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1. Quantitative perfusion and water transport time model from multi b-value diffusion magnetic resonance imaging validated against neutron capture microspheres

Author

Liu, M., Saadat, N., Jeong, Y., Roth, S., Niekrasz, M., Giurcanu, M., Carroll, T., and Christoforidis, G.

Subjects
Physics - Medical Physics, Electrical Engineering and Systems Science - Image and Video Processing
Abstract

Intravoxel Incoherent Motion (IVIM) is a non-contrast magnetic resonance imaging diffusion-based scan that uses a multitude of b-values to measure various speeds of molecular perfusion and diffusion, sidestepping inaccuracy of arterial input functions or bolus kinetics in quantitative imaging. We test a new method of IVIM quantification and compare our values to reference standard neutron capture microspheres across normocapnia, CO2 induced hypercapnia, and middle cerebral artery occlusion in a controlled animal model. Perfusion quantification in ml/100g/min compared to microsphere perfusion uses the 3D gaussian probability distribution and defined water transport time as when 50% of the molecules remain in the tissue of interest. Perfusion, water transport time, and infarct volume was compared to reference standards. Simulations were studied to suppress non-specific cerebrospinal fluid (CSF). Linear regression analysis of quantitative perfusion returned correlation (slope = .55, intercept = 52.5, $R^2$= .64). Linear regression for water transport time asymmetry in infarcted tissue was excellent (slope = .59, intercept = .3, $R^2$ = .93). Strong linear agreement also was found for infarct volume (slope = 1.01, $R^2$= .79). Simulation of CSF suppression via inversion recovery returned blood signal reduced by 82% from combined T1 and T2 effects. Intra-physiologic state comparison of perfusion shows potential partial volume effects which require further study especially in disease states. The accuracy and sensitivity of IVIM provides evidence that observed signal changes reflect cytotoxic edema and tissue perfusion. Partial volume contamination of CSF may be better removed during post-processing rather than with inversion recovery to avoid artificial loss of blood signal., Comment: 7 pages, 1 table, 6 figures, 3 pages appendix

Published
2023

5. ProAlgaZyme and its subfractions increase plasma HDL cholesterol via upregulation of ApoA1, ABCA1, and SRB1, and inhibition of CETP in hypercholesterolemic hamsters

Author

Geamanu A, Saadat N, Goja A, Wadehra M, Ji X, and Gupta SV

Subjects
Nutrition. Foods and food supply, TX341-641, Nutritional diseases. Deficiency diseases, RC620-627
Abstract

Andreea Geamanu, Nadia Saadat, Arvind Goja, Monika Wadehra, Xiangming Ji, Smiti V GuptaNutrition and Food Science, Wayne State University, Detroit, MI, USABackground: Plasma HDL cholesterol levels are inversely related to cardiovascular disease, which is the leading cause of death worldwide. This study investigated the effect of an algae infusion, ProAlgaZyme (PAZ), and its subfractions (P1, P2, P3, P4) on plasma HDL in a hamster model.Methods: Sixty male golden Syrian hamsters (8 weeks old) were randomized into controls (W) or PAZ (P), P1, P2, P3, and P4 (n = 10 per group). An infusion of either 5% (P1, P2, P3) or 20% (P, P4) concentration (v/v) was administered via the drinking water for 4 weeks, while the hamsters were being fed a high-fat diet (30% of calories from fat). Serum lipids were assayed and liver samples subjected to reverse transcription polymerase chain reaction to determine the relative transcription levels of genes involved in HDL/reverse cholesterol transport metabolism, ie, ApoA1, ABCA1, CETP, and SRB1.Results: Non-HDL cholesterol was significantly reduced in the P (P < 0.05), P3 and P4 (P < 0.001) groups as compared with the W group, while HDL cholesterol showed a significant increase in the P, P3, and P4 groups (P < 0.001). Moreover, the total cholesterol/HDL ratio was significantly improved in the P, P1, and P2 (P < 0.05), and P3 and P4 (P < 0.001) groups. The shift in cholesterol towards the higher density fractions was validated by density gradient ultracentrifugation. Real-time quantitative polymerase chain reaction showed a significant increase in hepatic ApoA1 (P, P4) and ABCA1 (P3, P4) expression, consistent with an increase in HDL production, biogenesis, and maturation. A two-fold increase in SRB1 expression indicates that P4 further augments the reverse cholesterol transport mechanism. Reduction of CETP expression (P4) is consistent with a decrease in the transfer of cholesteryl ester to LDL, further increasing the amount of cholesterol held as HDL particles.Conclusion: ProAlgaZyme and its subfractions significantly improved the plasma cholesterol profile by lowering non-HDL and increasing HDL, possibly via the reverse cholesterol transport mechanism.Keywords: ProAlgaZyme, ApoA1, ABCA1, SRB1, CETP, reverse cholesterol transport

Published
2012

6. Selective cutoff reporting in studies of the accuracy of the Patient Health Questionnaire‐9 and Edinburgh Postnatal Depression Scale: Comparison of results based on published cutoffs versus all cutoffs using individual participant data meta‐analysis

Author

Neupane, D., Levis, B., Bhandari, P.M., Thombs, B.D., Benedetti, A., Sun, Y., He, C., Wu, Y., Krishnan, A., Negeri, Z., Imran, M., Rice, D.B., Riehm, K.E., Saadat, N., Azar, M., Sanchez, T.A., Chiovitti, M.J., Levis, A.W., Boruff, J.T., Cuijpers, P., Gilbody, S., Ioannidis, J.P.A., Kloda, L.A., Patten, S.B., Shrier, I., Ziegelstein, R.C., Comeau, L., Mitchell, N.D., Tonelli, M., Vigod, S.N., Akena, D.H., Alvarado, R., Arroll, B., Bakare, M.O., Baradaran, H.R., Beck, C.T., Bombardier, C.H., Bunevicius, A., Carter, G., Chagas, M.H., Chaudron, L.H., Cholera, R., Clover, K., Conwell, Y., Castro e Couto, T., de Man-van Ginkel, J.M., Delgadillo, J., Fann, J.R., Favez, N., Fung, D., Garcia-Esteve, L., Gelaye, B., Goodyear-Smith, F., Hyphantis, T., Inagaki, M., Ismail, K., Jetté, N., Khalifa, D.S., Khamseh, M.E., Kohlhoff, J., Kozinszky, Z., Kusminskas, L., Liu, S.-I., Lotrakul, M., Loureiro, S.R., Löwe, B., Sidik, S.M., Nakić Radoš, S., Osório, F.L., Pawlby, S.J., Pence, B.W., Rochat, T.J., Rooney, A.G., Sharp, D.J., Stafford, L., Su, K.-P., Sung, S.C., Tadinac, M., Darius Tandon, S., Thiagayson, P., Töreki, A., Torres-Giménez, A., Turner, A., van der Feltz-Cornelis, C.M., Vega Dienstmaier, Johann Martín, Vöhringer, P.A., White, J., Whooley, M.A., Winkley, K., Yamada, M., DEPRESsion Screening Data (DEPRESSD) Collaboration, Clinical Psychology, World Health Organization (WHO) Collaborating Center, APH - Global Health, and APH - Mental Health

Subjects
Astrophysics::High Energy Astrophysical Phenomena, Bivariate analysis, Patient Health Questionnaire, Sensitivity and Specificity, 03 medical and health sciences, 0302 clinical medicine, male, diagnostic test accuracy, individual participant data meta‐analysis, meta‐analysis, publication bias, selective cutoff reporting, Bias, Statistics, Humans, Cutoff, Medicine, controlled study, Edinburgh Postnatal Depression Scale, diagnostic test accuracy study, human, Psychiatric Status Rating Scales, Depressive Disorder, Major, business.industry, adult, Individual participant data, article, Original Articles, Publication bias, Random effects model, individual participant data meta-analysis, 030227 psychiatry, meta-analysis, Psychiatry and Mental health, female, Meta-analysis, diagnostic accuracy, Original Article, business, 030217 neurology & neurosurgery, meta analysis, Patient Health Questionnaire 9
Abstract

Objectives\ud \ud Selectively reported results from only well-performing cutoffs in diagnostic accuracy studies may bias estimates in meta-analyses. We investigated cutoff reporting patterns for the Patient Health Questionnaire-9 (PHQ-9; standard cutoff 10) and Edinburgh Postnatal Depression Scale (EPDS; no standard cutoff, commonly used 10–13) and compared accuracy estimates based on published cutoffs versus all cutoffs.\ud \ud \ud \ud Methods\ud \ud We conducted bivariate random effects meta-analyses using individual participant data to compare accuracy from published versus all cutoffs.\ud \ud \ud \ud Results\ud \ud For the PHQ-9 (30 studies, N = 11,773), published results underestimated sensitivity for cutoffs below 10 (median difference: −0.06) and overestimated for cutoffs above 10 (median difference: 0.07). EPDS (19 studies, N = 3637) sensitivity estimates from published results were similar for cutoffs below 10 (median difference: 0.00) but higher for cutoffs above 13 (median difference: 0.14). Specificity estimates from published and all cutoffs were similar for both tools. The mean cutoff of all reported cutoffs in PHQ-9 studies with optimal cutoff below 10 was 8.8 compared to 11.8 for those with optimal cutoffs above 10. Mean for EPDS studies with optimal cutoffs below 10 was 9.9 compared to 11.8 for those with optimal cutoffs greater than 10.\ud \ud \ud \ud Conclusion\ud \ud Selective cutoff reporting was more pronounced for the PHQ-9 than EPDS.

