Abbreviations: CKD-aP, chronic kidney disease-associated pruritus; HD, hemodialysis; DOPPS, dialysis outcomes and practice patterns study; VRS, verbal rating scale; QOL, quality of life; SF, short form; CHF, congestive heart failure; Ca, calcium; phos, phosphorus; WBC, white blood cell; ESRD, end-stage renal disease; AOR, adjusted odds ratio; MCS, mental component summary; PCS, physical component summary; VAS, visual analog scale, BUN, blood urea nitrogen; PTH, parathyroid hormone; NRS, numeric rating scale; BII, brief itching inventory; SSMOS, sleep survey medical outcomes survey; MOS, medical outcomes survey; BDI, Beck’s depression inventory; KDQOL, kidney disease QOL; DM, diabetes mellitus; CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease; BMI, body mass index; Hgb, hemoglobin; HTN, hypertension; AVG, arteriovenous graft; CKD, chronic kidney disease; ACEi, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker; PD peritoneal dialysis; PSQI, pittsburgh sleep quality index; HR, health related; IV, intravenous; ESA, erythropoietin.
16 Read more
Background: In the development of patient-reported outcome (PRO) instruments, little documentation is provided on the justification of response scale selection. The selection of response scales is often based on the developers ’ preferences or therapeutic area conventions. The purpose of this literature review was to assemble evidence on the selection of response scale types, in PRO instruments. The literature search was conducted in EMBASE, MEDLINE, and PsycINFO databases. Secondary search was conducted on supplementary sources including reference lists of key articles, websites for major PRO-related working groups and consortia, and conference abstracts. Evidence on the selection of verbal rating scale (VRS), numeric rating scale (NRS), and visual analogue scale (VAS) was collated based on pre-determined categories pertinent to the development of PRO instruments: reliability, validity, and responsiveness of PRO instruments, select therapeutic areas, and optimal number of response scale options. Results: A total of 6713 abstracts were reviewed; 186 full-text references included. There was a lack of consensus in the literature on the justification for response scale type based on the reliability, validity, and responsiveness of a PRO instrument. The type of response scale varied within the following therapeutic areas: asthma, cognition, depression, fatigue in rheumatoid arthritis, and oncology. The optimal number of response options depends on the construct, but quantitative evidence suggests that a 5-point or 6-point VRS was more informative and discriminative than fewer response options.
14 Read more
Objective: Several scales are commonly used for assessing pain intensity. Among them, the numerical rating scale (NRS), visual analog scale (VAS), and verbal rating scale (VRS) are often used in clinical practice. However, no study has performed psychometric analyses of their reliability and validity in the measurement of osteoarthritic (OA) pain. Therefore, the present study examined the test–retest reliability, validity, and minimum detectable change (MDC) of the VAS, NRS, and VRS for the measurement of OA knee pain. In addition, the correlations of VAS, NRS, and VRS with demographic variables were evaluated.
Methods: The postoperative pain episodes, during the first postoperative day, of three patient groups were analyzed. Each pain episode was assessed by a visual analog scale, numerical rating scale, verbal rating scale, and a new tool – pain point system scale (PPSS) – based on the analgesics administered. The type of analgesic was defined based on the authors’ clinic protocol, patient comorbidities, pain assessment tool scores, and preadministered medications by an artificial neural network system. At each pain episode, each patient was asked to fill the three pain scales. Bartlett’s test and Kaiser–Meyer–Olkin criterion were used to evaluate sample sufficiency. The proper scoring system was defined by varimax rotation. Spearman’s and Pearson’s coefficients assessed PPSS correlation to the known pain scales.
Results The majority (84.4%) of patients rated their dry mouth as moderate or severe using the verbal rating scale (VRS). Seventy-five percent (74.7%) had a numeric rating scale (NRS) score of 6 or more for dry mouth severity. Patients reported that dry mouth interfered most with talking and was the most important function to assess (median score 6 out of 10) followed by eating (median 5) and taste (median 5). Taking sips of drink was the most common and most effective self-management strategy. Over half of patients (54.6%) also reported impact on swallow and sleep and associated dryness of lips, throat and nasal passages.
The Brief Psychiatric Rating Scale (BPRS) is a widely used instrument for assessing the positive, negative, and affective symptoms of individuals who have psychotic disorders, especially schizophrenia. It has proven particularly valuable for documenting the efficacy of treatment in patients who have moderate to severe disease.
