The Experts below are selected from a list of 117 Experts worldwide ranked by ideXlab platform
Brooke Levis - One of the best experts on this subject based on the ideXlab platform.
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shortening the edinburgh postnatal depression scale using optimal test assembly methods development of the epds dep 5
Acta Psychiatrica Scandinavica, 2021Co-Authors: Alan Stein, Daphna Harel, Brooke Levis, Miyabi Ishihara, A W Levis, Simone N Vigod, Louise M Howard, Brett D ThombsAbstract:Aims This study used a large database to develop a reliable and valid shortened form of the Edinburgh Postnatal Depression Scale (EPDS), a self-report questionnaire used for depression Screening in Pregnancy and postpartum, based on objective criteria. Methods Item responses from the 10-item EPDS were obtained from 5,157 participants (765 major depression cases) from 22 primary Screening accuracy studies that compared the EPDS to the Structured Clinical interview for DSM (SCID). Unidimensionality of the EPDS latent construct was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally informative shortened form for each possible scale length between 1 and 9 items. The final shortened form was selected based on pre-specified validity and reliability criteria and non-inferiority of Screening accuracy of the EPDS as compared to the SCID. Results A 5-item short form of the EPDS (EPDS-Dep-5) was selected. The EPDS-Dep-5 had a Cronbach's alpha of 0.82. Sensitivity and specificity of the EPDS-Dep-5 for a cutoff of 4 or greater were 0.83 (95% CI, 0.73, 0.89) and 0.86 (95% CI, 0.80, 0.90) and were statistically non-inferior to the EPDS. The correlation of total scores with the full EPDS was high (r = 0.91). Conclusion The EPDS-Dep-5 is a valid short form with minimal loss of information when compared to the full-length EPDS. The EPDS-Dep-5 was developed with OTA methods using objective, pre-specified criteria, but the approach is data-driven and exploratory. Thus, there is a need to replicate results of this study in different populations.
Sander Veldhuyzen Van Zanten - One of the best experts on this subject based on the ideXlab platform.
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Barriers and facilitators of mental health Screening in Pregnancy.
Journal of affective disorders, 2015Co-Authors: Dawn Kingston, Marie-paule Austin, Maureen Heaman, Sheila Mcdonald, Gerri Lasiuk, Wendy Sword, Rebecca Giallo, Kathy Hegadoren, Lydia Vermeyden, Sander Veldhuyzen Van ZantenAbstract:Abstract Background Access to mental health services during Pregnancy is most commonly mobilized through formal mental health Screening. However, few studies to date have identified barriers and facilitators that affect pregnant women’s responses to mental health Screening. The objective was to identify barriers and facilitators that influence pregnant women’s responses to the Screening process and factors associated with their identification. Methods This multi-site, cross-sectional survey recruited pregnant women >16 years of age who spoke/read English in Alberta, Canada. Main outcomes were barriers and facilitators of mental health Screening. Descriptive statistics were generated to identify the most common barriers and facilitators and multivariable logistic regression models were conducted to determine factors associated with barriers and facilitators. Results Study participation rate was 92% (460/500). Women’s most common barriers were: significant others normalizing their emotional difficulties; desiring to handle mental health problems on their own; preferring to discuss feelings with significant others; and not knowing what emotions were ‘normal’. Women who identified these barriers were more likely not to have been treated previously for mental illness, were primiparous, and could not be completely honest with their provider. Main facilitators were provider characteristics (sensitive, interested), reassurance that mental healthcare is a part of routine prenatal care, hearing that other women have emotional problems during Pregnancy and knowing that help was available. Limitations The sample comprised largely Caucasian, well-educated, and partnered women, which limits generalizability of the findings. Conclusions Personal and stigma-related barriers influence pregnant women’s responses to mental health Screening. Efforts to minimize barriers and enhance facilitators should be explored as potential strategies for optimizing prenatal mental health Screening.
Brett D Thombs - One of the best experts on this subject based on the ideXlab platform.
