescent; Child; Cost-Benefit Analysis; Female; Humans; Male; Mass Screening; School Health Services; Scoliosis
PubMed: 21901941
DOI: No ID Found -
Journal of Clinical Epidemiology Sep 2022Text-mining tool, Abstrackr, may potentially reduce the workload burden of title and abstract screening (Stage 1), using screening prioritization and truncation. This...
BACKGROUND AND OBJECTIVES
Text-mining tool, Abstrackr, may potentially reduce the workload burden of title and abstract screening (Stage 1), using screening prioritization and truncation. This study aimed to evaluate the performance of Abstrackr's text-mining functions ('Abstrackr-assisted screening'; screening undertaken by a single-human screener and Abstrackr) vs. Single-human screening.
METHODS
A systematic review of treatments for relapsed/refractory diffuse large B cell lymphoma (n = 7,723) was used. Citations, uploaded to Abstrackr, were screened by a human screener until a pre-specified maximum prediction score of 0.39540 was reached. Abstrackr's predictions were compared with the judgments of a second, human screener (who screened all citations in Covidence). The performance metrics were sensitivity, specificity, precision, false negative rate, proportion of relevant citations missed, workload savings, and time savings.
RESULTS
Abstrackr reduced Stage 1 workload by 67% (5.4 days), when compared with Single-human screening. Sensitivity was high (91%). The false negative rate at Stage 1 was 9%; however, none of those citations were included following full-text screening. The high proportion of false positives (n = 2,001) resulted in low specificity (72%) and precision (15.5%).
CONCLUSION
Abstrackr-assisted screening provided Stage 1 workload savings that did not come at the expense of omitting relevant citations. However, Abstrackr overestimated citation relevance, which may have negative workload implications at full-text screening.
Topics: Humans; Workload; Data Mining; Mass Screening; Research
PubMed: 35654270
DOI: 10.1016/j.jclinepi.2022.05.017 -
Parkinsonism & Related Disorders Mar 2012Parkinson's disease (PD) is a common, treatable movement disorder that often remains undiagnosed despite clinically manifest symptoms. Screening for parkinsonism could... (Review)
Review
Parkinson's disease (PD) is a common, treatable movement disorder that often remains undiagnosed despite clinically manifest symptoms. Screening for parkinsonism could lead to improved detection and earlier treatment, and facilitate research studies of PD prevalence. In order to determine the feasibility of screening, this study evaluated the validity of previously developed screening questionnaires. We systematically searched online databases PubMed and EMBASE for English-language studies published between 1980 and 2009. In each database a "Parkinson(s) disease" or "parkinsonism" term was combined with a screening term ("screening instrument," "screening questionnaire," "screen" or "prevalence survey") and a validity term ("validation," "sensitivity" and "specificity"). Included studies reported the psychometric properties of at least one self-report questionnaire for parkinsonism. Twenty-seven studies met the inclusion criteria. From these studies, 9 screening questionnaires were identified. Sensitivity and specificity estimates varied widely. Sensitivity estimates were as high as 100% when questionnaires were tested among previously diagnosed PD patients and included a high number of parkinsonism specific items, but were as low as 48% when tested among early cases in a community-based sample. Specificity estimates were lower, ranging from 22 to 100%. An older sample, presence of multiple co-morbid conditions and lower literacy led to lower specificity estimates. Higher specificity estimates were seen when the screening questionnaires were administered by a physician. Screening questionnaires can detect symptomatic parkinsonism. However, the performance of these questionnaires varied based on the individual items, study sample, and method of administration. The performance of screening questionnaires in the detection of early or mild parkinsonism was modest.
Topics: Humans; Mass Screening; Parkinson Disease; Sensitivity and Specificity; Surveys and Questionnaires
PubMed: 21930414
DOI: 10.1016/j.parkreldis.2011.09.003 -
Journal of Pediatric Surgery Dec 2021Pectus excavatum (PE) could be part of a genetic disorder, which then has implications regarding comorbidity, the surgical correction of PE, and reproductive choices.... (Review)
Review
BACKGROUND
Pectus excavatum (PE) could be part of a genetic disorder, which then has implications regarding comorbidity, the surgical correction of PE, and reproductive choices. However, referral of a patient presenting with PE for genetic analysis is often delayed because additional crucial clinical signs may be subtle or even missed in syndromic patients. We reviewed the literature to inventory known genetic disorders associated with PE and create a standardized protocol for clinical evaluation.
