Adverse Menstrual Events Reported After and Before (or Without) COVID-19 Vaccination: A Systematic Review and Meta-Analysis of Comparative Observational Studies.

BACKGROUND: Reports of adverse menstrual events emerged during the COVID-19 vaccination campaign in multiple countries. This raised the question whether these reports were caused by the vaccines. The aim of this systematic review was to evaluate comparative studies on this topic (registered at PROSPERO [CRD42022324973]). METHODS: We included observational studies such as cohort studies and surveys comparing the response to self-reported questionnaires between post- versus pre-vaccination data. PubMed and Cochrane Library searches were conducted on 1 September 2023. The primary outcome was the incidence of any prespecified adverse menstrual event, and the outcome measure was the risk ratio. The meta-analysis was conducted by using the Mantel-Haenszel method and the random effects model. We summarized the results on risk factors as well as key findings of the studies included. RESULTS: We retrieved 161 references from electronic databases and additional sources such as references lists. Of those, we considered 21 comparative observational studies. The meta-analysis of any adverse menstrual adverse event reported in 12 studies resulted in a pooled estimate (risk ratio 1.13; 95% CI, 0.96-1.31) that did not favor any group. The analysis was constrained by considerable clinical and statistical heterogeneity. Risk factors for self-reported menstrual changes included a history of COVID-19 infection, the concern about COVID-19 vaccines, smoking, previous cycle irregularities, depression, and stress, and other issues. CONCLUSIONS: The risk ratio did not favor any group and heterogeneity was prevalent among the studies. Most studies suggested that the reported changes were temporary, minor, and nonserious.

Simultaneous Utilization of Mood Disorder Questionnaire and Bipolar Spectrum Diagnostic Scale for Machine Learning-Based Classification of Patients With Bipolar Disorders and Depressive Disorders.

OBJECTIVE: Bipolar and depressive disorders are distinct disorders with clearly different clinical courses, however, distinguishing between them often presents clinical challenges. This study investigates the utility of self-report questionnaires, the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS), with machine learning-based multivariate analysis, to classify patients with bipolar and depressive disorders. METHODS: A total of 189 patients with bipolar disorders and depressive disorders were included in the study, and all participants completed both the MDQ and BSDS questionnaires. Machine-learning classifiers, including support vector machine (SVM) and linear discriminant analysis (LDA), were exploited for multivariate analysis. Classification performance was assessed through cross-validation. RESULTS: Both MDQ and BSDS demonstrated significant differences in each item and total scores between the two groups. Machine learning-based multivariate analysis, including SVM, achieved excellent discrimination levels with area under the ROC curve (AUC) values exceeding 0.8 for each questionnaire individually. In particular, the combination of MDQ and BSDS further improved classification performance, yielding an AUC of 0.8762. CONCLUSION: This study suggests the application of machine learning to MDQ and BSDS can assist in distinguishing between bipolar and depressive disorders. The potential of combining high-dimensional psychiatric data with machine learning-based multivariate analysis as an effective approach to psychiatric disorders.

Distribution of self-reported borderline personality disorder traits symptoms in a large-scale clinical population.

Introduction: Borderline Personality Disorder (BPD) traits play a crucial role in the prognosis of psychiatric disorders, as well as in assessing risks associated with negativity and impulsivity. However, there is a lack of data regarding the distribution characteristics of BPD traits and symptoms within clinical populations. Methods: A total of 3015 participants (1321 males, 1694 females) were consecutively sampled from outpatients at the psychiatric and psycho-counseling clinics at the Shanghai Mental Health Center. BPD symptoms were assessed using a self-reported personality diagnostic questionnaire. Having BPD traits is defined as having five or more positive items in self-reported BPD characteristics. Participants were stratified into male and female groups, age groups, and diagnostic groups (schizophrenia, mood disorders, anxiety disorders). Exploratory factor analysis using principal components analysis was conducted. Three factors were identified: "F1: Affective Instability and Impulsivity", "F2: Interpersonal Unstable and Extreme Reactions", and "F3: Identity Disturbance". Results: Among 3015 participants, 45.9% of the patients self-reported BPD traits. Comparing of male and female patients, there was no statistically significant difference in the occurrence rate of BPD traits (χ2 = 1.835, p=0.176). However, in terms of symptoms, female patients reported more symptoms than male patients. Female patients also exhibited more pronounced features on F2 compared to male patients (t =-1.972, p=0.049). There is a general decrease in BPD traits, symptoms, and factors with increasing age. Specifically, the proportion of positive BPD traits is approximately halved before the age of 30 and decreases to around one-third after the age of 30. BPD traits were most common in the Mood Disorders group at 55.7%, followed by the Anxiety Disorders group at 44.4%, and Schizophrenia group at 41.5% (χ2 = 38.084, p<0.001). Discussion: Our study revealed the pervasive presence of BPD traits and symptoms among psychiatric outpatients, exhibiting distinctive distributions across gender, age, and diagnostic categories. These findings emphasize the significance of identifying and addressing BPD pathology in the clinical care of psychiatric outpatients.

