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Centre for Policy on Ageing | |
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Getting the questions right
— an example of loss of validity during transfer of a brief screening approach for depression in the elderly | | Author(s) | A Howe, P Bath, F Goudie |
| Journal title | International Journal of Geriatric Psychiatry, vol 15, no 7, July 2000 |
| Pages | pp 650-655 |
| Keywords | Depression ; Screening ; Questionnaires ; Reliability. |
| Annotation | Screening for depression in older people has been advocated to improve detection and management. This article summarises trends towards briefer screening instruments. The study aimed to validate a single question depression screen which had previously shown adequate sensitivity and specificity in a new context: a multi-faceted assessment instrument used by nurse practitioners with a community sample of over 75 year olds. The GMS-AGECAT computerised interview assessment was used as a "gold standard" to determine the accuracy of the depression question. 328 patients were screened; 100 consenting patients underwent a further interview with a research assistant using the GMS-AGECAT. Prevalence of depression was 30%, the sensitivity of the question was 67% and its specificity 60% (compared with 88% and 71% previously). Responses indicating disability and loneliness were more closely correlated with depression than the depression score itself. Relevant factors may include: the derivation of the question, the effect of a different sample, altered reliability when used by multiple interviewers, differing patient expectations, and the wording and context of the question within the multi-faceted screening instrument. Depression screening questions need repeated validation when used different contexts. Patient and staff expectations may influence how screening instruments are used in practice in a way that may also alter reliability. (RH). |
| Accession Number | CPA-000823236 A |
| Classmark | ENR: 3V: 3DA: 5HC |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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