68 Read more
mal conditions for tuber infection and the effect of underwatering on infection progress was probably negligible. In a more comprehensive set of varieties Zadina (1975) included 74.7% of varieties into rating scores 4–6. In the studied set 53.85% of varieties were included in these scores, 42.30% were ranked into scores 7 and 8 and 3.85% of varieties were included in the rating score 3. From this finding a certain shift towards a higher resistance to common scab in modern varieties could be concluded. It is also
Bipolar disorder (BD) is a lifelong mental health condition characterized by extreme fluctuating mood including recurrent episodes of depression and mania, which generally starts in adolescence and affects approximately 1-1.5% of adults worldwide . The impact of BD on employment and relationships can be devastating, and the condition has high financial costs, estimated at £5.2 billion annually in England alone . Preventing relapse is a key goal of most interventions for BD. Interventions that teach people to recognize and respond to early warning signs (EWS) are recommended by clinical guidelines worldwide [3-5] but implementation in routine clinical practice is poor . Enhanced Relapse Prevention (ERP), a structured manualized intervention for frontline care staff, has shown significant benefit and is well received by patients and staff . However, delivered face-to-face it will only ever be available to a small percentage of people with BD due to low rates of psychological intervention provision even among those who remain in secondary care services. In this study, we test the feasibility and acceptability of a Web-based version of ERP: ERPonline. Web-based interventions in mental health offer the potential to broaden access, reduce waiting times, delivery costs and stigma, and improve quality through standardized delivery [8,9]. There is growing evidence for short-term benefits of Internet-delivered psychological treatments for depression and anxiety disorders compared with waitlist (WL) controls , although understanding their implementation into real-world services is still in its infancy . In BD, the evidence, while promising, is at an earlier stage, comprising small-scale feasibility studies [12-18]. These studies, along with results from an international multisite survey , suggest that people with BD can use, and are interested in further using, Web-based mental health support. However, detailed evidence is lacking on what kinds of psychosocial support can be Web-based, the best ways to deliver these, who accesses Web-based interventions, what processes and outcomes are impacted on, and how to best design rigorous trials to evaluate them on the Web. This information is essential to inform definitive clinical and cost-effectiveness trials. This study addresses these issues in a novel randomized controlled trial (RCT) to assess feasibility and acceptability of ERPonline with all recruitment and assessments of outcome performed remotely. Objectives
21 Read more
operative recovery . However, in the above studies, patients passively received psychologi- cal care and lacked interaction with nurses. Therefore, this study strengthened the interac- tion between nurses and patients, patients and patients, as well as patients and their fami- lies, in order to increase the effect of psycho- logical care. In addition, most psychological nursing reports apply self-rating scale to as- sess the psychological state of patients, lack- ing effective hematological indicators. In this study, the changes of neurotransmitters before and after nursing intervention were observed, which objectively confirms the effect of psycho- logical nursing.
ited data regarding their validity with young people. For adolescents aged 13 and older, the most widely used self- reports include the Centre for Epidemiological Studies Depression Scale (CES-D)  and the Beck Depression Inventory (BDI) . Likewise, the most frequently used clinician reports include the Hamilton Depression Rating Scale (HDRS) [8,9], the Montgomery-Asberg Depression Rating Scale (MADRS) , and the Children's Depres- sion Rating Scale CDRS-R . However, these instru- ments are not specific to adolescents, lack construct validity, and have limited or unknown reliability and validity in this age group [12-14].
10 Read more
The choice of scale depends on purpose, setting, and population. When precision and responsiveness to change are needed, complex multi-item scales may be preferable. 10 However, there are a range of scenarios where single-item dyspnea assessment scales are more appropriate, such as when part of routine clinical care, embedded in a larger group of patient-reported outcomes, or completed repeatedly at short intervals. Among single-item patient-reported scales, the Visual Analogue Scale, 11 Numerical Rating Scale (NRS, e.g., 0 = no breathlessness to 10 = worst breathlessness possible), 12,13 and the modified Borg scale 14,15 have all been validated, but none have been preferentially adopted.
16 Read more
Results: We identified 29 studies with 2530 people with vitiligo. Most studies included a measure of either depression (n=25) or anxiety (n=13).The commonest tools were the Hospital Anxiety and Depression Scale and the Centre for Epidemiology Studies Depression Scale. Ten studies provided information on thirteen other psychological outcomes. Pooled prevalence using depression-specific and anxiety-specific questionnaires was 0.29 (95%CI 0.21, 0.38) and 0.33 (95%CI 0.18, 0.49) respectively. Prevalence was lower for clinically diagnosed depression (0.21; 95%CI 0.15, 0.28) and anxiety (0.15; 95%CI 0.06, 0.24). When non-specific tools were used the prevalence remained similar for depression (0.27; 95%CI 0.08, 0.46) but increased for anxiety (0.46; 95% CI 0.39, 0.52). High heterogeneity was observed.
33 Read more
to hormonal treatment in women aged 40–70 years: Europe (Germany, France, Spain, Sweden), North America (USA), Latin America (Mexico, Argentine, Brazil), and as example for Asia – Indonesia. Study participants were accrued as a random sample of females aged 40 to 70 years from existing population panels. The sample size in each of the countries was about 1000 females aged 40–70 years, with exception of USA (n = 1500). The participation rates ranged between 46 and 94% across countries. The demographic details of the sample are: On average, about tertiles of the respondents were under 50 years, between 50–59, and over 60 years old in most of the countries, however, about 50% were less than 50 years in Indonesia and in Brazil. The majority of respondents reported a Christian religion in Europe (range: 74% (Germany) to 96% (Spain), 85% in USA, and in Latin America (range: 95% (Argentina) to 97% (Mexico). The use of the MRS was part of this survey, i.e. multinational data became available to reconsider methodological issues more thor- oughly such as internal structure of the scale, reliability (internal consistency alpha), and reference values for dif- ferent population.