Validation of self-reported morbidities of the Korean Atomic Bomb Survivor Cohort.

Objectives: This study aimed to evaluate the agreement of disease status collected through a survey of the Korean Atomic Bomb Survivor Cohort (K-ABC), compared with medical claim records from the Korean National Health Insurance Service (NHIS) database and the Korean Central Cancer Registry (KCCR). Methods: Data on the lifetime physician-diagnosed morbidities of 1,215 K-ABC participants were collected through an interviewer-administered questionnaire between 2020 and 2022. Survey data were linked to the NHIS and KCCR databases. Eleven diseases were included for validation. We evaluated the following indicators: sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, the area under the curve (AUC), and the kappa coefficient. Results: The mean (standard deviation) age was 62.1 (18.7) years, and 42.6% of the participants were aged ≥70 years. Hypertension and cataracts showed the highest prevalence rates (33.8% and 28.8%, respectively). Hypertension, diabetes, and cancer demonstrated high sensitivity (>0.8) and specificity (>0.9), whereas diabetes, cancer, myocardial infarction, angina pectoris, and asthma exhibited high accuracy (>0.9). In contrast, arthritis, allergic rhinitis, and asthma showed low sensitivity (<0.4) and kappa values (<0.3). In the participants aged ≥70 years, the kappa value was ≥0.4 for all diseases except arthritis, allergic rhinitis, and asthma. Conclusion: The results from this initial analysis showed relatively high agreement between the survey and NHIS/KCCR databases, especially for hypertension, diabetes, and cancer. Our findings suggest that the information on morbidities collected through the questionnaires in this cohort was valid for both younger and older individuals.

Building a composite score for patient self-report of flare in osteoarthritis: a comparison of methods with the Flare-OA-16 questionnaire.

OBJECTIVE: This study aims to compare methods of constructing a composite score for the Flare-OA-16 self-reported questionnaire. METHODS: Participants with knee and hip osteoarthritis (OA) completed a validated 16-item questionnaire assessing five domains of flare. Three estimation methods were compared: i) second-order confirmatory factor analysis (CFA); ii) logistic regression, according to the participant's self-report of flare (yes/no); and iii) Rasch method, with weighted scores in each dimension. The distribution (floor effect (FF) and ceiling effect (CF)) were described and the known-group validity (by self-reported flare) tested by Wilcoxon rank-sum test. Similarity between the scores was analyzed by intraclass correlation coefficient (ICC) and their performance against self-report compared by areas under ROC curves (AUC). Intra-score test-retest reliability at 14 days was assessed by ICC. RESULTS: In a sample of 381 participants, 247 reported having a flare. CFA showed fit indices (CFI=.95; RMSEA=.08) and estimated composite mean score=4.33(SD=2.85)[FF=14.9%, CF=0%]. For the logistic regression estimation, mean composite score was 6.48 (SD=3.13)[FF=0%, CF=0%]. With Rasch model, mean composite score was 4.35 (SD=2.60)[FF=14.9%, CF=0%]. Similarity analysis indicated a greater concordance between CFA and Rasch scores (ICC=.98) than between logistic regression score and the two others (ICC=.88 with Rasch score and .90 with CFA score). The AUC indicated similar performance of all methods: logistic model (AUC=.89 [.85-.92]), CFA and Rasch model (AUC=.86 [.82-.90]). The difference between groups was significant (p<.05) for scores estimated by CFA (3.98), Rasch model (4.95) and logistic regression (4.30). The reproducibility was ICC=.84[.75-.90] for Rasch and CFA scores and ICC=.78[.66-86] for logistic model. CONCLUSIONS: Three alternatives explored to build a composite score showed similar construct validity. Some metric superiority (better score distribution and reproducibility) of the Rasch model is promising for the detection of occurrence and assessment of severity of a flare in OA.

