Innovations In Clinical Neuroscience

MAR-APR 2017

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

Issue link: http://innovationscns.epubxp.com/i/822795

Contents of this Issue

Navigation

Page 19 of 45

Innovations in CLINICAL NEUROSCIENCE [ V O L U M E 1 4 , N U M B E R 3 – 4 , M A R C H – A P R I L 2 0 1 7 ] 20 used when the eC-SSRS is administered to the same patient multiple times) instead of over their lifetime. This yielded a total sample of 86 evaluable patients. Of these, 58 were hospital patients and 28 were hospital employees. The average age of the sample was 41.0 (standard deviation [SD]=12.5) years, and age did not differ between the patient (median [M]=40.1; SD=12.7) and control (M=43.1; SD=12.0) participants [t(84)=1.06, p=0.29]. There were 51 women and 35 men enrolled in the trial. The sex distribution was significantly different in the patient (28 women, 30 men) and control (23 women, 5 men) groups [c 2 (1 df)=8.97, p<0.005]. Seventy-three percent of the total sample were Caucasian, 20 percent were African-American, and five percent were Latino. The racial distribution did not differ across groups [c 2 (4 df)=8.16, p=0.09]. Diagnoses varied considerably across patients, and most patients had been given multiple diagnoses. The following broad diagnostic areas were represented in the patient sample: anxiety disorders (generalized anxiety; PTSD; obsessive compulsive disorder [OCD]; mood disorders (MDD; bipolar disorder; and mania, unspecified mood disorder), substance abuse, attention deficit hyperactivity disorder (ADHD), and schizoaffective disorder. Forty-four patients completed the IVR version first, and 42 completed the tablet version first. Equivalence analyses: suicidal ideation. Most severe lifetime ideation. The average score for most severe lifetime ideation reported on IVR was 2.72±1.99, and the average on the tablet was 2.72±1.96. The correlation between the tablet and IVR scores was 0.87, p<0.001; and the ICC was 0.89, p<0.001. Order of administration did not impact the magnitude of the ICC (IVR completed first— ICC=0.89, p<0.001; tablet completed first—ICC=0.89, p<0.001). The relationship between the two modes of administration was similar to the test- retest reliability for the same administration mode (IVR test-retest— ICC=0.87, p<0.001; tablet test-retest— ICC=0.87, p<0.001). Average scores for hospital patients were significantly higher than scores for hospital staff (Figure 1a): main effect for patient group—F (1, 82]=39.9, p<.001; and this was not moderated by mode of administration: patient group by mode of administration interaction term: F (1, 82)=0.1, ns). Most severe ideation in past six months. This analysis included 67 participants, as the questions regarding "recent" ideation were only administered if lifetime ideation was endorsed. All patients who reported no lifetime ideation on IVR also reported no ideation on the tablet. Therefore, the analysis is more conservative than if zero values had been imputed for the patients who were not administered the assessment. The correlation between the tablet and IVR scores was 0.69, p<0.001; and the ICC was 0.79, p<0.001. There was an order effect, in that patients who completed the IVR version first had a lower ICC (0.70) than participants who completed the tablet first (0.86). This discrepancy appeared to be due, in part, to one participant whose score changed from a 5 to a 0 and another patient whose score changed from 0 to 5 across the two administrations when the IVR version was administered first. This was also reflected in the test-retest reliability estimates: IVR test-retest—ICC=0.72, p<0.001; tablet test-retest—ICC=0.84, p<.001. Average scores for hospital patients were significantly higher than scores for hospital staff (Figure 1b): main effect for patient group—F (1, 63)=15.1, p<0.001; and this was not moderated by mode of administration: patient group by mode of administration interaction term—F (1, 63)=0.8, ns. Equivalence analyses: suicidal behaviors. The findings for the suicidal behavior scores are listed in Table 2. The results overwhelmingly demonstrated a high degree of concordance across the two modes of administration. The only equivalence metric that was not above the acceptable threshold was the kappa statistic for the lifetime aborted attempts score (k=0.54). The average kappa score for categorical variables was 0.73. The order of presentation was related to the lifetime aborted attempts and non- suicidal, self-injurious behavior kappas. For lifetime aborted attempts, the kappa when the IVR was administered first was 0.66 and it was 0.42 when the tablet was administered first. For non-suicidal, self- injurious behavior, the kappa was 1.0 when IVR was administered first and 0.48 when tablet was administered first. For the other variables, the difference between the order of administration groups on the equivalence metrics was less than 0.10, and all metrics were above the acceptability threshold. Table 2 also includes the findings from comparisons of the patient and FIGURE 1A. Most severe suicidal ideation in hospital patients and controls Lifetime ideation; group main effect F (1, 82)=39.9, p<0.001 FIGURE 1B. Most severe suicidal ideation in hospital patients and controls Ideation in last 6 months; group main effect F (1, 63)=15.1, p<0.001

Articles in this issue

Archives of this issue

view archives of Innovations In Clinical Neuroscience - MAR-APR 2017