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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One of the new criteria of positivity of exercise stress testing proposed by Detrano and Kligfield is the ST/HR index, obtained by calculating the ratio of additional ST depression on exercise over the corresponding variation in the heart rate. These authors reported that this ratio improved the diagnostic value of the exercise stress test with respect to the traditional ST segment depression, but that the proportion depended on whether the index was measured 80 or 60 ms after the J point. The object of this study was to assess the diagnostic performance of the ST/HR index measured 0, 20, 40, 60 and 80 ms after the J point by automatic analysis and to compare these five diagnostic indices with the classical ST segment depression (standard criterion) by ROC graphs and the Mac Nemar test. One hundred consecutive patients (73 men and 27 women) all symptomatic, underwent submaximal or symptom-limited exercise stress testing and accepted coronary angiography. The prevalence of greater than or equal to 50% coronary stenosis on at least one main vessel was 48%. None had previous myocardial infarction. The ROC graphs and areas under the curve demonstrated generally the superiority of the ST/HR index over the standard criteria. The optimal diagnostic performance was observed when the index was calculated 20 ms after the J point (ST 20/HR index).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Improvement of the diagnostic value of exercise test by heart-rate adjusted segment depression. Value of ST 20/HR index]. 156 19

Receiver operating characteristic analysis yields indices of diagnostic performance that permit innovative mathematical descriptions and comparisons of diagnostic tests whose results are distributed over a range of possible outcomes. We employed data from seven published studies to demonstrate how ROC analysis may be used to characterize the discriminative properties of the dexamethasone suppression test (DST). We also used an intrinsic property of test results--their ability to reduce diagnostic uncertainty--to select cortisol cutoff levels with the highest information content for each of the DST studies. These cutoffs often differ from original authors' definitions of nonsuppression. The information-maximizing cortisol levels vary depending on pretest estimates of the prevalence of depression or melancholia and vary among studies. Receiver operating characteristic analytic techniques provide important tools for a full description of the DST. Future studies should use receiver operating characteristic methods to select cortisol cutoffs and to assess the test's overall performance.
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PMID:Maximizing diagnostic information from the dexamethasone suppression test. An approach to criterion selection using receiver operating characteristic analysis. 266 Jul 71

We translated the Center for Epidemiologic Studies Depression (CES-D) Scale into Korean, paying careful attention to culturally different modes of expression of depressive feelings and thoughts. The final translated version (CES-D-K) was administered to 164 psychiatric patients and 464 normal subjects residing in the community. Reliability, validity, and the optimal cutoff point of this scale were estimated, including ROC analysis. The CES-D-K was reliable and valid for the Korean population. Two optimal cutoff points were suggested: 24/25, the point which best corresponded to the clinical diagnosis of depression, and 20/21, which most effectively detects and covers depressive symptoms during screening. The higher cutoff points than those in Western countries may be due to different ways of expression affect, especially the suppression of positive affect, in cultures based on Confucian ethics.
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PMID:Use of the Center for Epidemiologic Studies Depression (CES-D) Scale in Korea. 961 48

The Parent Questionnaire (scale A2), the Teacher Questionnaire (scale B2) by Rutter, and the Children's Depression Inventory (CDI) were validated using ROC-analysis. The material was collected from an epidemiological study of a normal population of 5664 8-9 year-old children. The screening results were compared with the corresponding parent, teacher, and child (DISC) interviews. In addition to this traditional way of validating the combined interview, results from all three interviews were also used. We found that the Teacher Questionnaire scale B2 was the most valid, and had the best overall power to discriminate psychiatric disturbances. The Teacher Questionnaire (scale B2) may be recommended when screening child psychiatric disturbances. The Parent Questionnaire (scale A2) was also found to be a valid instrument. Our results do not support the use of CDI as a sole screening instrument of psychiatric disturbances in children.
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PMID:Validity of child psychiatric screening methods. 971 75

This study assessed the diagnostic value of two new electrocardiographic criteria of coronary artery disease: the ST/HR index and the slope of the linear relationship between ST segment changes and the heart rate during the first three minutes of the post-exercise recovery period. These two criteria were compared to the standard criteria (> or = 1 mm horizontal or descending ST depression or > or = 2 mm ascending ST depression) to Detrano's ST/HR exercise index (> 1.6 microV/bpm in coronary patient), the exercise ST/HR slope (> or = 2.4 microV/bpm in coronary patients) and the exercise recovery loop (clockwise in normal and anticlockwise in coronary patients) in 88 subjects investigated for suspected coronary artery disease who underwent a computerised exercise stress test and coronary angiography (25 single vessel, 21 double vessel, 20 triple vessel disease; 22 with no significant coronary disease). The ROC identified thresholds of abnormality of the ST/HR recovery index at > or = 2.1 microV/bpm and of the ST/HR recovery slope at > or = 2.52 microV/bpm. Global comparison of the areas under the ROC showed the diagnostic superiority of the exercise ST/HR indices (0.96) over the standard criteria (0.92) and recovery indices (0.86) but without statistically significant values (p = 0.65 and p = 0.15 respectively). The ST/HR index and slope during recovery identify coronary disease with a diagnostic accuracy of 80% and 77% respectively which is similar to that (84%) of the standard ST criteria. The exercise-recovery loop was less accurate (64%).
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PMID:[Diagnostic value of ST depression corrected for heart rate in the post-exercise recovery period]. 974 32