How Similar Are Drug Data and Disease Self-report? Estimating the Prevalence of Chronic Diseases in Less Developed Settings.

BACKGROUND: Drug data has been used to estimate the prevalence of chronic diseases. Disease registries and annual surveys are lacking, especially in less-developed regions. At the same time, insurance drug data and self-reports of medications are easily accessible and inexpensive. We aim to investigate the similarity of prevalence estimation between self-report data of some chronic diseases and drug data in a less developed setting in southwestern Iran. METHODS: Baseline data from the Pars Cohort Study (PCS) was re-analyzed. The use of disease-related drugs were compared against self-report of each disease (hypertension [HTN], diabetes mellitus [DM], heart disease, stroke, chronic obstructive pulmonary disease [COPD], sleep disorder, anxiety, depression, gastroesophageal reflux disease [GERD], irritable bowel syndrome [IBS], and functional constipation [FC]). We used sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the Jaccard similarity index. RESULTS: The top five similarities were observed in DM (54%), HTN (53%), heart disease (32%), COPD (30%), and GERD (15%). The similarity between drug use and self-report was found to be low in IBS (2%), stroke (5%), depression (9%), sleep disorders (10%), and anxiety disorders (11%). CONCLUSION: Self-reports of diseases and the drug data show a different picture of most diseases' prevalence in our setting. It seems that drug data alone cannot estimate the prevalence of diseases in settings similar to ours. We recommend using drug data in combination with self-report data for epidemiological investigation in the less-developed setting.

Measurement invariance of the PROMIS emotional distress and subjective well-being domains among autistic and General Population adolescents.

PURPOSE: Quality of life (QoL) is identified as a clinical and research priority by the autistic community. Researchers have the responsibility to ensure that instruments used to measure QoL do so reliably and accurately among autistic participants. METHODS: Our study evaluated measurement invariance of Emotional Distress (Depression, Anxiety, Anger, Psychological Stress) and Subjective Well-Being (Life Satisfaction, Positive Affect, and Meaning & Purpose) scales of the Patient-Reported Outcomes Measurement Information System (PROMIS) among groups of autistic (N=140, n per scale=132-140) and general population (N=1,224, n per scale=406-411) teenagers (14-17 years). These scales were included in the PROMIS Autism Battery-Lifespan, which uses PROMIS scales to measure QoL domains most relevant for autistic people. RESULTS: Multi-group confirmatory factor analyses using permutation tests demonstrated that Depression and Positive Affect scales exhibited scalar invariance between groups, indicating that scores can be meaningfully compared across autistic and general population teens. Anger and Psychological Stress scales demonstrated metric invariance between groups, indicating that these scales measure the same latent trait in both groups, but group comparisons are not supported. CONCLUSION: We provide guidance as to how these scales can be used in psychometrically supported ways to capture constructs relevant for understanding QoL among autistic teens.

Quality of life is an important outcome for autistic people and their families. However, many quality of life scales have not been tested to make sure they accurately measure quality of life among autistic people. It is important to make sure that quality of life measures works similarly among the autistic population. The goal of our study is to test whether scales on a common quality of life measure ­ the Patient-Reported Outcomes Measurement Information System (PROMIS) ­ measures quality of life in the same way between autistic and general population adolescents. We found that some of the PROMIS scales worked the same way for autistic and general population adolescents and others did not. These results help researchers confidently use the PROMIS scales to measure different aspects of quality of life among autistic youth.

The accuracy of parent/carer proxy-reporting of caries experience in children and association with socioeconomic circumstances: a cross-sectional data linkage study.