Method: A cohort of patients with psychosis receiving treatment from traditional healers ’ shrines were recruited between January and March 2008 and followed up at three and six months. The Mini International Neuropsychiatry Interview (MINI Plus) was used for making specific diagnosis at the point of contact. For specific symptoms, Positive and Negative Symptom Scale (PANSS), Young Mania Rating Scale (YMRS) and Montgomery Asberg Depression Rating Scale (MADRS) were used to measure severity of schizophrenia, mania and psychotic depression, respectively. The Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) were used for objective assessments. The Compass Mental Health Index measured well being. Mean scores of the scales were computed using one way ANOVA for independent samples. Associations between outcome and categorical variables were examined at bivariate and multivariate levels.
11 Read more
developed to investigate the subjective experience of in- dividuals with schizophrenia in real-world social encoun- ters by collecting soft phenomena that are traditionally not included in checklists. The scale originates from pre- vious qualitative analyses based on in-depth interviews with persons with schizophrenia in clinical and research settings 14-18 . The result has been a rich and detailed col-
12 Read more
All participants were assessed using the K-BDRS and then interviewed with the Montgomery and Asberg De- pression Scale (MADRS, ), the 17-item Hamilton Depression Scale (HAMD, ), and the Young Mania Rating Scale (YMRS, ). These measures were se- lected to assess the concurrent validity of the K-BDRS. All investigators and raters involved in this study were clinical psychiatrists with more than 10 years of clinical experience in bipolar disorder, and had received formal training in the use of all the rating scales.
Carrying out this research, to determine the stages of dementia in AD, in contrast to the method of J.C. Morris’ “The Clinical Dementia Rating Scale” (CDR) , we have proposed a new rating scale based on the definition of objective morphological data obtained during visuali- zation of the severity of atrophic changes developing in the temporal lobes of the brain. Since lifetime brain morphological changes can be obtained by applying x-ray diagnostic methods, CT and MRI have been used. This scale has been named “The Tomography Dementia Rating Scale” (TDR) .
Intensity of pain can be quantified with help of various tools namely Numerical Rating Scale (0= no pain, 10= extreme pain), verbal descriptor scale (no pain, mild pain, moderate pain, severe pain, extreme pain and intense pain), pictorial pain scale/ Wong- baker faces pain, visual analog scale (left side= no pain, right side= most intense pain), Mc Gill Pain Questionnaire (it evaluates location of pain, intensity, tem- poral qualities and sensitivity to change, as well as sensory and affective aspect of pain)  and WILDA Approach, W= words to describe pain e.g. aching, stabbing, I= inten- sity of pain, L= location of pain, D= duration of pain, A= aggravating/ alleviating factor of pain .
The SLUMS is an 11-item test that yields a score out of 30 possible points. It takes approximately seven minutes to administer and assesses orientation, attention (digit span), numeric calculation, im- mediate and delayed verbal recall, verbal fluency (animal naming), executive functions (clock drawing), figure recognition/size differentiation, and immediate recall of contextual verbal information (story). Tariq et al. (2006) did not describe in depth their process for inclusion or exclusion of items or their the- oretical underpinnings. Certain items, such as the clock drawing, were included because they are ob- served to decline early in MNCD (Royall, Cordes, & Polk, 1998). It is possible that other items were in- cluded based on their ability to identify impairments in the domains delineated by the DSM-IV criteria for MNCD. MNCD requires impairment in two or more cognitive domains, thus essentially excluding sin- gle-domain subtypes of MCI. Furthermore, Tariq and colleagues did not report utilizing a comprehensive neuropsychological examination to diagnose MNCD, but instead diagnosed MNCD and dementia based on history, a physical and mental status examination, and laboratory findings. However, “evidence from neuropsychological testing or quantified cognitive assessment of an abnormality of decline in perfor- mance” (American Psychiatric Association, 2000) is required in the DSM-IV criteria for MNCD, so if a formal measure was used, it was not reported.
103 Read more
We aimed to examine the potential relationship between season of birth (SOB) and clinical characteristics in Korean patients with unipolar non-psychotic major depressive disorder (MDD). Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, 891 MDD patients were divided into two groups, those born in spring/summer (n=457) and those born in autumn/winter (n=434). Measurement tools comprising the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Scale for Suicidal Ideation, Clinical Global Impression of severity, Social and Occupa- tion Functional Assessment Scale, WHO Quality of Life assessment instrument-abbreviated version, Alcohol Use Disorder Identi- fication Test, and Temperament and Character Inventory were used to evaluate depression, anxiety, overall symptoms, suicidal ideation, global severity, social function, quality of life, drinking, and temperament and character, respectively. Using indepen- dent t-tests for continuous variables and χ 2 tests for discrete variables, the clinical characteristics of the two groups were com-