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shortening the edinburgh postnatal depression scale using optimal test assembly methods development of the epds dep 5
Acta Psychiatrica Scandinavica, 2021Co-Authors: Alan Stein, Daphna Harel, Brooke Levis, Miyabi Ishihara, A W Levis, Simone N Vigod, Louise M Howard, Brett D ThombsAbstract:Aims This study used a large database to develop a reliable and valid shortened form of the Edinburgh Postnatal Depression Scale (EPDS), a self-report questionnaire used for depression Screening in Pregnancy and postpartum, based on objective criteria. Methods Item responses from the 10-item EPDS were obtained from 5,157 participants (765 major depression cases) from 22 primary Screening accuracy studies that compared the EPDS to the Structured Clinical interview for DSM (SCID). Unidimensionality of the EPDS latent construct was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally informative shortened form for each possible scale length between 1 and 9 items. The final shortened form was selected based on pre-specified validity and reliability criteria and non-inferiority of Screening accuracy of the EPDS as compared to the SCID. Results A 5-item short form of the EPDS (EPDS-Dep-5) was selected. The EPDS-Dep-5 had a Cronbach's alpha of 0.82. Sensitivity and specificity of the EPDS-Dep-5 for a cutoff of 4 or greater were 0.83 (95% CI, 0.73, 0.89) and 0.86 (95% CI, 0.80, 0.90) and were statistically non-inferior to the EPDS. The correlation of total scores with the full EPDS was high (r = 0.91). Conclusion The EPDS-Dep-5 is a valid short form with minimal loss of information when compared to the full-length EPDS. The EPDS-Dep-5 was developed with OTA methods using objective, pre-specified criteria, but the approach is data-driven and exploratory. Thus, there is a need to replicate results of this study in different populations.
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Shortening the Edinburgh postnatal depression scale using optimal test assembly methods: Development of the EPDS‐Dep‐5
'Royal College of Obstetricians & Gynaecologists (RCOG)', 2021Co-Authors: Ishihara M, A W Levis, Brett D Thombs, Harel D, Levis B, Benedetti A, Howard L, Vigod S, Stein AAbstract:Aims: This study used a large database to develop a reliable and valid shortened form of the Edinburgh Postnatal Depression Scale (EPDS), a self‐report questionnaire used for depression Screening in Pregnancy and postpartum, based on objective criteria. Methods: Item responses from the 10‐item EPDS were obtained from 5157 participants (765 major depression cases) from 22 primary Screening accuracy studies that compared the EPDS to the Structured Clinical interview for DSM (SCID). Unidimensionality of the EPDS latent construct was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally informative shortened form for each possible scale length between 1 and 9 items. The final shortened form was selected based on pre‐specified validity and reliability criteria and non‐inferiority of Screening accuracy of the EPDS as compared to the SCID. Results: A 5‐item short form of the EPDS (EPDS‐Dep‐5) was selected. The EPDS‐Dep‐5 had a Cronbach's alpha of 0.82. Sensitivity and specificity of the EPDS‐Dep‐5 for a cutoff of 4 or greater were 0.83 (95% CI, 0.73, 0.89) and 0.86 (95% CI, 0.80, 0.90) and were statistically non‐inferior to the EPDS. The correlation of total scores with the full EPDS was high (r = 0.91). Conclusion: The EPDS‐Dep‐5 is a valid short form with minimal loss of information when compared to the full‐length EPDS. The EPDS‐Dep‐5 was developed with OTA methods using objective, pre‐specified criteria, but the approach is data‐driven and exploratory. Thus, there is a need to replicate results of this study in different populations.
Dawn Kingston - One of the best experts on this subject based on the ideXlab platform.
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Barriers and facilitators of mental health Screening in Pregnancy.