Published
2021

8. Selective cutoff reporting in studies of the accuracy of the Patient Health Questionnaire-9 and Edinburgh Postnatal Depression Scale: Comparison of results based on published cutoffs versus all cutoffs using individual participant data meta-analysis

Author

Neupane, D, Levis, B, Bhandari, PM, Thombs, BD, Benedetti, A, Sun, Y, He, C, Wu, Y, Krishnan, A, Negeri, Z, Imran, M, Rice, DB, Riehm, KE, Saadat, N, Azar, M, Sanchez, TA, Chiovitti, MJ, Levis, AW, Boruff, JT, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, Patten, SB, Shrier, I, Ziegelstein, RC, Comeau, L, Mitchell, ND, Tonelli, M, Vigod, SN, Akena, DH, Alvarado, R, Arroll, B, Bakare, MO, Baradaran, HR, Beck, CT, Bombardier, CH, Bunevicius, A, Carter, G, Chagas, MH, Chaudron, LH, Cholera, R, Clover, K, Conwell, Y, Castro e Couto, T, de Man-van Ginkel, JM, Delgadillo, J, Fann, JR, Favez, N, Fung, D, Garcia-Esteve, L, Gelaye, B, Goodyear-Smith, F, Hyphantis, T, Inagaki, M, Ismail, K, Jetté, N, Khalifa, DS, Khamseh, ME, Kohlhoff, J, Kozinszky, Z, Kusminskas, L, Liu, SI, Lotrakul, M, Loureiro, SR, Löwe, B, Sidik, SM, Nakić Radoš, S, Osório, FL, Pawlby, SJ, Pence, BW, Rochat, TJ, Rooney, AG, Sharp, DJ, Stafford, L, Su, KP, Sung, SC, Tadinac, M, Darius Tandon, S, Thiagayson, P, Töreki, A, Torres-Giménez, A, Turner, Alyna, van der Feltz-Cornelis, CM, Vega-Dienstmaier, JM, Vöhringer, PA, White, J, Whooley, MA, Winkley, K, Yamada, M, Neupane, D, Levis, B, Bhandari, PM, Thombs, BD, Benedetti, A, Sun, Y, He, C, Wu, Y, Krishnan, A, Negeri, Z, Imran, M, Rice, DB, Riehm, KE, Saadat, N, Azar, M, Sanchez, TA, Chiovitti, MJ, Levis, AW, Boruff, JT, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, Patten, SB, Shrier, I, Ziegelstein, RC, Comeau, L, Mitchell, ND, Tonelli, M, Vigod, SN, Akena, DH, Alvarado, R, Arroll, B, Bakare, MO, Baradaran, HR, Beck, CT, Bombardier, CH, Bunevicius, A, Carter, G, Chagas, MH, Chaudron, LH, Cholera, R, Clover, K, Conwell, Y, Castro e Couto, T, de Man-van Ginkel, JM, Delgadillo, J, Fann, JR, Favez, N, Fung, D, Garcia-Esteve, L, Gelaye, B, Goodyear-Smith, F, Hyphantis, T, Inagaki, M, Ismail, K, Jetté, N, Khalifa, DS, Khamseh, ME, Kohlhoff, J, Kozinszky, Z, Kusminskas, L, Liu, SI, Lotrakul, M, Loureiro, SR, Löwe, B, Sidik, SM, Nakić Radoš, S, Osório, FL, Pawlby, SJ, Pence, BW, Rochat, TJ, Rooney, AG, Sharp, DJ, Stafford, L, Su, KP, Sung, SC, Tadinac, M, Darius Tandon, S, Thiagayson, P, Töreki, A, Torres-Giménez, A, Turner, Alyna, van der Feltz-Cornelis, CM, Vega-Dienstmaier, JM, Vöhringer, PA, White, J, Whooley, MA, Winkley, K, and Yamada, M

Abstract

Objectives: Selectively reported results from only well-performing cutoffs in diagnostic accuracy studies may bias estimates in meta-analyses. We investigated cutoff reporting patterns for the Patient Health Questionnaire-9 (PHQ-9; standard cutoff 10) and Edinburgh Postnatal Depression Scale (EPDS; no standard cutoff, commonly used 10–13) and compared accuracy estimates based on published cutoffs versus all cutoffs. Methods: We conducted bivariate random effects meta-analyses using individual participant data to compare accuracy from published versus all cutoffs. Results: For the PHQ-9 (30 studies, N = 11,773), published results underestimated sensitivity for cutoffs below 10 (median difference: −0.06) and overestimated for cutoffs above 10 (median difference: 0.07). EPDS (19 studies, N = 3637) sensitivity estimates from published results were similar for cutoffs below 10 (median difference: 0.00) but higher for cutoffs above 13 (median difference: 0.14). Specificity estimates from published and all cutoffs were similar for both tools. The mean cutoff of all reported cutoffs in PHQ-9 studies with optimal cutoff below 10 was 8.8 compared to 11.8 for those with optimal cutoffs above 10. Mean for EPDS studies with optimal cutoffs below 10 was 9.9 compared to 11.8 for those with optimal cutoffs greater than 10. Conclusion: Selective cutoff reporting was more pronounced for the PHQ-9 than EPDS.

Published
2021

10. Accuracy of the PHQ-2 Alone and in Combination With the PHQ-9 for Screening to Detect Major Depression: Systematic Review and Meta-analysis

Author

Levis B, Sun Y, He C, Wu Y, Krishnan A, Bhandari PM, Neupane D, Imran M, Brehaut E, Negeri Z, Fischer FH, Benedetti A, Thombs BD, Depression Screening Data (DEPRESSD) PHQ Collaboration, Che L, Levis A, Riehm K, Saadat N, Azar M, Rice D, Boruff J, Kloda L, Cuijpers P, Gilbody S, Ioannidis J, McMillan D, Patten S, Shrier I, Ziegelstein R, Moore A, Akena D, Amtmann D, Arroll B, Ayalon L, Baradaran H, Beraldi A, Bernstein C, Bhana A, Bombardier C, Buji RI, Butterworth P, Carter G, Chagas M, Chan J, Chan LF, Chibanda D, Cholera R, Clover K, Conway A, Conwell Y, Daray F, de Man-van Ginkel J, Delgadillo J, Diez-Quevedo C, Fann J, Field S, Fisher J, Fung D, Garman E, Gelaye B, Gholizadeh L, Gibson L, Goodyear-Smith F, Green E, Greeno C, Hall B, Hampel P, Hantsoo L, Haroz E, Harter M, Hegerl U, Hides L, Hobfoll S, Honikman S, Hudson M, Hyphantis T, Inagaki M, Ismail K, Jeon HJ, Jetté N, Khamseh M, Kiely K, Kohler S, Kohrt B, Kwan Y, Lamers F, Asunción Lara M, Levin-Aspenson H, Lino V, Liu S-I, Lotrakul M, Loureiro S, Löwe B, Luitel N, Lund C, Marrie RA, Marsh L, Marx B, McGuire A, Mohd Sidik S, Munhoz T, Muramatsu K, Nakku J, Navarrete L, Osório F, Patel V, Pence B, Persoons P, Petersen I, Picardi A, Pugh S, Quinn T, Rancans E, Rathod S, Reuter K, Roch S, Rooney A, Rowe H, Santos I, Schram M, Shaaban J, Shinn E, Sidebottom A, Simning A, Spangenberg L, Stafford L, Sung S, Suzuki K, Swartz R, Tan PLL, Taylor-Rowan M, Tran T, Turner A, van der Feltz-Cornelis C, van Heyningen T, van Weert H, Wagner L, Li Wang J, White J, Winkley K, Wynter K, Yamada M, Zhi Zeng Q, and Zhang Y

Subjects
Adult, Male, Depressive Disorder, Major, Patient Health Questionnaire, behavioral disciplines and activities, Sensitivity and Specificity, humanities, Interviews as Topic, ROC Curve, General & Internal Medicine, mental disorders, Humans, Mass Screening, Female, 11 Medical and Health Sciences
Abstract

Importance:The Patient Health Questionnaire depression module (PHQ-9) is a 9-item self-administered instrument used for detecting depression and assessing severity of depression. The Patient Health Questionnaire-2 (PHQ-2) consists of the first 2 items of the PHQ-9 (which assess the frequency of depressed mood and anhedonia) and can be used as a first step to identify patients for evaluation with the full PHQ-9. Objective:To estimate PHQ-2 accuracy alone and combined with the PHQ-9 for detecting major depression. Data Sources:MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO, and Web of Science (January 2000-May 2018). Study Selection:Eligible data sets compared PHQ-2 scores with major depression diagnoses from a validated diagnostic interview. Data Extraction and Synthesis:Individual participant data were synthesized with bivariate random-effects meta-analysis to estimate pooled sensitivity and specificity of the PHQ-2 alone among studies using semistructured, fully structured, or Mini International Neuropsychiatric Interview (MINI) diagnostic interviews separately and in combination with the PHQ-9 vs the PHQ-9 alone for studies that used semistructured interviews. The PHQ-2 score ranges from 0 to 6, and the PHQ-9 score ranges from 0 to 27. Results:Individual participant data were obtained from 100 of 136 eligible studies (44 318 participants; 4572 with major depression [10%]; mean [SD] age, 49 [17] years; 59% female). Among studies that used semistructured interviews, PHQ-2 sensitivity and specificity (95% CI) were 0.91 (0.88-0.94) and 0.67 (0.64-0.71) for cutoff scores of 2 or greater and 0.72 (0.67-0.77) and 0.85 (0.83-0.87) for cutoff scores of 3 or greater. Sensitivity was significantly greater for semistructured vs fully structured interviews. Specificity was not significantly different across the types of interviews. The area under the receiver operating characteristic curve was 0.88 (0.86-0.89) for semistructured interviews, 0.82 (0.81-0.84) for fully structured interviews, and 0.87 (0.85-0.88) for the MINI. There were no significant subgroup differences. For semistructured interviews, sensitivity for PHQ-2 scores of 2 or greater followed by PHQ-9 scores of 10 or greater (0.82 [0.76-0.86]) was not significantly different than PHQ-9 scores of 10 or greater alone (0.86 [0.80-0.90]); specificity for the combination was significantly but minimally higher (0.87 [0.84-0.89] vs 0.85 [0.82-0.87]). The area under the curve was 0.90 (0.89-0.91). The combination was estimated to reduce the number of participants needing to complete the full PHQ-9 by 57% (56%-58%). Conclusions and Relevance:In an individual participant data meta-analysis of studies that compared PHQ scores with major depression diagnoses, the combination of PHQ-2 (with cutoff ≥2) followed by PHQ-9 (with cutoff ≥10) had similar sensitivity but higher specificity compared with PHQ-9 cutoff scores of 10 or greater alone. Further research is needed to understand the clinical and research value of this combined approach to screening.

