Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

Objective: To determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression. Design: Individual participant data meta-analysis. Data sources: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (January 2000-February 2015). Inclusion criteria: Eligible studies compared PHQ-9 scores with major depression diagnoses from validated diagnostic interviews. Primary study data and study level data extracted from primary reports were synthesized. For PHQ-9 cut-off scores 5-15, bivariate random effects meta-analysis was used to estimate pooled sensitivity and specificity, separately, among studies that used semistructured diagnostic interviews, which are designed for administration by clinicians; fully structured interviews, which are designed for lay administration; and the Mini International Neuropsychiatric (MINI) diagnostic interviews, a brief fully structured interview. Sensitivity and specificity were examined among participant subgroups and, separately, using meta-regression, considering all subgroup variables in a single model. Results: Data were obtained for 58 of 72 eligible studies (total n=17 357; major depression cases n=2312). Combined sensitivity and specificity was maximized at a cut-off score of 10 or above among studies using a semistructured interview (29 studies, 6725 participants; sensitivity 0.88, 95% confidence interval 0.83 to 0.92; specificity 0.85, 0.82 to 0.88). Across cut-off scores 5-15, sensitivity with semistructured interviews was 5-22% higher than for fully structured interviews (MINI excluded; 14 studies, 7680 participants) and 2-15% higher than for the MINI (15 studies, 2952 participants). Specificity was similar across diagnostic interviews. The PHQ-9 seems to be similarly sensitive but may be less specific for younger patients than for older patients; a cut-off score of 10 or above can be used regardless of age.. Conclusions: PHQ-9 sensitivity compared with semistructured diagnostic interviews was greater than in previous conventional meta-analyses that combined reference standards. A cut-off score of 10 or above maximized combined sensitivity and specificity overall and for subgroups. Registration: PROSPERO CRD42014010673

Probability of major depression diagnostic classification using semi-structured vs. fully structured diagnostic interviews

Background: Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification. Aims: To evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics. Method: Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analyzed. Binomial Generalized Linear Mixed Models were fit. Results: 17,158 participants (2,287 major depression cases) from 57 primary studies were analyzed. Among fully structured interviews, odds of major depression were higher for the MINI compared to the Composite International Diagnostic Interview (CIDI) [OR (95% CI) = 2.10 (1.15-3.87)]. Compared to semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores 6) as having major depression [OR (95% CI) = 3.13 (0.98-10.00)], similarly likely for moderate-level symptoms (PHQ-9 scores 7-15) [OR (95% CI) = 0.96 (0.56-1.66)], and significantly less likely for high-level symptoms (PHQ-9 scores 16) [OR (95% CI) = 0.50 (0.26-0.97)]. Conclusions: The MINI may identify more depressed cases than the CIDI, and semi- and fully structured interviews may not be interchangeable methods, but these results should be replicated

Temperament and Language Skills as Predictors of Teacher–Child Relationship Quality in Preschool

Current educational policy emphasizes “school readiness” of young children with a premium placed on preschool interventions that facilitate academic and social readiness for children who have had limited learning experiences prior to kindergarten (Rouse, Brooks–Gunn, & McLanahan, 2005). The teacher–child relationship is viewed as a critical mechanism for the effectiveness of interventions (Girolametto, Weitzman, & Greenberg, 2003; National Institute of Child Health and Human Development Early Child Care Research Network, 2003). The purpose of this study was to determine how children’s temperament and language skills predict teacher–child relationship quality. The sample consisted of 99 at-risk preschool students. Three findings emerged: (a) bolder children with lower language complexity were more likely to have higher levels of conflict in their relationships with teachers, (b) shyer children with greater language complexity were more likely to have dependent relationships with their teachers, and (c) teacher effects accounted for more of the variance in conflictual and dependent teacher–child relationships compared to children’s behavioral inhibition and language complexity. This study shows that teacher–child relationships are multirelational. Individual differences in temperament and language skills affect teacher–child interactions, and ultimately, contribute to the effectiveness of classroom interventions. Such information helps to unpack the complexities of classroom quality by increasing awareness among practitioners of factors contributing to positive teacher–child relationships

Dual excitation wavelength system for combined fingerprint and high wavenumber Raman spectroscopy

A fiber optic probe-based Raman spectroscopy system using a single laser module with two excitation wavelengths, at 680 and 785 nm, has been developed for measuring the fingerprint and high wavenumber regions using a single detector. This system is simpler and less expensive than previously reported configurations of combined fingerprint and high wavenumber Raman systems, and its probe-based implementation facilitates numerous in vivo applications. The high wavenumber region of the Raman spectrum ranges from 2800-3800 cm-1 and contains valuable information corresponding to the molecular vibrations of proteins, lipids, and water, which is complimentary to the biochemical signatures found in the fingerprint region (800-1800 cm-1), which probes DNA, lipids, and proteins. The efficacy of the system is demonstrated by tracking changes in water content in tissue-mimicking phantoms, where Voigtian decomposition of the high wavenumber water peak revealed a correlation between the water content and type of water-tissue interactions in the samples. This dual wavelength system was then used for in vivo assessment of cervical remodeling during mouse pregnancy, a physiologic process with known changes in tissue hydration. The system shows that Raman spectroscopy is sensitive to changes in collagen content in the fingerprint region and hydration state in the high wavenumber region, which was verified using an ex vivo comparison of wet and dry weight. Simultaneous fingerprint and high wavenumber Raman spectroscopy will allow precise in vivo quantification of tissue water content in the high wavenumber region, paired with the high biochemical specificity of the fingerprint region

Exposure to multiple career pathways by biomedical doctoral students at a public research university

<div><p>The Broadening Experiences in Scientific Experiences (BEST) program at Wayne State University was designed to increase doctoral students’ awareness of multiple employment sectors beyond academia, improve their knowledge of transferable skills required to succeed in any career path, provide opportunities to explore diverse career paths, and gain in-depth knowledge about those paths using experiential learning opportunities. We devised a three-phase program that ranged from providing students with a broad introduction to multiple career opportunities to immersive experiential learning in a specific career sector. Importantly, program content was developed and delivered by alumni and industry experts in five employment sectors–business/industry, communication, government, law/regulatory affairs, and undergraduate/PUI teaching–in partnership with WSU faculty. This article provides data on two notable outcomes: doctoral students participate equally in BEST activities regardless of gender, race, and citizenship status, and student participation in BEST activities did not correlate with lower GRE ratings, lower GPA, or increased time-to-degree. Further, a “halo” effect of the program is evidenced by participation of students from all disciplines, not just the biomedical sciences. Centralizing BEST activities within the Graduate School will allow faculty and individual programs to save resources and time.</p></div

Demographics of doctoral students participating in BEST events.

<p>The number of events attended by unique participants from 2014–17 (total N = 223) are displayed by (A) gender, (B) ethnicity, and (C) U.S citizenship status.</p