Journal of affective disorders, 2015Co-Authors: Dawn Kingston, Marie-paule Austin, Maureen Heaman, Sheila Mcdonald, Gerri Lasiuk, Wendy Sword, Rebecca Giallo, Kathy Hegadoren, Lydia Vermeyden, Sander Veldhuyzen Van ZantenAbstract:Abstract Background Access to mental health services during Pregnancy is most commonly mobilized through formal mental health Screening. However, few studies to date have identified barriers and facilitators that affect pregnant women’s responses to mental health Screening. The objective was to identify barriers and facilitators that influence pregnant women’s responses to the Screening process and factors associated with their identification. Methods This multi-site, cross-sectional survey recruited pregnant women >16 years of age who spoke/read English in Alberta, Canada. Main outcomes were barriers and facilitators of mental health Screening. Descriptive statistics were generated to identify the most common barriers and facilitators and multivariable logistic regression models were conducted to determine factors associated with barriers and facilitators. Results Study participation rate was 92% (460/500). Women’s most common barriers were: significant others normalizing their emotional difficulties; desiring to handle mental health problems on their own; preferring to discuss feelings with significant others; and not knowing what emotions were ‘normal’. Women who identified these barriers were more likely not to have been treated previously for mental illness, were primiparous, and could not be completely honest with their provider. Main facilitators were provider characteristics (sensitive, interested), reassurance that mental healthcare is a part of routine prenatal care, hearing that other women have emotional problems during Pregnancy and knowing that help was available. Limitations The sample comprised largely Caucasian, well-educated, and partnered women, which limits generalizability of the findings. Conclusions Personal and stigma-related barriers influence pregnant women’s responses to mental health Screening. Efforts to minimize barriers and enhance facilitators should be explored as potential strategies for optimizing prenatal mental health Screening.
Philippa Middleton - One of the best experts on this subject based on the ideXlab platform.
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Screening and subsequent management for thyroid dysfunction pre Pregnancy and during Pregnancy for improving maternal and infant health
Cochrane Database of Systematic Reviews, 2015Co-Authors: Laura Spencer, Tanya Bubner, Emily Bain, Philippa MiddletonAbstract:Background Thyroid dysfunction pre-Pregnancy and during Pregnancy (both hyper- and hypothyroidism) is associated with increased risk of adverse outcomes for mothers and infants in the short- and long-term. Managing the thyroid dysfunction (e.g. thyroxine for hypothyroidism, or antithyroid medication for hyperthyroidism) may improve outcomes. The best method of Screening to identify and subsequently manage thyroid dysfunction pre-Pregnancy and during Pregnancy is unknown. Objectives To assess the effects of different Screening methods (and subsequent management) for thyroid dysfunction pre-Pregnancy and during Pregnancy on maternal and infant outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (14 July 2015) and reference lists of retrieved studies. Selection criteria Randomised or quasi-randomised controlled trials, comparing any Screening method (e.g. tool, program, guideline/protocol) for detecting thyroid dysfunction (including hypothyroidism, hyperthyroidism, and/or thyroid autoimmunity) pre-Pregnancy or during Pregnancy with no Screening, or alternative Screening methods. Data collection and analysis Two review authors independently assessed eligibility of studies, extracted and checked data accuracy, and assessed the risk of bias of included studies. Main results We included two randomised controlled trials (involving 26,408 women) - these trials were considered to be at low risk of bias. Universal Screening (Screening all women) versus case finding (Screening only those at perceived increased risk) in Pregnancy for thyroid dysfunction One trial (4562 women) compared universal Screening with case finding for thyroid dysfunction. Before 11 weeks' gestation, women in the universal Screening group, and 'high-risk' women in the case finding group had their sera tested for TSH (thyroid stimulating hormone), fT4 (free thyroxine) and TPO-Ab (thyroid peroxidase antibody); women with hypothyroidism (TSH > 2.5 mIU/litre) received levothyroxine; women with hyperthyroidism (undetectable TSH and elevated fT4) received antithyroid medication. in regards to this review's primary outcomes, compared with