Published
2020

11. Probability of major depression classification based on the SCID, CIDI, and MINI diagnostic interviews: A synthesis of three individual participant data meta-analyses

Author

Wu, Y. Levis, B. Ioannidis, J.P.A. Benedetti, A. Thombs, B.D. Sun, Y. He, C. Krishnan, A. Bhandari, P.M. Neupane, D. Negeri, Z. Imran, M. Rice, D.B. Riehm, K.E. Saadat, N. Azar, M. Levis, A.W. Sanchez, T.A. Chiovitti, M.J. Yan, X.W. Boruff, J. Kloda, L.A. Cuijpers, P. Gilbody, S. McMillan, D. Patten, S.B. Shrier, I. Ziegelstein, R.C. Comeau, L. Mitchell, N.D. Tonelli, M. Vigod, S.N. Henry, M. Ismail, Z. Loiselle, C.G. Akena, D.H. Al-Adawi, S. Alamri, S.H. Alvarado, R. Alvarado-Esquivel, C. Amtmann, D. Arroll, B. Ayalon, L. Bakare, M.O. Baradaran, H.R. Barnes, J. Bavle, A.D. Beck, C.T. Beraldi, A. Bernstein, C.N. Bhana, A. Bindt, C. Bombardier, C.H. Boyce, P.M. Büel-Drabe, N. Buji, R.I. Bunevicius, A. Butnoriene, J. Bunevicius, R. Butterworth, P. Carter, G. Chagas, M.H. Chan, J.C.N. Chan, L.F. Chaudron, L.H. Chen, C.-K. Cholera, R. Clover, K. Conroy, R.M. Conway, A. Conwell, Y. Correa, H. Castro E Couto, T. Cukor, D. Dabscheck, E. Daray, F.M. De Figueiredo, F.P. De Man-Van Ginkel, J.M. Diez-Quevedo, C. Douven, E. Downing, M.G. Eapen, V. Fann, J.R. Feinstein, A. Ferentinos, P.P. Fernandes, M. Field, S. Figueiredo, B. Fischer, F.H. Fisher, J.R.W. Flint, A.J. Fujimori, M. Fung, D.S.S. Gallagher, P. Gandy, M. Garcia-Esteve, L. Garman, E.C. Gelaye, B. Gholizadeh, L. Giardinelli, L. Gibson, L.J. Goodyear-Smith, F. Grassi, L. Green, E.P. Greeno, C.G. Hall, B.J. Hantsoo, L. Haroz, E.E. Harter, M. Hegerl, U. Helle, N. Hides, L. Hobfoll, S.E. Honikman, S. Howard, L.M. Hudson, M. Hyphantis, T. Inagaki, M. Jenewein, J. Jeon, H.J. Jette, N. Keller, M. Khalifa, D.S. Khamseh, M.E. Kiely, K.M. Kim, S.-W. Kjargaard, M. Kohler, S. Kohlhoff, J. Kohrt, B.A. Kozinszky, Z. Kusminskas, L. Kwan, Y. Lamers, F. Lara, M.A. Lelli, L. Leonardou, A.A. Levin-Aspenson, H.F. Lotrakul, M. Loureiro, S.R. Lowe, B. Luitel, N.P. Lund, C. Maes, M. Marrie, R.A. Marsh, L. Martin-Santos, R. Marx, B.P. Massardo, L. Matsuoka, Y. Mehner, A. Meuti, V. Michopoulos, I. Misery, L. Sidik, S.M. Munhoz, T.N. Muramatsu, K. Radoš, S.N. Nakku, J.E.M. Navarrete, L. Garcia, P.N. Navines, R. Nishi, D. O'Donnell, M.L. Luwa E-Andjafono, D.O. Osório, F.L. Öztürk, A. Peceliuniene, J. Pence, B.W. Persoons, P. Picardi, A. Pintor, L. Ponsford, J.L. Pugh, S.L. Quinn, T.J. Rancans, E. Rathod, S.D. Reme, S.E. Reuter, K. Robertson-Blackmore, E. Rochat, T.J. Rooney, A.G. Rowe, H.J. Sánchez-González, R. Santos, I.S. Schram, M.T. Schwarzbold, M.L. Cankorur, V.S. Shaaban, J. Sharpe, L. Shinn, E.H. Sidebottom, A. Simard, S. Simning, A. Singer, S. Siu, B.W.M. Skalkidou, A. Spangenberg, L. Stafford, L. Stein, A. Stewart, R.C. Stone, J. Su, K.-P. Sultan, S. Sundström-Poromaa, I. Sung, S.C. Suzuki, K. Tadinac, M. Tan, P.L.L. Tandon, S.D. Taylor-Rowan, M. Teixeira, A.L. Tendais, I. Thiagayson, P. Tiringer, I. Töreki, A. Torres-Giménez, A. Tran, T.D. Trevillion, K. Tung, K.-Y. Turner, A. Turner, K. Van Der Feltz-Cornelis, C.M. Van Heyningen, T. Van Weert, H.C. Vega-Dienstmaier, J.M. Vöhringer, P.A. Wagner, L.I. Walterfang, M. Wang, J.L. Wang, W. Wang, L.-J. White, J. Wong, D.K. Wynter, K. Yamada, M. Yonkers, K.A. Zeng, Q.Z. Zhang, Y. DEPRESsion Screening Data (DEPRESSD) Collaboration

Abstract

Introduction: Three previous individual participant data meta-analyses (IPDMAs) reported that, compared to the Structured Clinical Interview for the DSM (SCID), alternative reference standards, primarily the Composite International Diagnostic Interview (CIDI) and the Mini International Neuropsychiatric Interview (MINI), tended to misclassify major depression status, when controlling for depression symptom severity. However, there was an important lack of precision in the results. Objective: To compare the odds of the major depression classification based on the SCID, CIDI, and MINI. Methods: We included and standardized data from 3 IPDMA databases. For each IPDMA, separately, we fitted binomial generalized linear mixed models to compare the adjusted odds ratios (aORs) of major depression classification, controlling for symptom severity and characteristics of participants, and the interaction between interview and symptom severity. Next, we synthesized results using a DerSimonian-Laird random-effects meta-analysis. Results: In total, 69,405 participants (7,574 [11%] with major depression) from 212 studies were included. Controlling for symptom severity and participant characteristics, the MINI (74 studies; 25,749 participants) classified major depression more often than the SCID (108 studies; 21,953 participants; aOR 1.46; 95% confidence interval [CI] 1.11-1.92]). Classification odds for the CIDI (30 studies; 21,703 participants) and the SCID did not differ overall (aOR 1.19; 95% CI 0.79-1.75); however, as screening scores increased, the aOR increased less for the CIDI than the SCID (interaction aOR 0.64; 95% CI 0.52-0.80). Conclusions: Compared to the SCID, the MINI classified major depression more often. The odds of the depression classification with the CIDI increased less as symptom levels increased. Interpretation of research that uses diagnostic interviews to classify depression should consider the interview characteristics. © 2020

Published
2020

12. Depression prevalence using the HADS-D compared to SCID major depression classification: An individual participant data meta-analysis

Author

Brehaut, E. Neupane, D. Levis, B. Wu, Y. Sun, Y. Krishnan, A. He, C. Bhandari, P.M. Negeri, Z. Riehm, K.E. Rice, D.B. Azar, M. Yan, X.W. Imran, M. Chiovitti, M.J. Saadat, N. Cuijpers, P. Ioannidis, J.P.A. Markham, S. Patten, S.B. Ziegelstein, R.C. Henry, M. Ismail, Z. Loiselle, C.G. Mitchell, N.D. Tonelli, M. Boruff, J.T. Kloda, L.A. Beraldi, A. Braeken, A.P.B.M. Carter, G. Clover, K. Conroy, R.M. Cukor, D. da Rocha e Silva, C.E. De Souza, J. Downing, M.G. Feinstein, A. Ferentinos, P.P. Fischer, F.H. Flint, A.J. Fujimori, M. Gallagher, P. Goebel, S. Jetté, N. Julião, M. Keller, M. Kjærgaard, M. Love, A.W. Löwe, B. Martin-Santos, R. Michopoulos, I. Navines, R. O'Rourke, S.J. Öztürk, A. Pintor, L. Ponsford, J.L. Rooney, A.G. Sánchez-González, R. Schwarzbold, M.L. Sharpe, M. Simard, S. Singer, S. Stone, J. Tung, K.-Y. Turner, A. Walker, J. Walterfang, M. White, J. Benedetti, A. Thombs, B.D.

Abstract

Objectives: Validated diagnostic interviews are required to classify depression status and estimate prevalence of disorder, but screening tools are often used instead. We used individual participant data meta-analysis to compare prevalence based on standard Hospital Anxiety and Depression Scale – depression subscale (HADS-D) cutoffs of ≥8 and ≥11 versus Structured Clinical Interview for DSM (SCID) major depression and determined if an alternative HADS-D cutoff could more accurately estimate prevalence. Methods: We searched Medline, Medline In-Process & Other Non-Indexed Citations via Ovid, PsycINFO, and Web of Science (inception-July 11, 2016) for studies comparing HADS-D scores to SCID major depression status. Pooled prevalence and pooled differences in prevalence for HADS-D cutoffs versus SCID major depression were estimated. Results: 6005 participants (689 SCID major depression cases) from 41 primary studies were included. Pooled prevalence was 24.5% (95% Confidence Interval (CI): 20.5%, 29.0%) for HADS-D ≥8, 10.7% (95% CI: 8.3%, 13.8%) for HADS-D ≥11, and 11.6% (95% CI: 9.2%, 14.6%) for SCID major depression. HADS-D ≥11 was closest to SCID major depression prevalence, but the 95% prediction interval for the difference that could be expected for HADS-D ≥11 versus SCID in a new study was −21.1% to 19.5%. Conclusions: HADS-D ≥8 substantially overestimates depression prevalence. Of all possible cutoff thresholds, HADS-D ≥11 was closest to the SCID, but there was substantial heterogeneity in the difference between HADS-D ≥11 and SCID-based estimates. HADS-D should not be used as a substitute for a validated diagnostic interview. © 2020 Elsevier Inc.

