Does method matter? Assessing the validity and clinical utility of structured diagnostic interviews among a clinical sample of first-admitted patients with psychosis: A replication study

IntroductionIncreasingly, diagnostic assessments in clinical practice are made using structured diagnostic interviews or self-rating scales imported into clinical practice from research studies and big-scale surveys. Although structured diagnostic interviews have been shown to be highly reliable in research, the use of such method in clinical contexts are more questionable. In fact the validity and clinical utility of such methods in naturalistic contexts have rarely been evaluated. In this study we report on a replication study of Nordgaard et al (22) Assessing the diagnostic validity of a structured psychiatric interview in a first-admission hospital sample. World Psychiatry, 11 (3): 181–185.MethodsThe study sample comprises 55 first-admitted inpatients to a treatment facility specializing in the assessment and treatment of patients with psychotic disorders.ResultsWe found poor agreement between diagnoses generated by Structured Clinical Interview for DSM-IV and Best-estimate consensus diagnoses (κ value 0.21).DiscussionWe identified over-reliance on self-report, vulnerability to response set in dissimulating patients, and a strong diagnosis and comorbidity focus, as possible reasons for misdiagnosis with the SCID. We conclude that structured diagnostic interviews performed by mental health professionals without solid psychopathological knowledge and experience are not recommendable for clinical practice

En mulighetsstudie for økt vekst innen innlandsoppdrett

Source at http://hdl.handle.net/11250/2482490SINTEF Fiskeri og havbruk har sammen med Bioforsk Nord og Nofuna Marked gjennomført en vurdering av mulighetene for økt vekst innen innlandsoppdrett i Norge. Følgende arter er vurdert: Røye, ørret, sik, regnbueørret, gjørs, abbor og lake. Studien gir en oversikt over innlandsoppdrett i Norge og i andre nordiske land. Mulighetene for utvikling av en innlandsoppdrettsnæring i Norge er ellers vurdert ut fra status og potensial innen produkt og marked, biologiske forhold, ressursbruk og miljøeffekter, teknologi samt forretningsmessige forhold. FoU-behovet er beskrevet og prioritert på grunnlag av vurderingene av status og potensia

En mulighetsstudie for økt vekst innen innlandsoppdrett

SINTEF Fiskeri og havbruk har sammen med Bioforsk Nord og Nofuna Marked gjennomført en vurdering av mulighetene for økt vekst innen innlandsoppdrett i Norge. Følgende arter er vurdert: Røye, ørret, sik, regnbueørret, gjørs, abbor og lake. Studien gir en oversikt over innlandsoppdrett i Norge og i andre nordiske land. Mulighetene for utvikling av en innlandsoppdrettsnæring i Norge er ellers vurdert ut fra status og potensial innen produkt og marked, biologiske forhold, ressursbruk og miljøeffekter, teknologi samt forretningsmessige forhold. FoU-behovet er beskrevet og prioritert på grunnlag av vurderingene av status og potensialpublishedVersio

Editorial Board

Source at http://dx.doi.org/10.1186/s12888-017-1345-8 Background: The duration of untreated psychosis is determined by both patient and service related factors. Few studies have considered the geographical accessibility of services in relation to treatment delay in early psychosis. To address this, we investigated whether treatment delay is co-determined by straight-line distance to hospital based specialist services in a mainly rural mental health context. Methods: A naturalistic cross-sectional study was conducted among a sample of recent onset psychosis patients in northern Norway (n = 62). Data on patient and service related determinants were analysed. Results: Half of the cohort had a treatment delay longer than 4.5 months. In a binary logistic regression model, straight-line distance was found to make an independent contribution to delay in which we controlled for other known risk factors. Conclusions: The determinants of treatment delay are complex. This study adds to previous studies on treatment delay by showing that the spatial location of services also makes an independent contribution. In addition, it may be that insidious onset is a more important factor in treatment delay in remote areas, as the logistical implications of specialist referral are much greater than for urban dwellers. The threshold for making a diagnosis in a remote location may therefore be higher. Strategies to reduce the duration of untreated psychosis in rural areas would benefit from improving appropriate referral by crisis services, and the detection of insidious onset of psychosis in community based specialist services

Does method matter? Assessing the validity and clinical utility of structured diagnostic interviews among a clinical sample of first-admitted patients with psychosis: A replication study

Introduction: Increasingly, diagnostic assessments in clinical practice are made using structured diagnostic interviews or self-rating scales imported into clinical practice from research studies and big-scale surveys. Although structured diagnostic interviews have been shown to be highly reliable in research, the use of such method in clinical contexts are more questionable. In fact the validity and clinical utility of such methods in naturalistic contexts have rarely been evaluated. In this study we report on a replication study of Nordgaard et al (22) Assessing the diagnostic validity of a structured psychiatric interview in a first-admission hospital sample. World Psychiatry, 11 (3): 181–185. Methods: The study sample comprises 55 first-admitted inpatients to a treatment facility specializing in the assessment and treatment of patients with psychotic disorders. Results: We found poor agreement between diagnoses generated by Structured Clinical Interview for DSM-IV and Best-estimate consensus diagnoses (κ value 0.21). Discussion: We identified over-reliance on self-report, vulnerability to response set in dissimulating patients, and a strong diagnosis and comorbidity focus, as possible reasons for misdiagnosis with the SCID. We conclude that structured diagnostic interviews performed by mental health professionals without solid psychopathological knowledge and experience are not recommendable for clinical practice

Plan S and the Economics of Scientific Journal Publishing

Securing open access to research will not remove the fundamental problem that commercial publishers have substantial market power. Thus, even if Plan S is successful, large commercial publishers are likely to put financial pressure on universities and funders in the future. One underlying source of publishers’ market power is the hierarchical ordering of journals’ quality. Whether one likes it or not, such rankings are likely to arise as a response to asymmetric information. Plan S does not, and probably cannot, address the substantial information problems in research publishing. In the absence of journal hierarchies, other and more malign responses may easily arise, including discrimination along dimensions such as gender, age, personal networks, and the prestige of institutional affiliations. Paywalls and subscription requirements are currently tools publishers use to exercise their market power. However, the underlying reason for publishers’ market power is not this tool, but rather the fact that journals provide services that cannot, at least from the point of view of individual researchers, be easily replaced by the services of other journals. This will prevail even with open access. Rather than imposing very strict requirements on journals’ business models, we would encourage funders to collaborate with academies and professional organizations. These organizations have the professional credibility to establish new but still highly regarded journals if needed. Funders can fully finance such journals, presumably at a reasonable cost, making subscription fees as well as publication fees redundant. It is well-established in economics that, if so-called market failures are present, unregulated markets will not function efficiently. In scientific publishing, market failures abound. Below, we discuss some of them and their interplay, before concluding with respect to implications for the scientific publishing market, for the potential success of Plan S, and alternative approaches