METHODS
A systematic literature search was performed in electronic databases. Genetic disorders were considered associated with PE if studies reported at least five cases with PE. Characteristics of each genetic disorder were extracted from the literature and the OMIM database in order to create a practical guide for the clinician.
RESULTS
After removal of duplicates from the initial search, 1632 citations remained. Eventually, we included 119 full text articles, representing 20 different genetic disorders. Relevant characteristics and important clinical signs of each genetic disorder were summarized providing a standardized protocol in the form of a scoring list. The most important clinical sign was a positive family history for PE and/or congenital heart defect.
CONCLUSIONS
Twenty unique genetic disorders have been found associated with PE. We have created a scoring list for the clinician that systematically evaluates crucial clinical signs, thereby facilitating decision making for referral to a clinical geneticist.
Topics: Comorbidity; Funnel Chest; Heart Defects, Congenital; Humans; Mass Screening; Physicians
PubMed: 34039477
DOI: 10.1016/j.jpedsurg.2021.04.016 -
BMJ Open Apr 2022To systematically synthesise available evidence on the nature and effectiveness of interventions for improving timely diagnosis of breast and cervical cancers in low and...
OBJECTIVES
To systematically synthesise available evidence on the nature and effectiveness of interventions for improving timely diagnosis of breast and cervical cancers in low and middle-income countries (LMICs).
DESIGN
A systematic review of published evidence. The review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses.
DATA SOURCES
A comprehensive search of published literature was conducted. In addition, relevant grey literature sources and bibliographical references of included studies were searched for potentially eligible evidence.
STUDY SELECTION
Studies published between January 2010 and November 2020 were eligible for inclusion. To be eligible, studies had to report on interventions/strategies targeted at women, the general public or healthcare workers, aimed at improving the timely diagnosis of breast and/or cervical cancers in LMIC settings.
DATA EXTRACTION AND SYNTHESIS
Literature search, screening, study selection, data extraction and quality appraisal were conducted by two independent reviewers. Evidence was synthesised and reported using a global taxonomy framework for early cancer diagnosis.
RESULTS
From the total of 10 593 records identified, 21 studies conducted across 20 LMICs were included in this review. Most of the included studies (16/21) focused primarily on interventions addressing breast cancers; two focused on cervical cancer while the rest examined multiple cancer types. Reported interventions targeted healthcare workers (12); women and adolescent girls (7) and both women and healthcare workers (3). Eight studies reported on interventions addressing access delays; seven focused on interventions addressing diagnostic delays; two reported on interventions targeted at addressing both access and diagnostic delays, and four studies assessed interventions addressing access, diagnostic and treatment delays. While most interventions were demonstrated to be feasible and effective, many of the reported outcome measures are of limited clinical relevance to diagnostic timeliness.
CONCLUSIONS
Though limited, evidence suggests that interventions aimed at addressing barriers to timely diagnosis of breast and cervical cancer are feasible in resource-limited contexts. Future interventions need to address clinically relevant measures to better assess efficacy of interventions.
PROSPERO REGISTRATION NUMBER
CRD42020177232.
Topics: Adolescent; Developing Countries; Female; Humans; Income; Mass Screening; Poverty; Uterine Cervical Neoplasms
PubMed: 35470184
DOI: 10.1136/bmjopen-2021-054501 -
Social Science & Medicine (1982) Oct 2021In a context of increasing international dialogue around the appropriate means and ends of newborn screening programmes, it is critical to explore the perspectives of... (Review)
Review
In a context of increasing international dialogue around the appropriate means and ends of newborn screening programmes, it is critical to explore the perspectives of those directly impacted by such screening. This meta-ethnography uses a systematic review process to identify qualitative studies that focus on parents' experiences of newborn screening published in English-language academic journals from 2000 to 2019 (n = 36). The included studies represent a range of moments, outcomes, and conditions that illuminate discrete elements of the newborn screening journey. We draw on these varied studies to construct a diagram of possible newborn screening pathways and through so-doing identify a critical window of time between the signalling of a positive newborn screen and the end of the screening process. During this critical window of time, families navigate complex emotional reactions, information, and decisions. From an in-depth analysis of this data, we develop the concept of "absorptive capacity" as a lens through which to understand parents' responses to new and emerging information. Alongside this, we identify how the "concertinaing of time" - the various ways that parents experience the expansion and compression of time throughout and beyond the screening pathway - affects their absorptive capacities. This study underscores the need to move away from viewing newborn screening as a discrete series of clinical events and instead understand it as a process that can have far-reaching implications across time, space, and family groups. Using this understanding of screening as a starting point, we make recommendations to facilitate communication and support for screened families, including the antenatal provision of information to parents and accommodations for the fluctuations in parents' absorptive capacities across the screening trajectory.