Published
2020

13. Probability of major depression diagnostic classification based on the SCID, CIDI and MINI diagnostic interviews controlling for Hospital Anxiety and Depression Scale – Depression subscale scores: An individual participant data meta-analysis of 73 primary studies

Author

Wu, Y. Levis, B. Sun, Y. Krishnan, A. He, C. Riehm, K.E. Rice, D.B. Azar, M. Yan, X.W. Neupane, D. Bhandari, P.M. Imran, M. Chiovitti, M.J. Saadat, N. Boruff, J.T. Cuijpers, P. Gilbody, S. McMillan, D. Ioannidis, J.P.A. Kloda, L.A. Patten, S.B. Shrier, I. Ziegelstein, R.C. Henry, M. Ismail, Z. Loiselle, C.G. Mitchell, N.D. Tonelli, M. Al-Adawi, S. Beraldi, A. Braeken, A.P.B.M. Büel-Drabe, N. Bunevicius, A. Carter, G. Chen, C.-K. Cheung, G. Clover, K. Conroy, R.M. Cukor, D. da Rocha e Silva, C.E. Dabscheck, E. Daray, F.M. Douven, E. Downing, M.G. Feinstein, A. Ferentinos, P.P. Fischer, F.H. Flint, A.J. Fujimori, M. Gallagher, P. Gandy, M. Goebel, S. Grassi, L. Härter, M. Jenewein, J. Jetté, N. Julião, M. Kim, J.-M. Kim, S.-W. Kjærgaard, M. Köhler, S. Loosman, W.L. Löwe, B. Martin-Santos, R. Massardo, L. Matsuoka, Y. Mehnert, A. Michopoulos, I. Misery, L. Navines, R. O'Donnell, M.L. Öztürk, A. Peceliuniene, J. Pintor, L. Ponsford, J.L. Quinn, T.J. Reme, S.E. Reuter, K. Rooney, A.G. Sánchez-González, R. Schwarzbold, M.L. Senturk Cankorur, V. Shaaban, J. Sharpe, L. Sharpe, M. Simard, S. Singer, S. Stafford, L. Stone, J. Sultan, S. Teixeira, A.L. Tiringer, I. Turner, A. Walker, J. Walterfang, M. Wang, L.-J. White, J. Wong, D.K. Benedetti, A. Thombs, B.D.

Abstract

Objective: Two previous individual participant data meta-analyses (IPDMAs) found that different diagnostic interviews classify different proportions of people as having major depression overall or by symptom levels. We compared the odds of major depression classification across diagnostic interviews among studies that administered the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Methods: Data accrued for an IPDMA on HADS-D diagnostic accuracy were analysed. We fit binomial generalized linear mixed models to compare odds of major depression classification for the Structured Clinical Interview for DSM (SCID), Composite International Diagnostic Interview (CIDI), and Mini International Neuropsychiatric Interview (MINI), controlling for HADS-D scores and participant characteristics with and without an interaction term between interview and HADS-D scores. Results: There were 15,856 participants (1942 [12%] with major depression) from 73 studies, including 15,335 (97%) non-psychiatric medical patients, 164 (1%) partners of medical patients, and 357 (2%) healthy adults. The MINI (27 studies, 7345 participants, 1066 major depression cases) classified participants as having major depression more often than the CIDI (10 studies, 3023 participants, 269 cases) (adjusted odds ratio [aOR] = 1.70 (0.84, 3.43)) and the semi-structured SCID (36 studies, 5488 participants, 607 cases) (aOR = 1.52 (1.01, 2.30)). The odds ratio for major depression classification with the CIDI was less likely to increase as HADS-D scores increased than for the SCID (interaction aOR = 0.92 (0.88, 0.96)). Conclusion: Compared to the SCID, the MINI may diagnose more participants as having major depression, and the CIDI may be less responsive to symptom severity. © 2019 Elsevier Inc.

Published
2020

15. The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis

Author

He, C, Levis, B, Riehm, KE, Saadat, N, Levis, AW, Azar, M, Rice, DB, Krishnan, A, Wu, Y, Sun, Y, Imran, M, Boruff, J, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, McMillan, D, Patten, SB, Shrier, I, Ziegelstein, RC, Turner, Alyna, He, C, Levis, B, Riehm, KE, Saadat, N, Levis, AW, Azar, M, Rice, DB, Krishnan, A, Wu, Y, Sun, Y, Imran, M, Boruff, J, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, McMillan, D, Patten, SB, Shrier, I, Ziegelstein, RC, and Turner, Alyna

Published
2020

16. Probability of major depression diagnostic classification based on the SCID, CIDI and MINI diagnostic interviews controlling for Hospital Anxiety and Depression Scale - Depression subscale scores: An individual participant data meta-analysis of 73 primary studies

Author

Wu, Y, Levis, B, Sun, Y, Krishnan, A, He, C, Riehm, KE, Rice, DB, Azar, M, Yan, XW, Neupane, D, Bhandari, PM, Imran, M, Chiovitti, MJ, Saadat, N, Boruff, JT, Cuijpers, P, Gilbody, S, McMillan, D, Ioannidis, JPA, Kloda, LA, Patten, SB, Shrier, I, Ziegelstein, RC, Henry, M, Ismail, Z, Loiselle, CG, Mitchell, ND, Tonelli, M, Al-Adawi, S, Beraldi, A, Braeken, APBM, Bueel-Drabe, N, Bunevicius, A, Carter, G, Chen, C-K, Cheung, G, Clover, K, Conroy, RM, Cukor, D, Rocha e Silva, CE, Dabscheck, E, Daray, FM, Douven, E, Downing, MG, Feinstein, A, Ferentinos, PP, Fischer, FH, Flint, AJ, Fujimori, M, Gallagher, P, Gandy, M, Goebel, S, Grassi, L, Haerter, M, Jenewein, J, Jette, N, Juliao, M, Kim, J-M, Kim, S-W, Kjaergaard, M, Kohler, S, Loosman, WL, Loewe, B, Martin-Santos, R, Massardo, L, Matsuoka, Y, Mehnert, A, Michopoulos, I, Misery, L, Navines, R, O'Donnell, ML, Ozturk, A, Peceliuniene, J, Pintor, L, Ponsford, JL, Quinn, TJ, Reme, SE, Reuter, K, Rooney, AG, Sanchez-Gonzalez, R, Schwarzbold, ML, Cankorur, VS, Shaaban, J, Sharpe, L, Sharpe, M, Simard, S, Singer, S, Stafford, L, Stone, J, Sultan, S, Teixeira, AL, Tiringer, I, Turner, A, Walker, J, Walterfang, M, Wang, L-J, White, J, Wong, DK, Benedetti, A, Thombs, BD, Wu, Y, Levis, B, Sun, Y, Krishnan, A, He, C, Riehm, KE, Rice, DB, Azar, M, Yan, XW, Neupane, D, Bhandari, PM, Imran, M, Chiovitti, MJ, Saadat, N, Boruff, JT, Cuijpers, P, Gilbody, S, McMillan, D, Ioannidis, JPA, Kloda, LA, Patten, SB, Shrier, I, Ziegelstein, RC, Henry, M, Ismail, Z, Loiselle, CG, Mitchell, ND, Tonelli, M, Al-Adawi, S, Beraldi, A, Braeken, APBM, Bueel-Drabe, N, Bunevicius, A, Carter, G, Chen, C-K, Cheung, G, Clover, K, Conroy, RM, Cukor, D, Rocha e Silva, CE, Dabscheck, E, Daray, FM, Douven, E, Downing, MG, Feinstein, A, Ferentinos, PP, Fischer, FH, Flint, AJ, Fujimori, M, Gallagher, P, Gandy, M, Goebel, S, Grassi, L, Haerter, M, Jenewein, J, Jette, N, Juliao, M, Kim, J-M, Kim, S-W, Kjaergaard, M, Kohler, S, Loosman, WL, Loewe, B, Martin-Santos, R, Massardo, L, Matsuoka, Y, Mehnert, A, Michopoulos, I, Misery, L, Navines, R, O'Donnell, ML, Ozturk, A, Peceliuniene, J, Pintor, L, Ponsford, JL, Quinn, TJ, Reme, SE, Reuter, K, Rooney, AG, Sanchez-Gonzalez, R, Schwarzbold, ML, Cankorur, VS, Shaaban, J, Sharpe, L, Sharpe, M, Simard, S, Singer, S, Stafford, L, Stone, J, Sultan, S, Teixeira, AL, Tiringer, I, Turner, A, Walker, J, Walterfang, M, Wang, L-J, White, J, Wong, DK, Benedetti, A, and Thombs, BD

Abstract

OBJECTIVE: Two previous individual participant data meta-analyses (IPDMAs) found that different diagnostic interviews classify different proportions of people as having major depression overall or by symptom levels. We compared the odds of major depression classification across diagnostic interviews among studies that administered the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). METHODS: Data accrued for an IPDMA on HADS-D diagnostic accuracy were analysed. We fit binomial generalized linear mixed models to compare odds of major depression classification for the Structured Clinical Interview for DSM (SCID), Composite International Diagnostic Interview (CIDI), and Mini International Neuropsychiatric Interview (MINI), controlling for HADS-D scores and participant characteristics with and without an interaction term between interview and HADS-D scores. RESULTS: There were 15,856 participants (1942 [12%] with major depression) from 73 studies, including 15,335 (97%) non-psychiatric medical patients, 164 (1%) partners of medical patients, and 357 (2%) healthy adults. The MINI (27 studies, 7345 participants, 1066 major depression cases) classified participants as having major depression more often than the CIDI (10 studies, 3023 participants, 269 cases) (adjusted odds ratio [aOR] = 1.70 (0.84, 3.43)) and the semi-structured SCID (36 studies, 5488 participants, 607 cases) (aOR = 1.52 (1.01, 2.30)). The odds ratio for major depression classification with the CIDI was less likely to increase as HADS-D scores increased than for the SCID (interaction aOR = 0.92 (0.88, 0.96)). CONCLUSION: Compared to the SCID, the MINI may diagnose more participants as having major depression, and the CIDI may be less responsive to symptom severity.