OBJECTIVES: To compare parent/carer proxy-reported dental caries experience of their 5-year-old child with epidemiological survey clinician examination of caries experience in the same children. To determine any differences in the accuracy by area-based socioeconomic group. METHODS: A cross-sectional data linkage study linked data from the Growing Up in Scotland (GUS) study and the National Dental Inspection Programme (NDIP) school epidemiology survey. Parent/carer proxy-reported caries experience was compared with clinician-measured caries experience on n=3008 children, and data were stratified by home-residential area-based socioeconomic deprivation levels (Scottish Index of Multiple Deprivation (SIMD)). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated overall and stratified by SIMD. RESULTS: Overall, parent/carer proxy-reporting had low sensitivity (42.3% 95%CI: 39.0, 45.7) that decreased with decreasing deprivation (SIMD-1(most deprived): 49.4% to SIMD-5 (least deprived): 37.2%). Specificity remained consistently high overall and across area-based socioeconomic deprivation levels (overall=96.2%, 95%CI: 95.3, 97.0; SIMD-1: 94.4% SIMD-5: 97.8%). In children whose parents/carers reported them to have caries experience (GUS) a high percentage were found to have caries experience (NDIP) (PPV=81.8%, 95%CI: 78.2, 84.9). CONCLUSION: Parent/carer proxy-reporting of caries experience in 5-year-old children had very low sensitivity and was lowest in children from the least deprived areas. In contrast, parents/carers who reported their child had caries experience did so reasonably accurately. This study concludes that proxy reporting caries experience is not sufficiently sensitive to replace clinician examination in assessing dental caries experience in surveys of child populations and highlights the importance of data linkage to routine datasets.

Conceptualisation of health among young people: a protocol for systematic review and thematic synthesis of qualitative studies.

BACKGROUND: Self-reported health is a widely used health indicator in surveys and questionnaires. The measure gained attention when research identified its association with mortality in the 1970s and 1980s. The measure is also associated with morbidity and other health outcomes such as the utilisation of health services. Self-reported health is a particularly useful measure for young people because this age group is generally clinically healthy. However, it is known that many chronic conditions have long latency periods that are initiated early in life. Because of its predictive nature, self-reported health can be used to estimate young people's current and future health. Despite its widespread use, however, self-reported health remains a poorly understood concept. This paper presents the protocol for a systematic review that will identify and synthesise qualitative studies that investigate the factors that are considered by young people when they assess their health, and when they talk about health overall. METHODS: The population of the review is young people aged 10-24 years, with or without health conditions. We will search the databases of MEDLINE (Ovid®), PsycINFO (APA PsycNet), ProQuest Sociology Collection, and Web of Science Core Collection™. We will also utilise techniques of reference checking and forward citation searching, as this strategy has been shown to result in a higher number of high-quality studies in social science systematic reviews. Google Scholar and Google Search were used during preliminary searches; Google Scholar will be utilised for forward citation searching. We will include studies written in English, German, or Finnish; there will be no lower date limit. One reviewer will screen all citations. A second reviewer will independently screen a sample of 20% of the abstracts. Data will be extracted by one researcher, two other researchers will independently review all data extracted, and quality appraisal will be completed by the first reviewer. We will utilise the Quality Framework for the appraisal of included articles and thematic synthesis of qualitative studies. DISCUSSION: The results of this systematic review will improve the understanding of the factors that are considered during the self-assessments of health; this will improve the interpretation of the results of quantitative research. Also, an improved understanding of the conceptualisation of health will inform the development of health policies and interventions that support young people's health. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022367519.

A Multi-Informant Assessment of Food Security in Adolescents: Discordance in Self-Report and Parent-Proxy Report.

Food insecurity is associated with a multitude of negative outcomes among adolescents. Despite adolescents' burgeoning autonomy, much of the research has relied on parent-proxy report, with few studies directly comparing adolescents' and parents' perceptions of adolescent food security. In the present study, parent-adolescent dyads (N = 144) completed questionnaires measuring perceptions of adolescent food security. Adolescents (12-17 years) completed the Child Food Security Survey Module. Parents completed the Household Food Security Survey Module. Dyads demonstrated discordant perceptions of adolescent food security on categorical- and item-levels of analysis. Further research is needed to elucidate explanations for these discrepancies using longitudinal designs.

