Screening for depression in older adults on an acute medical ward: the validity of NICE guidance in using two questions.
Background: depression is common in older people in general hospital settings and associated with poor outcomes. This study aimed to evaluate the validity of two screening questions recommended by the UK National Institute for Health and Clinical Excellence (NICE). Methods: one hundred and eighteen...
| Publicado en: | Age & Ageing Vol. 44; no. 5; pp. 771 - 776 |
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| Autores principales: | , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Sep2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=110181310&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 110181310 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Sep2015 vid: 44 iid: 5 pid: 622 pub: Oxford University Press / USA artinfo: ui: 110181310 10.1093/ageing/afv018 ppf: 771 ppct: 5 formats: tig: atl: Screening for depression in older adults on an acute medical ward: the validity of NICE guidance in using two questions. aug: au: ESIWE, COLLINS BAILLON, SARAH RAJKONWAR, ANIRUDDHA LINDESAY, JAMES LO, NELSON DENNIS, MICHAEL affil: Lincolnshire Partnership NHS Foundation Trust, Sleaford, Lincolnshire, UK Department of Health Sciences, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK Tees, Esk andWear Valley NHS Trust, County Durham, UK Department of Health Sciences, University of Leicester, Leicester, UK Department of Geriatric Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK College of Medicine, Swansea University, Swansea, UK su: United Kingdom Diagnosis of mental depression Critical care medicine Medical screening Psychological tests Old age Academic medical centers Confidence intervals Fisher exact test Probability theory T-test (Statistics) Research methodology evaluation Data analysis software Descriptive statistics Odds ratio sug: subj: Diagnosis of mental depression Critical care medicine Medical screening Psychological tests Old age United Kingdom All Other Miscellaneous Ambulatory Health Care Services Academic medical centers Confidence intervals Fisher exact test Probability theory T-test (Statistics) Research methodology evaluation Data analysis software Descriptive statistics Odds ratio keyword: acute medical wards depression older people screening acute medical wards depression older people screening ab: Background: depression is common in older people in general hospital settings and associated with poor outcomes. This study aimed to evaluate the validity of two screening questions recommended by the UK National Institute for Health and Clinical Excellence (NICE). Methods: one hundred and eighteen patients aged over 65 years, admitted to acute medical wards at a teaching hospital, were interviewed in a standardised manner using relevant sections of the Present State Examination—Schedules for Clinical Assessment in Neuropsychiatry to identify depression according to ICD-10 criteria. Subsequently, participants completed the two depression screening questions and the 15-item version of the Geriatric Depression Scale (GDS-15). Results: a threshold of one or more positive responses to the two NICE depression screening questions gave a sensitivity of 100%, specificity of 71%, positive predictive value (PPV) of 49% and negative predictive value (NPV) of 100%. The GDS-15 optimal cut-off was 6/7 with a sensitivity of 80%, specificity of 86%, PPV of 62% and NPV of 94%. A two-stage screening process utilising the NICE two questions followed by the GDS-15 with these cut-offs gave a sensitivity of 80%, specificity of 91%, PPVof 71% and NPVof 94%. Conclusion: the two depression questions perform well as an initial screening process for non-cognitively impaired older people in the acute medical setting. A positive response to either question would indicate that further assessment is required by a clinician competent in diagnosing depression in this population, or the possible use of a more detailed instrument such as the GDS-15 to reduce the number of false-positive cases. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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