Published
2020

17. Depression prevalence using the HADS-D compared to SCID major depression classification: An individual participant data meta-analysis

Author

Brehaut, E, Neupane, D, Levis, B, Wu, Y, Sun, Y, Krishnan, A, He, C, Bhandari, PM, Negeri, Z, Riehm, KE, Rice, DB, Azar, M, Yan, XW, Imran, M, Chiovitti, MJ, Saadat, N, Cuijpers, P, Ioannidis, JPA, Markham, S, Patten, SB, Ziegelstein, RC, Henry, M, Ismail, Z, Loiselle, CG, Mitchell, ND, Tonelli, M, Boruff, JT, Kloda, LA, Beraldi, A, Braeken, APBM, Carter, G, Clover, K, Conroy, RM, Cukor, D, da Rocha E Silva, CE, De Souza, J, Downing, MG, Feinstein, A, Ferentinos, PP, Fischer, FH, Flint, AJ, Fujimori, M, Gallagher, P, Goebel, S, Jette, N, Juliao, M, Keller, M, Kjaergaard, M, Love, AW, Loewe, B, Martin-Santos, R, Michopoulos, I, Navines, R, O'Rourke, SJ, Ozturk, A, Pintor, L, Ponsford, JL, Rooney, AG, Sanchez-Gonzalez, R, Schwarzbold, ML, Sharpe, M, Simard, S, Singer, S, Stone, J, Tung, K-Y, Turner, A, Walker, J, Walterfang, M, White, J, Benedetti, A, Thombs, BD, Brehaut, E, Neupane, D, Levis, B, Wu, Y, Sun, Y, Krishnan, A, He, C, Bhandari, PM, Negeri, Z, Riehm, KE, Rice, DB, Azar, M, Yan, XW, Imran, M, Chiovitti, MJ, Saadat, N, Cuijpers, P, Ioannidis, JPA, Markham, S, Patten, SB, Ziegelstein, RC, Henry, M, Ismail, Z, Loiselle, CG, Mitchell, ND, Tonelli, M, Boruff, JT, Kloda, LA, Beraldi, A, Braeken, APBM, Carter, G, Clover, K, Conroy, RM, Cukor, D, da Rocha E Silva, CE, De Souza, J, Downing, MG, Feinstein, A, Ferentinos, PP, Fischer, FH, Flint, AJ, Fujimori, M, Gallagher, P, Goebel, S, Jette, N, Juliao, M, Keller, M, Kjaergaard, M, Love, AW, Loewe, B, Martin-Santos, R, Michopoulos, I, Navines, R, O'Rourke, SJ, Ozturk, A, Pintor, L, Ponsford, JL, Rooney, AG, Sanchez-Gonzalez, R, Schwarzbold, ML, Sharpe, M, Simard, S, Singer, S, Stone, J, Tung, K-Y, Turner, A, Walker, J, Walterfang, M, White, J, Benedetti, A, and Thombs, BD

Abstract

OBJECTIVES: Validated diagnostic interviews are required to classify depression status and estimate prevalence of disorder, but screening tools are often used instead. We used individual participant data meta-analysis to compare prevalence based on standard Hospital Anxiety and Depression Scale - depression subscale (HADS-D) cutoffs of ≥8 and ≥11 versus Structured Clinical Interview for DSM (SCID) major depression and determined if an alternative HADS-D cutoff could more accurately estimate prevalence. METHODS: We searched Medline, Medline In-Process & Other Non-Indexed Citations via Ovid, PsycINFO, and Web of Science (inception-July 11, 2016) for studies comparing HADS-D scores to SCID major depression status. Pooled prevalence and pooled differences in prevalence for HADS-D cutoffs versus SCID major depression were estimated. RESULTS: 6005 participants (689 SCID major depression cases) from 41 primary studies were included. Pooled prevalence was 24.5% (95% Confidence Interval (CI): 20.5%, 29.0%) for HADS-D ≥8, 10.7% (95% CI: 8.3%, 13.8%) for HADS-D ≥11, and 11.6% (95% CI: 9.2%, 14.6%) for SCID major depression. HADS-D ≥11 was closest to SCID major depression prevalence, but the 95% prediction interval for the difference that could be expected for HADS-D ≥11 versus SCID in a new study was -21.1% to 19.5%. CONCLUSIONS: HADS-D ≥8 substantially overestimates depression prevalence. Of all possible cutoff thresholds, HADS-D ≥11 was closest to the SCID, but there was substantial heterogeneity in the difference between HADS-D ≥11 and SCID-based estimates. HADS-D should not be used as a substitute for a validated diagnostic interview.

Published
2020

18. Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis.

Author

Wu, Y, Levis, B, Riehm, KE, Saadat, N, Levis, AW, Azar, M, Rice, DB, Boruff, J, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, McMillan, D, Patten, SB, Shrier, I, Ziegelstein, RC, Akena, DH, Arroll, B, Ayalon, L, Baradaran, HR, Baron, M, Bombardier, CH, Butterworth, P, Carter, G, Chagas, MH, Chan, JCN, Cholera, R, Conwell, Y, de Man-van Ginkel, JM, Fann, JR, Fischer, FH, Fung, D, Gelaye, B, Goodyear-Smith, F, Greeno, CG, Hall, BJ, Harrison, PA, Härter, M, Hegerl, U, Hides, L, Hobfoll, SE, Hudson, M, Hyphantis, T, Inagaki, MD, Jetté, N, Khamseh, ME, Kiely, KM, Kwan, Y, Lamers, F, Liu, S-I, Lotrakul, M, Loureiro, SR, Löwe, B, McGuire, A, Mohd-Sidik, S, Munhoz, TN, Muramatsu, K, Osório, FL, Patel, V, Pence, BW, Persoons, P, Picardi, A, Reuter, K, Rooney, AG, Santos, IS, Shaaban, J, Sidebottom, A, Simning, A, Stafford, MD, Sung, S, Tan, PLL, Turner, A, van Weert, HC, White, J, Whooley, MA, Winkley, K, Yamada, M, Benedetti, A, Thombs, BD, Wu, Y, Levis, B, Riehm, KE, Saadat, N, Levis, AW, Azar, M, Rice, DB, Boruff, J, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, McMillan, D, Patten, SB, Shrier, I, Ziegelstein, RC, Akena, DH, Arroll, B, Ayalon, L, Baradaran, HR, Baron, M, Bombardier, CH, Butterworth, P, Carter, G, Chagas, MH, Chan, JCN, Cholera, R, Conwell, Y, de Man-van Ginkel, JM, Fann, JR, Fischer, FH, Fung, D, Gelaye, B, Goodyear-Smith, F, Greeno, CG, Hall, BJ, Harrison, PA, Härter, M, Hegerl, U, Hides, L, Hobfoll, SE, Hudson, M, Hyphantis, T, Inagaki, MD, Jetté, N, Khamseh, ME, Kiely, KM, Kwan, Y, Lamers, F, Liu, S-I, Lotrakul, M, Loureiro, SR, Löwe, B, McGuire, A, Mohd-Sidik, S, Munhoz, TN, Muramatsu, K, Osório, FL, Patel, V, Pence, BW, Persoons, P, Picardi, A, Reuter, K, Rooney, AG, Santos, IS, Shaaban, J, Sidebottom, A, Simning, A, Stafford, MD, Sung, S, Tan, PLL, Turner, A, van Weert, HC, White, J, Whooley, MA, Winkley, K, Yamada, M, Benedetti, A, and Thombs, BD

Abstract

BACKGROUND: Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9. METHODS: We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy. RESULTS: 16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (-0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01). CONCLUSIONS: PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.