Protocol for a systematic review evaluating psychometric properties and gender-related measurement (non)invariance of self-report assessment tools for autism in adults.

BACKGROUND: Given the recent evidence on gender differences in the presentation of autism, there is an increasing concern that current tools for autism do not adequately capture traits more often found in women. If tools for autism measure autistic traits differently based on gender alone, their validity may be compromised as they may not be measuring the same construct across genders. Measurement invariance investigations of autism measures can help assess the validity of autism constructs for different genders. The aim of this systematic review is to identify and critically appraise the psychometric properties of all self-report tools for autism in adults that meet two criteria: (a) they have been published since or included in the NICE (2014) recommendations, and (b) they have undergone gender-related measurement invariance investigations as part of their validation process. METHODS: A search of electronic databases will be conducted from 2014 until the present using MEDLINE, Embase, and PsycINFO using predefined search terms to identify eligible studies. The search for grey literature will include sources such as OpenGrey, APA PsycEXTRA, and Scopus. Two reviewers will independently screen titles, abstracts, and full texts for eligibility. The references of included studies will be searched for additional records. The methodological quality of the studies will be evaluated using the COSMIN Risk of Bias checklist, while psychometric quality of findings will be assessed based on criteria for good measurement properties and ConPsy checklist. The quality of the total body of evidence will be appraised using the approach outlined in the modified GRADE guidelines. DISCUSSION: This systematic review will be among the first to assess the psychometric properties and gender-related measurement invariance of self-reported measures for autism in adults that were published since (or included in) NICE (2014) guidelines. The review will provide recommendations for the most suitable tool to assess for autism without gender bias. If no such measure is found, it will identify existing tools with promising psychometric properties that require further testing, or suggest developing a new measure. SYSTEMATIC REVIEW REGISTRATION: The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO). The registration number is CRD42023429350.

A novel method to monitor rheumatoid arthritis prevalence using hospital and medication databases.

BACKGROUND: Most estimates of rheumatoid arthritis (RA) prevalence, including all official figures in Australia and many other countries, are based on self-report. Self-report has been shown to overestimate RA, but the 'gold standard' of reviewing individual medical records is costly, time-consuming and impractical for large-scale research and population monitoring. This study provides an algorithm to estimate RA cases using administrative data that can be adjusted for use in multiple contexts to provide the first approximate RA cohort in Australia that does not rely on self-report. METHODS: Survey data on self-reported RA and medications from 25 467 respondents of the Australian Longitudinal Study on Women's Health (ALSWH) were linked with data from the national medication reimbursement database, hospital and emergency department (ED) episodes, and Medicare Benefits codes. RA prevalence was calculated for self-reported RA, self-reported RA medications, dispensed RA medications, and hospital/ED RA presentations. Linked data were used to exclude individuals with confounding autoimmune conditions. RESULTS: Of 25 467 survey respondents, 1367 (5·4%) women self-reported disease. Of the 26 840 women with hospital or ED presentations, 292 (1·1%) received ICD-10 codes for RA. There were 1038 (2·8%) cases by the medication database definition, and 294 cases (1·5%) by the self-reported medication definition. After excluding individuals with other rheumatic conditions, prevalence was 3·9% for self-reported RA, 1·9% based on the medication database definition and 0·5% by self-reported medication definition. This confirms the overestimation of RA based on self-reporting. CONCLUSIONS: We provide an algorithm for identifying individuals with RA, which could be used for population studies and monitoring RA in Australia and, with adjustments, internationally. Its balance of accuracy and practicality will be useful for health service planning using relatively easily accessible input data.

Psychometric properties of the self-report version of the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale in a sample of Hungarian adolescents and young adults.