Changes in the time courses of serum levels of interleukin-6 (IL6) and the soluble form of CD25 (sCD25) were evaluated in 48 burned patients (31 had sepsis, 21 died). Differences among groups along the time were assessed with ANOVA. The Pearson's r correlation coefficient was used to relate quantitative variables. ROC curves were constructed to analyse the prognostic value of IL6 and sCD25. The values of IL6 and sCD25 were related to treatment outcome and time post-burn. In general, two patterns emerged: In non-survivors, there was a depression of sCD25 with time, and an increase in IL6 levels previous to death, whereas survivors had the opposite pattern. On admission, patients with higher levels of sCD25 had a bad prognosis.
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PMID:Dynamic profiles of interleukin-6 and the soluble form of CD25 in burned patients. 1049 55

This study validated a French language version of an inventory designed to detect symptoms of depression and anxiety [Goldberg et al, 1987] in a sample of elderly French-speaking inpatients at risk for one of these disorders. Latent trait analysis was used to replicate the structure of the symptoms in the inventory, and receiver operating characteristic analysis was used to assess the performance of the inventory as a screening measure for Major Depressive Episode and Generalised Anxiety Disorder according to DSM-IV criteria. Reflecting the ascertainment of individuals in the sample as being at risk for a disorder, prevalence of individual symptoms was high although the general structure of the inventory was found to be comparable to that found in samples of both community elderly and younger medical patients. ROC analyses showed that the subscales of inventory performed satisfactorily as screening measures for anxiety or depression but lacked specificity for each disorder. In addition to providing further evidence for the utility of this inventory to detect general psychiatric distress in elderly persons, this study provides a valid means of detecting symptoms of depression and anxiety in French speaking groups.
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PMID:Detecting anxiety and depression in hospitalised elderly patients using a brief inventory. 1057 20

The psychometric properties of the Beck Depression Inventory (BDI) in subjects with Alzheimer's disease (AD) and depression have not been fully evaluated. Item endorsement patterns may be distorted by the presence of AD. This was tested by applying the BDI to a sample of 129 subjects with probable AD without depression and to 57 subjects with both probable AD and depression. It was found that the BDI under diagnoses depression in the context of AD. ROC curves for total BDI and cognitive and somatic items subsets showed low sensitivity and low areas under the curve indices. The results suggest that the BDI is not an ideal instrument to measure depression in AD. This may not result solely from the swing of the somatic items subset, but from other aspects which require further investigation.
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PMID:Psychometric behaviour of BDI in Alzheimer's disease patients with depression. 1063 6

The concurrent validity of the Hamilton Rating Scale for Depression (HAMD-17) and the Montgomery-Asberg Depression Rating Scale (MADRS) against the DSM-IV diagnosis 'depressive disorder' was assessed in patients with Parkinson's disease (PD). Sixty-three non-demented Parkinson's Disease (PD) patients who attended the outpatient department of an academic hospital were diagnosed according to a standardised research protocol. This protocol consisted of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) to establish the presence or absence of 'depressive disorder' according to the DSM-IV criteria, as well as the HAMD-17 and the MADRS. Receiver Operating Characteristics curves (ROC curves) were obtained and the positive and negative predictive values (PPV, NPV) were calculated for different cut-off scores. Maximum discrimination between depressed and non-depressed patients was reached at a cut-off score of 13/14 for the HAMD-17, and at 14/15 for the MADRS. At lower cut-offs, like 11/12 for the HAMD-17 and 14/15 for the MADRS, the high sensitivity and NPV make these scales good screening instruments. At higher cut-offs, such as 16/17 for the HAMD-17 and 17/18 for the MADRS, the high specificity and PPV make these instruments good diagnostic instruments. The diagnostics performance of the HAMD-17 is slightly better than that of the MADRS. This study shows that it is justified to use the HAMD-17 and the MADRS to measure depressive symptoms in both non-depressed and depressed PD patients, to diagnose depressive disorder in PD, and to dichotomize patient samples into depressed and non-depressed groups.
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PMID:The validity of the Hamilton and Montgomery-Asberg depression rating scales as screening and diagnostic tools for depression in Parkinson's disease. 1091 46

This is an open-label, single-arm, phase 3b study (part of phase 3 development) to evaluate the efficacy and safety of Fortovase-soft gelatin formulation (saquinavir-SGC), combined with zidovudine (ZDV) and lamivudine (3TC), human immune deficiency virus type 1 in (HIV-1)-positive, antiretroviral-naive individuals. Forty-two HIV-1-positive adults with plasma HIV RNA >10,000 copies per milliliter (Roche Amplicor HIV Monitor assay) and CD4 cell count >100 cells/mm(3) were treated with SQV-SGC, 1200 mg three times per day; ZDV, 300 mg; and 3TC, 150 mg each twice per day for 48 weeks. High proportions were drug users (26%), demonstrated psychiatric disorders (alcohol abuse [14%]/depression [14%]), or were inadequately housed (5%). At 48 weeks, 50% of patients achieved viral suppression <400 copies per milliliter with 43% <20 copies per milliliter using an intent-to-treat analysis (missing values counted as virological failures). Corresponding proportions for patients remaining on therapy at 48 weeks were 91% <400 copies per milliliter and 78% <20 copies per milliliter. Most adverse events were mild. Saquinavir-SGC combined with ZDV and 3TC, achieved potent and durable HIV RNA suppression and was well tolerated over 48 weeks in an antiretroviral-naive population including high proportions of individuals considered difficult to treat, such as drug users, people with psychiatric problems and homeless individuals.
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PMID:Challenges of antiretroviral treatment in transient and drug-using populations: the SUN study. 1131 25


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