Published
2020

19. Estimating the sample mean and standard deviation from commonly reported quantiles in meta-analysis

Author

McGrath, S, Zhao, X, Steele, R, Thombs, BD, Benedetti, A, Levis, B, Riehm, KE, Saadat, N, Levis, AW, Azar, M, Rice, DB, Sun, Y, Krishnan, A, He, C, Wu, Y, Bhandari, PM, Neupane, D, Imran, M, Boruff, J, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, McMillan, D, Patten, SB, Shrier, I, Ziegelstein, RC, Akena, DH, Arroll, B, Ayalon, L, Baradaran, HR, Baron, M, Beraldi, A, Bombardier, CH, Butterworth, P, Carter, G, Chagas, MH, Chan, JCN, Cholera, R, Chowdhary, N, Clover, K, Conwell, Y, Ginkel, JMDM-V, Delgadillo, J, Fann, JR, Fischer, FH, Fischler, B, Fung, D, Gelaye, B, Goodyear-Smith, F, Greeno, CG, Hall, BJ, Harrison, PA, Harter, M, Hegerl, U, Hides, L, Hobfoll, SE, Hudson, M, Hyphantis, T, Inagaki, M, Ismail, K, Jette, N, Khamseh, ME, Kiely, KM, Kwan, Y, Lamers, F, Liu, S-I, Lotrakul, M, Loureiro, SR, Loewe, B, Marsh, L, McGuire, A, Sidik, SM, Munhoz, TN, Muramatsu, K, Osorio, FL, Patel, V, Pence, BW, Persoons, P, Picardi, A, Reuter, K, Rooney, AG, Santos, IS, Shaaban, J, Sidebottom, A, Simning, A, Stafford, L, Sung, SC, Tan, PLL, Turner, A, van der Feltz-Cornelis, CM, van Weert, HC, Vohringer, PA, White, J, Whooley, MA, Winkley, K, Yamada, M, Zhang, Y, McGrath, S, Zhao, X, Steele, R, Thombs, BD, Benedetti, A, Levis, B, Riehm, KE, Saadat, N, Levis, AW, Azar, M, Rice, DB, Sun, Y, Krishnan, A, He, C, Wu, Y, Bhandari, PM, Neupane, D, Imran, M, Boruff, J, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, McMillan, D, Patten, SB, Shrier, I, Ziegelstein, RC, Akena, DH, Arroll, B, Ayalon, L, Baradaran, HR, Baron, M, Beraldi, A, Bombardier, CH, Butterworth, P, Carter, G, Chagas, MH, Chan, JCN, Cholera, R, Chowdhary, N, Clover, K, Conwell, Y, Ginkel, JMDM-V, Delgadillo, J, Fann, JR, Fischer, FH, Fischler, B, Fung, D, Gelaye, B, Goodyear-Smith, F, Greeno, CG, Hall, BJ, Harrison, PA, Harter, M, Hegerl, U, Hides, L, Hobfoll, SE, Hudson, M, Hyphantis, T, Inagaki, M, Ismail, K, Jette, N, Khamseh, ME, Kiely, KM, Kwan, Y, Lamers, F, Liu, S-I, Lotrakul, M, Loureiro, SR, Loewe, B, Marsh, L, McGuire, A, Sidik, SM, Munhoz, TN, Muramatsu, K, Osorio, FL, Patel, V, Pence, BW, Persoons, P, Picardi, A, Reuter, K, Rooney, AG, Santos, IS, Shaaban, J, Sidebottom, A, Simning, A, Stafford, L, Sung, SC, Tan, PLL, Turner, A, van der Feltz-Cornelis, CM, van Weert, HC, Vohringer, PA, White, J, Whooley, MA, Winkley, K, Yamada, M, and Zhang, Y

Abstract

Researchers increasingly use meta-analysis to synthesize the results of several studies in order to estimate a common effect. When the outcome variable is continuous, standard meta-analytic approaches assume that the primary studies report the sample mean and standard deviation of the outcome. However, when the outcome is skewed, authors sometimes summarize the data by reporting the sample median and one or both of (i) the minimum and maximum values and (ii) the first and third quartiles, but do not report the mean or standard deviation. To include these studies in meta-analysis, several methods have been developed to estimate the sample mean and standard deviation from the reported summary data. A major limitation of these widely used methods is that they assume that the outcome distribution is normal, which is unlikely to be tenable for studies reporting medians. We propose two novel approaches to estimate the sample mean and standard deviation when data are suspected to be non-normal. Our simulation results and empirical assessments show that the proposed methods often perform better than the existing methods when applied to non-normal data.

Published
2020

20. Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis.

Author

Levis, B, Benedetti, A, Ioannidis, JPA, Sun, Y, Negeri, Z, He, C, Wu, Y, Krishnan, A, Bhandari, PM, Neupane, D, Imran, M, Rice, DB, Riehm, KE, Saadat, N, Azar, M, Boruff, J, Cuijpers, P, Gilbody, S, Kloda, LA, McMillan, D, Patten, SB, Shrier, I, Ziegelstein, RC, Alamri, SH, Amtmann, D, Ayalon, L, Baradaran, HR, Beraldi, A, Bernstein, CN, Bhana, A, Bombardier, CH, Carter, G, Chagas, MH, Chibanda, D, Clover, K, Conwell, Y, Diez-Quevedo, C, Fann, JR, Fischer, FH, Gholizadeh, L, Gibson, LJ, Green, EP, Greeno, CG, Hall, BJ, Haroz, EE, Ismail, K, Jetté, N, Khamseh, ME, Kwan, Y, Lara, MA, Liu, S-I, Loureiro, SR, Löwe, B, Marrie, RA, Marsh, L, McGuire, A, Muramatsu, K, Navarrete, L, Osório, FL, Petersen, I, Picardi, A, Pugh, SL, Quinn, TJ, Rooney, AG, Shinn, EH, Sidebottom, A, Spangenberg, L, Tan, PLL, Taylor-Rowan, M, Turner, A, van Weert, HC, Vöhringer, PA, Wagner, LI, White, J, Winkley, K, Thombs, BD, Levis, B, Benedetti, A, Ioannidis, JPA, Sun, Y, Negeri, Z, He, C, Wu, Y, Krishnan, A, Bhandari, PM, Neupane, D, Imran, M, Rice, DB, Riehm, KE, Saadat, N, Azar, M, Boruff, J, Cuijpers, P, Gilbody, S, Kloda, LA, McMillan, D, Patten, SB, Shrier, I, Ziegelstein, RC, Alamri, SH, Amtmann, D, Ayalon, L, Baradaran, HR, Beraldi, A, Bernstein, CN, Bhana, A, Bombardier, CH, Carter, G, Chagas, MH, Chibanda, D, Clover, K, Conwell, Y, Diez-Quevedo, C, Fann, JR, Fischer, FH, Gholizadeh, L, Gibson, LJ, Green, EP, Greeno, CG, Hall, BJ, Haroz, EE, Ismail, K, Jetté, N, Khamseh, ME, Kwan, Y, Lara, MA, Liu, S-I, Loureiro, SR, Löwe, B, Marrie, RA, Marsh, L, McGuire, A, Muramatsu, K, Navarrete, L, Osório, FL, Petersen, I, Picardi, A, Pugh, SL, Quinn, TJ, Rooney, AG, Shinn, EH, Sidebottom, A, Spangenberg, L, Tan, PLL, Taylor-Rowan, M, Turner, A, van Weert, HC, Vöhringer, PA, Wagner, LI, White, J, Winkley, K, and Thombs, BD

Abstract

OBJECTIVES: Depression symptom questionnaires are not for diagnostic classification. Patient Health Questionnaire-9 (PHQ-9) scores ≥10 are nonetheless often used to estimate depression prevalence. We compared PHQ-9 ≥10 prevalence to Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) major depression prevalence and assessed whether an alternative PHQ-9 cutoff could more accurately estimate prevalence. STUDY DESIGN AND SETTING: Individual participant data meta-analysis of datasets comparing PHQ-9 scores to SCID major depression status. RESULTS: A total of 9,242 participants (1,389 SCID major depression cases) from 44 primary studies were included. Pooled PHQ-9 ≥10 prevalence was 24.6% (95% confidence interval [CI]: 20.8%, 28.9%); pooled SCID major depression prevalence was 12.1% (95% CI: 9.6%, 15.2%); and pooled difference was 11.9% (95% CI: 9.3%, 14.6%). The mean study-level PHQ-9 ≥10 to SCID-based prevalence ratio was 2.5 times. PHQ-9 ≥14 and the PHQ-9 diagnostic algorithm provided prevalence closest to SCID major depression prevalence, but study-level prevalence differed from SCID-based prevalence by an average absolute difference of 4.8% for PHQ-9 ≥14 (95% prediction interval: -13.6%, 14.5%) and 5.6% for the PHQ-9 diagnostic algorithm (95% prediction interval: -16.4%, 15.0%). CONCLUSION: PHQ-9 ≥10 substantially overestimates depression prevalence. There is too much heterogeneity to correct statistically in individual studies.

Published
2020

25. Comparison of major depression diagnostic classification probability using the SCID, CIDI, and MINI diagnostic interviews among women in pregnancy or postpartum: An individual participant data meta-analysis

Author

Levis, B, McMillan, D, Sun, Y, He, C, Rice, DB, Krishnan, A, Wu, Y, Azar, M, Sanchez, TA, Chiovitti, MJ, Bhandari, PM, Neupane, D, Saadat, N, Riehm, KE, Imran, M, Boruff, JT, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, Patten, SB, Shrier, I, Ziegelstein, RC, Comeau, L, Mitchell, ND, Tonelli, M, Vigod, SN, Aceti, F, Alvarado, R, Alvarado-Esquivel, C, Bakare, MO, Barnes, J, Beck, CT, Bindt, C, Boyce, PM, Bunevicius, A, Couto, TCE, Chaudron, LH, Correa, H, de Figueiredo, FP, Eapen, V, Fernandes, M, Figueiredo, B, Fisher, JRW, Garcia-Esteve, L, Giardinelli, L, Helle, N, Howard, LM, Khalifa, DS, Kohlhoff, J, Kusminskas, L, Kozinszky, Z, Lelli, L, Leonardou, AA, Lewis, BA, Maes, M, Meuti, V, Nakić Radoš, S, Navarro García, P, Nishi, D, Okitundu Luwa E-Andjafono, D, Robertson-Blackmore, E, Rochat, TJ, Rowe, HJ, Siu, BWM, Skalkidou, A, Stein, A, Stewart, RC, Su, KP, Sundström-Poromaa, I, Tadinac, M, Tandon, SD, Tendais, I, Thiagayson, P, Töreki, A, Torres-Giménez, A, Tran, TD, Trevillion, K, Turner, K, Vega-Dienstmaier, JM, Wynter, K, Yonkers, KA, Benedetti, A, Thombs, BD, Levis, B, McMillan, D, Sun, Y, He, C, Rice, DB, Krishnan, A, Wu, Y, Azar, M, Sanchez, TA, Chiovitti, MJ, Bhandari, PM, Neupane, D, Saadat, N, Riehm, KE, Imran, M, Boruff, JT, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, Patten, SB, Shrier, I, Ziegelstein, RC, Comeau, L, Mitchell, ND, Tonelli, M, Vigod, SN, Aceti, F, Alvarado, R, Alvarado-Esquivel, C, Bakare, MO, Barnes, J, Beck, CT, Bindt, C, Boyce, PM, Bunevicius, A, Couto, TCE, Chaudron, LH, Correa, H, de Figueiredo, FP, Eapen, V, Fernandes, M, Figueiredo, B, Fisher, JRW, Garcia-Esteve, L, Giardinelli, L, Helle, N, Howard, LM, Khalifa, DS, Kohlhoff, J, Kusminskas, L, Kozinszky, Z, Lelli, L, Leonardou, AA, Lewis, BA, Maes, M, Meuti, V, Nakić Radoš, S, Navarro García, P, Nishi, D, Okitundu Luwa E-Andjafono, D, Robertson-Blackmore, E, Rochat, TJ, Rowe, HJ, Siu, BWM, Skalkidou, A, Stein, A, Stewart, RC, Su, KP, Sundström-Poromaa, I, Tadinac, M, Tandon, SD, Tendais, I, Thiagayson, P, Töreki, A, Torres-Giménez, A, Tran, TD, Trevillion, K, Turner, K, Vega-Dienstmaier, JM, Wynter, K, Yonkers, KA, Benedetti, A, and Thombs, BD