The Strengths and Weaknesses of ADHD Symptoms and Normal Behaviour Scale (SWAN) measures the full spectrum of attention and activity symptoms, not just the negative end of the distribution. Previous studies revealed strong psychometric properties of the parent and teacher report versions; however, there is little research on the new self-report form of the SWAN. Therefore, our research aimed to explore the psychometric characteristics of the SWAN self-report. A non-clinical sample of young women (N = 664, mean age: 20.01 years, SD: 3.08 years) completed the SWAN self-report, the Strengths and Difficulties Questionnaire (SDQ) and the Mental Health Continuum Short Form (MHC-SF). We tested several models using confirmatory factor analyses to assess the factorial validity of the SWAN self-report. Distributional characteristics, convergent, and predictive validity were assessed. A bifactor model with a general factor and a specific inattention factor (bifactor-1) provided the best fit in our data (CFI = 0.977, TLI/NFI = 0.972, RMSEA = 0.053 [90% CI: 0.047 - 0.059], SRMR = 0.061, ω = 0.90). The reliability of the general ADHD factor was good (ωh = 0.87), and the specific inattention factor was acceptable (ωh = 0.73). The distribution of the SWAN self-report scores did not differ from the normal distribution. A strong correlation between the SWAN and the SDQ Hyperactivity subscale was found. The analyses revealed good predictive validity. Our results suggest that the SWAN self-report is a valuable tool for assessing symptoms of ADHD in adolescents and young adults.

Stability and Validity of Self-Reported Depression and Anxiety in Autistic Youth.

The aim of this study was to assess test-retest reliability and diagnostic validity of self-report instruments of depression and anxiety in autistic youth. Participants were 55 autistic youth aged 8-17 years presenting with depressive or anxiety symptoms. They were interviewed with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL) and completed the Children's Depression Inventory, Second Edition - Self Report Short (CDI 2:SR[S]) and the Revised Child Anxiety and Depression Scale (RCADS) twice, separated by a two-week interval. Test-retest reliability was measured with intraclass correlation coefficients (ICCs), and diagnostic validity was assessed using receiver operating characteristic (ROC) curves with the summary ratings on the K-SADS-PL as the criterion. The effect of participant characteristics was analyzed through a moderation analysis. Generalized anxiety (GAD) and social anxiety disorder (SOC) were the two most prevalent disorders in the sample. Test-retest reliability for most of the subscales was good (ICC = 0.74 - 0.87), with the exception of the RCADS obsessive-compulsive disorder (OCD) and GAD. The Adaptive Behavior conceptual score was a significant moderator of the reliability of the CDI 2:SR[S]. The ROC analysis suggested the RCADS SOC and the CDI 2:SR[S] to be good screening tools with inadequate specificity when appropriately sensitive cutoff scores are used. Optimal cutoff scores in this sample were lower than originally published. The findings suggest that autistic youth can provide stable reports of anxiety and depressive symptoms over time. Diagnostic validity varied according to the construct and instrument.

Change on the Revised Hearing Handicap Inventory and associated factors: results from a longitudinal cohort study.

OBJECTIVE: Describe how the Revised Hearing Handicap Inventory (RHHI) changes over time and determine associated factors. DESIGN: Data were from a community-based cohort study. Linear regression models were used to estimate mean baseline and final RHHI scores and change (final minus baseline score). Logistic regression models were used to determine factors associated with substantial RHHI change, defined as ±6 points. Factors included baseline age, sex, race, hearing aid use, and baseline pure-tone average (PTA; 0.5, 1.0, 2.0, 4.0 kHz, worse ear). STUDY SAMPLE: This study included 583 participants (mean age: 66.4 [SD 9.1] years; 59.9% female; 14.2% Minority race) with a mean follow-up time of 7.6 (SD 4.9) years. RESULTS: Baseline and final RHHI scores were 7.9 and 9.2 points, corresponding to an average 1.3-point increase in hearing difficulty over time. Most participants (65.4%) did not show substantial RHHI change, whereas 21.4% and 13.2% experienced substantial increase and decrease, respectively. In separate multivariable models, PTA and hearing aid use were associated with substantial increase in hearing difficulty, and PTA was associated with substantial decrease. CONCLUSIONS: The average RHHI change was relatively small. Hearing aid use and PTA were associated with RHHI change.

Exploration of a Machine Learning Model Using Self-rating Questionnaires for Detecting Depression in Patients with Breast Cancer.