the case finding group, more women in the universal Screening group were diagnosed with hypothyroidism (risk ratio (RR) 3.15, 95% confidence interval (CI) 1.91 to 5.20; 4562 women; GRADE: high quality evidence), with a trend towards more women being diagnosed with hyperthyroidism (RR 4.50, 95% CI 0.97 to 20.82; 4562 women; P = 0.05; GRADE: moderate quality evidence). No clear differences were seen in the risks of pre-eclampsia (RR 0.87, 95% CI 0.64 to 1.18; 4516 women; GRADE: moderate quality evidence), or preterm birth (RR 0.99, 95% CI 0.80 to 1.24; 4516 women; GRADE: high quality evidence) between groups. This trial did not report on neurosensory disability for the infant as a child. Considering this review's secondary outcomes, more women in the universal Screening group received pharmacological treatment for thyroid dysfunction (RR 3.15, 95% CI 1.91 to 5.20; 4562 women). No clear differences between groups were observed for miscarriage (RR 0.90, 95% CI 0.68 to 1.19; 4516 women; GRADE: moderate quality evidence), fetal and neonatal death (RR 0.92, 95% CI 0.42 to 2.02; 4516 infants; GRADE: moderate quality evidence), or other secondary outcomes: Pregnancy-induced hypertension, gestational diabetes, congestive heart failure, thyroid storm, mode of birth (caesarean section), preterm labour, placental abruption, respiratory distress syndrome, low birthweight, neonatal intensive care unit admission, or other congenital malformations. The trial did not report on a number of outcomes including adverse effects associated with the intervention. Universal Screening versus no Screening in Pregnancy for hypothyroidism One trial (21,846 women) compared universal Screening with no Screening for hypothyroidism. Before 15 + 6 weeks' gestation, women in the universal Screening group had their sera tested; women who screened 'positive' (TSH > 97.5th percentile, fT4 < 2.5th percentile, or both) received levothyroxine. Considering primary review outcomes, compared with the no Screening group, more women in the universal Screening screened 'positive' for hypothyroidism (RR 998.18, 95% CI 62.36 to 15,978.48; 21,839 women; GRADE: high quality evidence). No data were provided for the outcome pre-eclampsia, and for preterm birth, the trial reported rates of 5.6% and 7.9% for the Screening and no Screening groups respectively (it was unclear if these percentages related to the entire cohort or women who screened positive). No clear difference was seen for neurosensory disability for the infant as a child (three-year follow-up IQ score < 85) (RR 0.85, 95% CI 0.60 to 1.22; 794 infants; GRADE: moderate quality evidence). More women in the universal Screening group received pharmacological treatment for thyroid dysfunction (RR 1102.90, 95% CI 69.07 to 17,610.46; 1050 women); 10% had their dose lowered because of low TSH, high fT4 or minor side effects. No clear differences were observed for other secondary outcomes, including developmental delay/intellectual impairment at three years. Most of our secondary outcomes, including miscarriage, fetal or neonatal death were not reported. Authors' conclusions Based on the existing evidence, though universal Screening for thyroid dysfunction in Pregnancy increases the number of women diagnosed with hypothyroidism who can be subsequently treated, it does not clearly impact (benefit or harm) maternal and infant outcomes. While universal Screening versus case finding for thyroid dysfunction increased diagnosis and subsequent treatment, we found no clear differences for the primary outcomes: pre-eclampsia or preterm birth. No clear differences were seen for secondary outcomes, including miscarriage and fetal or neonatal death; data were lacking for the primary outcome: neurosensory disability for the infant as a child, and for many secondary outcomes. Though universal Screening versus no Screening for hypothyroidism similarly increased diagnosis and subsequent treatment, no clear difference was seen for the primary outcome: neurosensory disability for the infant as a child (IQ < 85 at three years); data were lacking for the other primary outcomes: pre-eclampsia and preterm birth, and for the majority of secondary outcomes. For outcomes assessed using the GRADE approach the evidence was considered to be moderate or high quality, with any downgrading of the evidence based on the presence of wide confidence intervals crossing the line of no effect. More evidence is needed to assess the benefits or harms of different Screening methods for thyroid dysfunction in Pregnancy, on maternal, infant and child health outcomes. Future trials should assess impacts on use of health services and costs, and be adequately powered to evaluate the effects on short- and long-term outcomes.