Abstract

Objectives: A previous individual participant data meta-analysis (IPDMA) identified differences in major depression classification rates between different diagnostic interviews, controlling for depressive symptoms on the basis of the Patient Health Questionnaire-9. We aimed to determine whether similar results would be seen in a different population, using studies that administered the Edinburgh Postnatal Depression Scale (EPDS) in pregnancy or postpartum. Methods: Data accrued for an EPDS diagnostic accuracy IPDMA were analysed. Binomial generalised linear mixed models were fit to compare depression classification odds for the Mini International Neuropsychiatric Interview (MINI), Composite International Diagnostic Interview (CIDI), and Structured Clinical Interview for DSM (SCID), controlling for EPDS scores and participant characteristics. Results: Among fully structured interviews, the MINI (15 studies, 2,532 participants, 342 major depression cases) classified depression more often than the CIDI (3 studies, 2,948 participants, 194 major depression cases; adjusted odds ratio [aOR] = 3.72, 95% confidence interval [CI] [1.21, 11.43]). Compared with the semistructured SCID (28 studies, 7,403 participants, 1,027 major depression cases), odds with the CIDI (interaction aOR = 0.88, 95% CI [0.85, 0.92]) and MINI (interaction aOR = 0.95, 95% CI [0.92, 0.99]) increased less as EPDS scores increased. Conclusion: Different interviews may not classify major depression equivalently.

Published
2019

26. Shortening self-report mental health symptom measures through optimal test assembly methods: Development and validation of the Patient Health Questionnaire-Depression-4

Author

Ishihara, M., Harel, D., Levis, B., Levis, A.W., Riehm, K.E., Saadat, N., Azar, M., Rice, D.B., Sanchez, T.A., Chiovitti, M.J., Cuijpers, P., Gilbody, S., Ioannidis, J.P.A., Kloda, L.A., McMillan, D., Patten, S.B., Shrier, I., Arroll, B., Bombardier, C.H., Butterworth, P., Carter, G., Clover, K., Conwell, Y., Goodyear-Smith, F., Greeno, C.G., Hambridge, J., Harrison, P.A., Hudson, M., Jetté, N., Kiely, K.M., McGuire, A., Pence, B.W., Rooney, A.G., Sidebottom, A., Simning, A., Turner, A., White, J., Whooley, M.A., Winkley, K., Benedetti, A., Thombs, B.D., Ishihara, M., Harel, D., Levis, B., Levis, A.W., Riehm, K.E., Saadat, N., Azar, M., Rice, D.B., Sanchez, T.A., Chiovitti, M.J., Cuijpers, P., Gilbody, S., Ioannidis, J.P.A., Kloda, L.A., McMillan, D., Patten, S.B., Shrier, I., Arroll, B., Bombardier, C.H., Butterworth, P., Carter, G., Clover, K., Conwell, Y., Goodyear-Smith, F., Greeno, C.G., Hambridge, J., Harrison, P.A., Hudson, M., Jetté, N., Kiely, K.M., McGuire, A., Pence, B.W., Rooney, A.G., Sidebottom, A., Simning, A., Turner, A., White, J., Whooley, M.A., Winkley, K., Benedetti, A., and Thombs, B.D.

Abstract

Background: The objective of this study was to develop and validate a short form of the Patient Health Questionnaire-9 (PHQ-9), a self-report questionnaire for assessing depressive symptomatology, using objective criteria. Methods: Responses on the PHQ-9 were obtained from 7,850 English-speaking participants enrolled in 20 primary diagnostic test accuracy studies. PHQ unidimensionality was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally precise short form for each possible length between one and eight items, including and excluding the ninth item. The final short form was selected based on prespecified validity, reliability, and diagnostic accuracy criteria. Results: A four-item short form of the PHQ (PHQ-Dep-4) was selected. The PHQ-Dep-4 had a Cronbach's alpha of 0.805. Sensitivity and specificity of the PHQ-Dep-4 were 0.788 and 0.837, respectively, and were statistically equivalent to the PHQ-9 (sensitivity = 0.761, specificity = 0.866). The correlation of total scores with the full PHQ-9 was high (r = 0.919). Conclusion: The PHQ-Dep-4 is a valid short form with minimal loss of information of scores when compared to the full-length PHQ-9. Although OTA methods have been used to shorten patient-reported outcome measures based on objective, prespecified criteria, further studies are required to validate this general procedure for broader use in health research. Furthermore, due to unexamined heterogeneity, there is a need to replicate the results of this study in different patient populations.

Published
2019
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27. Comparison of major depression diagnostic classification probability using the SCID, CIDI, and MINI diagnostic interviews among women in pregnancy or postpartum: an individual participant data meta-analysis

Author

Levis, B., McMillan, D., Sun, Y., He, C., Rice, D. B., Krishnan, A., Wu, Y., Azar, M., Sanchez, T. A., Chiovitti, M. J., Bhandari, P. M., Neupane, D., Saadat, N., Riehm, K. E., Imran, M., Boruff, J. T., Cuijpers, P., Gilbody, S., Ioannidis, J. P. A., ., Wynter, K., Levis, B., McMillan, D., Sun, Y., He, C., Rice, D. B., Krishnan, A., Wu, Y., Azar, M., Sanchez, T. A., Chiovitti, M. J., Bhandari, P. M., Neupane, D., Saadat, N., Riehm, K. E., Imran, M., Boruff, J. T., Cuijpers, P., Gilbody, S., Ioannidis, J. P. A., ., and Wynter, K.

Published
2019

28. Shortening self-report mental health symptom measures through optimal test assembly methods: Development and validation of the Patient Health Questionnaire-Depression-4

Author

Ishihara, M, Harel, D, Levis, B, Levis, AW, Riehm, KE, Saadat, N, Azar, M, Rice, DB, Sanchez, TA, Chiovitti, MJ, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, McMillan, D, Patten, SB, Shrier, I, Arroll, B, Bombardier, CH, Butterworth, P, Carter, G, Clover, K, Conwell, Y, Goodyear-Smith, F, Greeno, CG, Hambridge, J, Harrison, PA, Hudson, M, Jetté, N, Kiely, KM, McGuire, A, Pence, BW, Rooney, AG, Sidebottom, A, Simning, A, Turner, A, White, J, Whooley, MA, Winkley, K, Benedetti, A, Thombs, BD, Ishihara, M, Harel, D, Levis, B, Levis, AW, Riehm, KE, Saadat, N, Azar, M, Rice, DB, Sanchez, TA, Chiovitti, MJ, Cuijpers, P, Gilbody, S, Ioannidis, JPA, Kloda, LA, McMillan, D, Patten, SB, Shrier, I, Arroll, B, Bombardier, CH, Butterworth, P, Carter, G, Clover, K, Conwell, Y, Goodyear-Smith, F, Greeno, CG, Hambridge, J, Harrison, PA, Hudson, M, Jetté, N, Kiely, KM, McGuire, A, Pence, BW, Rooney, AG, Sidebottom, A, Simning, A, Turner, A, White, J, Whooley, MA, Winkley, K, Benedetti, A, and Thombs, BD

Abstract

Background: The objective of this study was to develop and validate a short form of the Patient Health Questionnaire-9 (PHQ-9), a self-report questionnaire for assessing depressive symptomatology, using objective criteria. Methods: Responses on the PHQ-9 were obtained from 7,850 English-speaking participants enrolled in 20 primary diagnostic test accuracy studies. PHQ unidimensionality was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally precise short form for each possible length between one and eight items, including and excluding the ninth item. The final short form was selected based on prespecified validity, reliability, and diagnostic accuracy criteria. Results: A four-item short form of the PHQ (PHQ-Dep-4) was selected. The PHQ-Dep-4 had a Cronbach's alpha of 0.805. Sensitivity and specificity of the PHQ-Dep-4 were 0.788 and 0.837, respectively, and were statistically equivalent to the PHQ-9 (sensitivity = 0.761, specificity = 0.866). The correlation of total scores with the full PHQ-9 was high (r = 0.919). Conclusion: The PHQ-Dep-4 is a valid short form with minimal loss of information of scores when compared to the full-length PHQ-9. Although OTA methods have been used to shorten patient-reported outcome measures based on objective, prespecified criteria, further studies are required to validate this general procedure for broader use in health research. Furthermore, due to unexamined heterogeneity, there is a need to replicate the results of this study in different patient populations.

Published
2019

29. Does Twice-weekly Cabergoline Improve Anthropometrical and Biochemical Profiles in Prediabetes? A Randomized Double-blind Clinical Trial Pilot Study

Author

Saadat, N., Hadi Esmaily, Abbasinazari, M., Tohidi, M., Salamzadeh, J., Hadaegh, F., Tolabi, M., Kalantar-Hormozi, M., and Dibaj, M.