Objective: Given the long-term and severe distress experienced during breast cancer treatment, detecting depression among breast cancer patients is clinically crucial. This study aimed to explore a machine-learning model using self-report questionnaires to screen for depression in patients with breast cancer. Methods: A total of 327 patients who visited the breast cancer clinic were included in this study. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9), Beck Depression Inventory (BDI), and Hospital Anxiety and Depression Scale (HADS). The depression was evaluated according to the Diagnostic and Statistical Manual of Mental Disorders 5th edition. The prediction model's performance based on supervised machine learning was conducted using MATLAB2022. Results: The BDI showed an area under the curve (AUC) of 0.785 when using the logistic regression (LR) classifier. The HADS and PHQ-9 showed an AUC of 0.784 and 0.756 when using the linear discriminant analysis, respectively. The combinations of BDI and HADS showed an AUC of 0.812 when using the LR. The combinations of PHQ-9, BDI, and HADS showed an AUC of 0.807 when using LR. Conclusion: The combination model with BDI and HADS in breast cancer patients might be better than the method using a single scale. In future studies, it is necessary to explore strategies that can improve the performance of the model by integrating the method using questionnaires and other methods.

Use of an electronic wellness instrument in the integrated health and social care of older adults: a group concept mapping study.

BACKGROUND: Health system fragmentation directly contributes to poor health and social outcomes for older adults with multiple chronic conditions and their care partners. Older adults often require support from primary care, multiple specialists, home care, community support services, and other health-care sectors and communication between these providers is unstructured and not standardized. Integrated and interprofessional team-based models of care are a recommended strategy to improve health service delivery to older adults with complex needs. Standardized assessment instruments deployed on digital platforms are considered a necessary component of integrated care. The aim of this study was to develop strategies to leverage an electronic wellness instrument, interRAI Check Up Self Report, to support integrated health and social care for older adults and their care partners in a community in Southern Ontario, Canada. METHODS: Group concept mapping, a participatory mixed-methods approach, was conducted. Participants included older adults, care partners, and representatives from: home care, community support services, specialized geriatric services, primary care, and health informatics. In a series of virtual meetings, participants generated ideas to implement the interRAI Check Up and rated the relative importance of these ideas. Hierarchical cluster analysis was used to map the ideas into clusters of similar statements. Participants reviewed the map to co-create an action plan. RESULTS: Forty-one participants contributed to a cluster map of ten action areas (e.g., engagement of older adults and care partners, instrument's ease of use, accessibility of the assessment process, person-centred process, training and education for providers, provider coordination, health information integration, health system decision support and quality improvement, and privacy and confidentiality). The health system decision support cluster was rated as the lowest relative importance and the health information integration was cluster rated as the highest relative importance. CONCLUSIONS: Many person-, provider-, and system-level factors need to be considered when implementing and using an electronic wellness instrument across health- and social-care providers. These factors are highly relevant to the integration of other standardized instruments into interprofessional team care to ensure a compassionate care approach as technology is introduced.

Psychometric validation of the Montgomery-åsberg Depression Rating Scale - Youth (MADRS-Y) in a clinical sample.

BACKGROUND: Depression in adolescence is a serious major global health problem with increasing rates of prevalence. Measures of depression that are valid for young people are clearly needed in clinical contexts. METHODS: The study included 577 patients from child and adolescent psychiatry (n = 471) and primary care (n = 106) aged 12-22 years in Sweden (Mage=16.7 years; 76% female). The reliability and validity for Montgomery-Åsberg Depression Rating Scale - Youth (MADRS-Y) were investigated. To confirm the latent structure, we used a single-factor confirmatory factor analysis (CFA). A Kruskal-Wallis test was performed to test total score differences between diagnostic groups. Using Spearman's rho correlations, we examine whether single items in the MADRS-Y correlate with suicidal ideation measured by The Suicidal Ideation Questionnaire-JR (SIQ-JR). RESULTS: The internal consistency using McDonald's coefficient omega was excellent. The CFA of the 12-item MADRS-Y supported a one factor structure. Evidence of convergent and discriminant validity was shown. There was a significant difference in MADRS-Y scores across diagnostic groups, with higher results for depressive disorders. A strong correlation with suicidal ideation was found for two items. CONCLUSIONS: The results support MADRS-Y as a brief, reliable, and valid self-report questionnaire of depressive symptoms for young patients in a clinical setting.