Topics: Anthropology, Cultural; Communication; Female; Humans; Infant, Newborn; Neonatal Screening; Parents; Pregnancy; Qualitative Research
PubMed: 34534781
DOI: 10.1016/j.socscimed.2021.114367 -
Annals of Internal Medicine May 2010National guideline groups recommend screening and discussion of screening options for persons at average risk for colorectal cancer (CRC). However, emerging evidence... (Review)
Review
BACKGROUND
National guideline groups recommend screening and discussion of screening options for persons at average risk for colorectal cancer (CRC). However, emerging evidence suggests that CRC screening is simultaneously underused, overused, and misused and that adequate patient-provider discussions about screening are infrequent.
PURPOSE
To summarize evidence on factors that influence CRC screening and strategies that increase the appropriate use and quality of CRC screening and CRC screening discussions.
DATA SOURCES
MEDLINE, the Cochrane Library, and the Cochrane Central Register of Controlled Trials were searched for English-language publications describing studies conducted in the United States from January 1998 through September 2009.
STUDY SELECTION
Two reviewers independently selected studies that addressed the study questions and met eligibility criteria.
DATA EXTRACTION
Information on study design, setting, intervention, outcomes, and quality were extracted by one reviewer and double-checked by another. Reviewers assigned a strength-of-evidence grade for intervention categories by using criteria plus a consensus process.
DATA SYNTHESIS
Reviewers found evidence of simultaneous underuse, overuse, and misuse of CRC screening as well as inadequate clinical discussions about CRC screening. Several patient-level factors were independently associated with lower screening rates, including having low income or less education, being uninsured, being Hispanic or Asian, being less acculturated into the United States, or having limited access to care. Evidence that interventions that included patient reminders or one-on-one interactions (that is, between patients and nonphysician clinic staff), eliminated structural barriers (for example, simplifying access to fecal occult blood test cards), or made system-level changes (for example, using systematic screening as opposed to opportunistic screening) were effective in enhancing use of CRC screening was strong. Evidence on how best to enhance discussions about CRC screening options is limited. No studies focused on reducing overuse, and very few focused on misuse.
LIMITATIONS
Reporting and publication bias may have affected our findings. The independent effect of individual elements of multicomponent interventions was often uncertain.
CONCLUSION
Although CRC screening is underused overall, important problems of overuse and misuse also exist. System- and policy-level interventions that target vulnerable populations are needed to reduce underuse. Interventions aimed at reducing barriers by making the screening process easier are likely to be effective. Studies aimed at reducing overuse and misuse and at enhancing the quality and frequency of discussions about CRC screening options are needed.
PRIMARY FUNDING SOURCE
Agency for Healthcare Research and Quality.
Topics: Colorectal Neoplasms; Health Services Misuse; Humans; Mass Screening; National Institutes of Health (U.S.); Population Surveillance; United States
PubMed: 20388703
DOI: 10.7326/0003-4819-152-10-201005180-00239 -
Oral Surgery, Oral Medicine, Oral... May 2021This systematic review aims to describe the value of saliva as a noninvasive sample for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in... (Review)
Review
OBJECTIVE
This systematic review aims to describe the value of saliva as a noninvasive sample for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in comparison with the current method for sample collection, the nasopharyngeal swab.
STUDY DESIGN
We conducted a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. We searched in 5 databases (PubMed, Cochrane, EBSCO, Elsevier, and MEDLINE) and included articles published between December 2019 and July 2020.
RESULTS
This review included 22 publications that met inclusion criteria, 17 of which were case series, 2 of which were case reports, and 3 of which were massive screenings. All articles compared saliva with nasopharyngeal swabs. The detection rate of SARS-CoV-2 in saliva was similar to that for nasopharyngeal swabs. The sensitivity ranged between 20% and 97%, and specificity ranged between 66% and 100%.
CONCLUSIONS
This systematic review found that saliva might be an appropriate, fast, painless, simple, and noninvasive sample for SARS-CoV-2 detection, making it ideal for massive screening of SARS-CoV-2 infection.
Topics: COVID-19; Humans; Mass Screening; SARS-CoV-2; Saliva
PubMed: 33637473
DOI: 10.1016/j.oooo.2021.01.028