Subjects
Glucose metabolism, Cabergoline, Anthropometric, IFG, Original Article, IGT, Prediabetes
Abstract

Dopaminergic signaling is one of the regulatory pathways being investigated for its implication in glucose metabolism. The aim of this study was to determine the effect of cabergoline on biochemical and anthropometric parameters in prediabetes stage (impaired fasting glucose and impaired glucose tolerance). In this double blind, placebo-controlled, pilot study, 27 prediabetic adults were randomized to receive 0.25-mg cabergoline twice weekly for two weeks, followed by 0.5 mg twice weekly for next 14 weeks (n = 13) or placebo (n = 14). All subjects were advised to follow a 500 kcal-deficit energy diet. Fasting plasma glucose (FPG), oral glucose tolerance, glycated hemoglobin (A1c), fasting, and 2-h insulin were measured at baseline and at 16-week follow-up. Homeostasis model assessment (HOMA) 2 was calculated to estimate steady-state beta-cell function, insulin sensitivity, and insulin resistance. Our results showed significant reductions in fasting (P = 0.004) and 2-h plasma glucose (P = 0.01) after treatment, and significant improvements in beta-cell function (P = 0.03) and insulin resistance (P = 0.04) in the cabergoline group. The trend of non-significant A1c changes was decreasing in the cabergoline group versus an increasing trend in the placebo group. All anthropometric parameters were similar between the two groups. Our results revealed that twice-weekly cabergoline could improve glucose metabolism in prediabetes stage. Larger studies of longer duration are warranted to investigate the effect of cabergoline in preventing progression of prediabetes to type 2 diabetes mellitus.

Published
2015

30. Comparison of Self-Efficacy for Managing Chronic Disease between patients with systemic sclerosis and other chronic conditions: A systematic review

Author

Thombs, B.D., Kwakkenbos, L., Riehm, K.E., Saadat, N., Fedoruk, C., Thombs, B.D., Kwakkenbos, L., Riehm, K.E., Saadat, N., and Fedoruk, C.

Abstract

Contains fulltext : 165999.pdf (publisher's version ) (Closed access), The complexity and burden of systemic sclerosis (SSc) pose challenges to developing and sustaining disease management self-efficacy. The objective of this systematic review was to compare scores on a commonly used self-efficacy measure, the Self-Efficacy for Managing Chronic Disease (SEMCD) Scale, between SSc and other diseases. Data sources included the CINAHL, EMBASE, MEDLINE, and Scopus databases, searched through January 25, 2016, and reference lists of included articles and relevant reviews. Studies in any language that reported total SEMCD scores or individual item scores in adult non-psychiatric medical patients were eligible. We identified one eligible non-intervention study of SSc patients (n = 553), 13 other non-intervention studies, and 21 studies with pre-intervention data for patients enrolled in a self-management program or a trial of a program. Of 13 non-intervention studies with published total score means in cancer, cardiovascular disease, Parkinson’s disease, spinal cord injuries, organ transplant candidates and recipients, dialysis, and lupus, SEMCD scores were statistically significantly lower (poorer self-efficacy) in SSc than 6 other disease samples, not significantly different from 6, and significantly higher than lupus patients. Compared to 18 studies of patients in self-management programs or trials with published total score means, SSc patients were similar or lower than 9 samples and significantly higher than 9 samples. Compared to patients with other diseases not enrolled in programs to improve self-efficacy, SSc patients report lower self-efficacy scores than most patient groups. Rigorously tested self-care interventions designed to meet the unique needs of patients with SSc are needed.

Published
2017

31. The diagnostic accuracy of the Hospital Anxiety and Depression Scale (HADS) for detecting major depression: Protocol for a systematic review and individual patient data meta-analyses

Author

Thombs, B.D, Benedetti, A., Kloda, L.A., Levis, B., Azar, M., Riehm, K.E., Saadat, N., Cuijpers, Pim, Gilbody, S., Ioannidis, J.P.A., McMillan, Dean, Patten, S.B., Shrier, I., Steele, R.J., Ziegelstein, R.C., Loiselle, C.G., Henry, M., Ismail, Z., Mitchell, N., Tonelli, M., Clinical Psychology, and EMGO+ - Mental Health

Published
2016

32. The Protective Effects of Exogenous Melatonin on Nicotine-induced Changes in Mouse Ovarian Follicles

Author

Fahimeh Mohammadghasemi, Jahromi, S. K., Hajizadeh, H., Homafar, M. A., and Saadat, N.

Subjects
Nicotine, Protection, Mouse, Ovary, Original Article, Ovarian follicle, Melatonin
Abstract

Background Nicotine exposure causes impaired fertility and ovarian dysfunction. The aim of this study was to investigate the possible protective role of melatonin, which is known as an antioxidant agent on altered ovarian functions upon nicotine exposure. Methods A total of 32 female adult NMRI mice were divided randomly into four groups (n = 8). The control group received vehicle, while group 2 received nicotine (40 µg/kg) for 15 days and group 3 melatonin (10 mg/kg) for 5 days. Group 4 received both nicotine (40 µg/kg) and melatonin (10 mg/kg) for the same periods. All animals were treated intraperitoneally. After autopsy on the 16th day, histopathological and morphometrical examinations were performed and serum estradiol concentrations were measured. The data were analyzed using ANOVA and Tukey post hoc test. A value of p < 0.05 was considered significant. Results Nicotine significantly reduced the number of pre-antral and antral follicles, as well as estradiol concentration compared to the control group (p < 0.05). However, the decrease in the number of primordial follicles was not significant in the nicotine treated group. A significant increase in the atretic follicles were observed in group 2 compared to the control group (p < 0.05). Moreover, melatonin caused a marked normalization in the number of ovarian follicles and estradiol levels in group 4 compared to group 2. Conclusion The results from this study suggest that melatonin may have a protective effect against nicotine-induced ovarian changes on the number of different stages of follicle growth.

Published
2012

35. A statistical evaluation of the capability of distributed renewable generator-energy-storage system in providing load low-voltage ride-through

Author

Saadat, N., Choi, San Shing, Vilathgamuwa, D., Saadat, N., Choi, San Shing, and Vilathgamuwa, D.

Abstract

© 1986-2012 IEEE. The capability of a distributed renewable generator (DRG) in providing load low-voltage ride-through (LVRT) is examined. The harnessed renewable power, load demand, and the occurrences of low-voltage incidents are treated as random variables. The probability of successful load LVRT is assessed through the use of a copula function to quantify the stochastic dependency between the load and the renewable power. The analysis is then applied to the case of a series-connected photovoltaic DRG incorporated with capacitor energy storage, wherein the focus is to establish the analytical relationship between the probability of successful load LVRT and the rated power/energy capacities of the DRG capacitor. Determination of the optimal capacities of the DRG capacitor is achieved through maximization of the expected economic benefits obtained from the renewable energy harness and load LVRT minus the cost of the DRG capacitor.

Published
2015

39. Effects of administration of iron, iodine and simultaneous iron-plus-iodine on the thyroid hormone profile in iron-deficient adolescent Iranian girls

Author

Eftekhari, M.H., Simondon, Kirsten, Jalali, M., Keshavarz, S.A., Elguero, Eric, Eshraghian, M.R., and Saadat, N.

Subjects
thyroid hormones, IODE, ferritin, GLANDE THYROIDE, supplementation trial, ADOLESCENT, FER, SUPPLEMENTATION, CONSOMMATION ALIMENTAIRE, HORMONE, iron, micronutrients, ANEMIE, ETUDE COMPARATIVE, DEFICIENCE, FERRITINE, SULFATE DE FER, ANALYSE STATISTIQUE
Abstract

Objective: To investigate whether iron supplementation can improve thyroid hormone function in iron-deficient adolescent girls. Design: A double-blind randomized intervention study. Setting: The study was performed from 2002 through 2003 in the Islamic Republic of Iran. Subjects: 103 iron-deficient non-anaemic girls who fulfilled all inclusion criteria were included, and 94 subjects successfully completed the study. Interventions: Patients were randomly assigned to one of four groups and treated with a single oral dose of 190 mg iodine plus 300 mg ferrous sulphate 5 times/week (n = 24), 300 mg ferrous sulphate 5 times/week (n = 23), a single oral dose of 190 mg iodine ( n 25), or a placebo ( n 22) for 12 weeks. Results: All groups were comparable at baseline. After the intervention, there was a significant increase in ferritin and transferrin saturation in the iron + iodine group (17.6 vs 8.7 mu g/dl, and 18.8 vs 7.2%, respectively, P

Published
2006

40. A series-connected photovoltaic distributed generator capable of enhancing power quality

Author

Saadat, N., Choi, San Shing, Vilathgamuwa, D., Saadat, N., Choi, San Shing, and Vilathgamuwa, D.

Abstract

Design of a series-connected photovoltaic generator (SPVG) capable of enhancing power quality is investigated. Analysis of the SPVG operations under disturbance conditions shows explicitly how achievable network voltage quality is affected by the SPVG injected power and its apparent power rating, and that voltage quality can be significantly improved even with a modest level of energy storage capacity incorporated in the SPVG. A control system for the SPVG is also proposed. Both simulation and laboratory tests confirm the efficacy of the distributed generator system. © 1986-2012 IEEE.

Published
2013

41. A statistical approach to quantify the impact on voltage quality caused by PV generators

Author

Liu, Y, Dong, Z, Saadat, N, Choi, S, Vilathgamuwa, Don, Liu, Y, Dong, Z, Saadat, N, Choi, S, and Vilathgamuwa, Don

Abstract

A probabilistic method is proposed to evaluate voltage quality of grid-connected photovoltaic (PV) power systems. The random behavior of solar irradiation is described in statistical terms and the resulting voltage fluctuation probability distribution is then derived. Reactive power capabilities of the PV generators are then analyzed and their operation under constant power factor mode is examined. By utilizing the reactive power capability of the PV-generators to the full, it is shown that network voltage quality can be greatly enhanced.

Published
2011

42. A statistical approach to quantify the impact on voltage quality caused by PV generators

Author

Saadat, N., Choi, San Shing, Vilathgamuwa, D., Saadat, N., Choi, San Shing, and Vilathgamuwa, D.

Abstract

A probabilistic method is proposed to evaluate voltage quality of grid-connected photovoltaic (PV) power systems. The random behavior of solar irradiation is described in statistical terms and the resulting voltage fluctuation probability distribution is then derived. Reactive power capabilities of the PV generators are then analyzed and their operation under constant power factor mode is examined. By utilizing the reactive power capability of the PV-generators to the full, it is shown that network voltage quality can be greatly enhanced. © 2011 IEEE.

Published
2011

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