Utilizing Digital Tools for Self-Report Symptom Assessment and Management in Pediatric Oncology: A Systematic Review.

PURPOSE: This study aims to identify, evaluate, and summarize evidence on digital tools that enable self-reported symptom assessment and management for pediatric oncology patients. METHODS: Seven academic databases, including PubMed, Cochrane Library, Scopus, Web of Science, CINAHL, and Medline (OVID), were searched systematically from inception until February 28, 2024. Inclusion criteria were the following: (a) study subjects were pediatric oncology patients and young adults, (b) using digital tools, (c) self-report symptom assessment and management, (d) employed either qualitative or quantitative study design, (e) written in English (f) published in peer-reviewed journals. This is a systematic review, and its protocol was registered in PROSPERO (ID: CRD42024528285). The study was conducted following the PRISMA statement. RESULTS: Twenty-seven studies were included in this systematic review. All included studies were conducted to develop digital tools for assessing and managing the symptoms. Eight of these studies focused only on the pain; three were only for nausea and vomiting, one for nausea, and the other 15 for all symptoms. The studies' quality ranged from low to high, with overall scores ranging between 4 and 24 out of 28. CONCLUSION: It shows that studies have generally focused on developing digital tools to address pain, nausea, vomiting, and other symptoms commonly experienced by pediatric oncology patients. While the quality of the included studies ranged from low to high, the overall findings show promise for the effectiveness and usability of these digital tools for symptom assessment and management in pediatric oncology care.

Simple Hip Value: a simple score to evaluate Hip function.

BACKGROUND: Several self-administered questionnaires are available for assessing hip function in clinical practice (HOOS-12, Oxford-12). These questionnaires can be used to assess and monitor patients with hip pathology. However, they are sometimes difficult to deploy in clinical practice. Recent studies on the shoulder and knee have shown that a single-question assessment provides a relevant evaluation of joint function, and correlates with more complex scores. However, this has not yet been evaluated for the hip. We set out to develop a single-question test that would enable patients to assess their hip function between 0 and 100. Therefore, we did a prospective study aiming to assess: (1) the relevance of the SHV (Simple Hip Value) test by comparing it with the Oxford-12 and HOOS-12 scores, (2) the discriminatory capacity and reproducibility of this test. HYPOTHESIS: The hypothesis of this study was that the assessment of hip function by a single-question patient-completed questionnaire (PROM) would be reliable and useful in clinical practice. PATIENTS AND METHODS: We conducted a prospective study including 74 patients operated on for total hip arthroplasty from February 2020 to April 2021 in a high-volume center and 20 healthy subjects. The SHV questionnaire, as well as HOOS-12 and OXFORD-12 were submitted on average 18 months after surgery, with values scaled to 100 points. A second test containing the 3 questionnaires was resubmitted to 20 patients randomly chosen from hip arthroplasty group to evaluate the reproducibility of the test. To evaluate the discrimination capacity of our test, 20 controls were selected to respond to the three questionnaires. RESULTS: Test results were median SHV, Oxford-12 and HOOS-12 scores of 90/100 (Interquartile Range [IQR]: 80-95), 88.5 (IQR: 77.1-95.8) and 79.1 (IQR: 65.1-93.2), respectively. The SHV was strongly correlated with the Oxford-12 (Spearman coefficient: 0.63 [IQR: 0.45-0.76]) and the HOOS-12 (Spearman coefficient: 0.66 [IQR: 0.46-0.79]). The SHV differed significantly from the control group (90.0 vs 100.0 in the control group [p < 0.001]) and had excellent reproducibility (Interclass Correlation Coefficient [ICC]: ICC: 0.82 [CI95%, 0.59-0.93]). DISCUSSION: The SHV test seems to be a reliable, reproducible and discriminating tool for assessing hip function after total hip arthroplasty, thus offering a simplified and practical approach for practitioners. Further testing in different populations would be useful to validate this test. LEVEL OF EVIDENCE: III; prospective comparative diagnostic study.