Publications by authors named "Ankur Krishnan"
Importance: Test accuracy studies often use small datasets to simultaneously select an optimal cutoff score that maximizes test accuracy and generate accuracy estimates.
Objective: To evaluate the degree to which using data-driven methods to simultaneously select an optimal Patient Health Questionnaire-9 (PHQ-9) cutoff score and estimate accuracy yields (1) optimal cutoff scores that differ from the population-level optimal cutoff score and (2) biased accuracy estimates.
Design, Setting, And Participants: This study used cross-sectional data from an existing individual participant data meta-analysis (IPDMA) database on PHQ-9 screening accuracy to represent a hypothetical population.
Oral health in systemic sclerosis: A scoping review.
J Scleroderma Relat Disord
May 2024
Article Synopsis
- Limited research on oral health in systemic sclerosis prompts a scoping review to identify studies related to quality of life across five key domains: symptoms, functional impacts, psychosocial factors, patient-related variables, and self-care practices.
- From 1460 studies reviewed, only 91 were included, with most being conducted in Europe or North America and featuring small participant numbers, indicating a significant gap in comprehensive research.
- The majority of studies focus on oral manifestations and symptoms, with fewer addressing other crucial areas; further systematic reviews and larger studies are essential to improve understanding and care for systemic sclerosis patients.
Objectives: To examine the proportion of eligible primary studies that contributed data, study characteristics associated with data contribution, and reasons for noncontribution using diagnostic test accuracy Individual Participant Data Meta-Analysis (IPDMA) data sets from the DEPRESsion Screening Data project.
Study Design And Setting: We reviewed data set contributions from four IPDMAs. A multivariable logistic regression model was fitted to evaluate study factors associated with data contribution.
Objective: To synthesise results of mental health outcomes in cohorts before and during the covid-19 pandemic.
Design: Systematic review.
Data Sources: Medline, PsycINFO, CINAHL, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, medRxiv, and Open Science Framework Preprints.
Article Synopsis
- The study compares the effectiveness of two screening tools for major depression: the seven-item Hospital Anxiety and Depression Scale Depression subscale (HADS-D) and the total score of the 14-item version (HADS-T), which includes anxiety items and takes longer to complete.
- An analysis of data from 20,700 participants revealed that both HADS-D and HADS-T had similar sensitivity and specificity for detecting major depression, with optimal cutoffs being ≥7 for HADS-D and ≥15 for HADS-T.
- Overall, while both tools are accurate, the shorter HADS-D is preferred in most clinical settings due to its simplicity and time efficiency.
Women and gender-diverse individuals have faced disproportionate socioeconomic burden during COVID-19. There have been reports of greater negative mental health changes compared to men based on cross-sectional research that has not accounted for pre-COVID-19 differences. We compared mental health changes from pre-COVID-19 to during COVID-19 by sex or gender.
View Article and Find Full Text PDFObjective: We evaluated the effects of mental health interventions among people hospitalized with COVID-19.
Methods: We conducted a systematic review and searched 9 databases (2 Chinese-language) from December 31, 2019 to June 28, 2021. Eligible randomized controlled trials assessed interventions among hospitalized COVID-19 patients that targeted mental health symptoms.
Objectives: Our objective was to assess the effects of mental health interventions for children, adolescents, and adults not quarantined or undergoing treatment due to COVID-19 infection.
Methods: We searched 9 databases (2 Chinese-language) from December 31, 2019, to March 22, 2021. We included randomised controlled trials of interventions to address COVID-19 mental health challenges among people not hospitalised or quarantined due to COVID-19 infection.
Objective: To update a previous individual participant data meta-analysis and determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9), the most commonly used depression screening tool in general practice, for detecting major depression overall and by study or participant subgroups.
Design: Systematic review and individual participant data meta-analysis.
Data Sources: Medline, Medline In-Process, and Other Non-Indexed Citations via Ovid, PsycINFO, Web of Science searched through 9 May 2018.
Objective: To evaluate the accuracy of the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) to screen for major depression among people with physical health problems.
Design: Systematic review and individual participant data meta-analysis.
Data Sources: Medline, Medline In-Process and Other Non-Indexed Citations, PsycInfo, and Web of Science (from inception to 25 October 2018).
Introduction: Systemic sclerosis (SSc; scleroderma) is a rare, chronic, autoimmune disease with a high level of burden, a significant impact on the ability to carry out daily activities, and a considerable negative impact on health-related quality of life. Non-pharmacological interventions could be provided to potentially improve mental and physical health outcomes. However, the effectiveness of non-pharmacological interventions on health and well-being among individuals with SSc has not been well established.
View Article and Find Full Text PDFObjective: Visible differences in appearance are associated with poor social and psychological outcomes. Effectiveness of non-surgical cosmetic and other camouflage interventions is poorly understood. The objective was to evaluate effects of cosmetic and other camouflage interventions on appearance-related outcomes, general psychological outcomes and adverse effects for adults with visible appearance differences.
View Article and Find Full Text PDFObjective: The Maternal Mental Health in Canada, 2018/2019, survey reported that 18% of 7,085 mothers who recently gave birth reported "feelings consistent with postpartum depression" based on scores ≥7 on a 5-item version of the Edinburgh Postpartum Depression Scale (EPDS-5). The EPDS-5 was designed as a screening questionnaire, not to classify disorders or estimate prevalence; the extent to which EPDS-5 results reflect depression prevalence is unknown. We investigated EPDS-5 ≥7 performance relative to major depression prevalence based on a validated diagnostic interview, the Structured Clinical Interview for DSM (SCID).
View Article and Find Full Text PDFObjective: Fear associated with medical vulnerability should be considered when assessing mental health among individuals with chronic medical conditions during the COVID-19 pandemic. The objective was to develop and validate the COVID-19 Fears Questionnaire for Chronic Medical Conditions.
Methods: Fifteen initial items were generated based on suggestions from 121 people with the chronic autoimmune disease systemic sclerosis (SSc; scleroderma).
Objectives: Estimates of depression prevalence in pregnancy and postpartum are based on the Edinburgh Postnatal Depression Scale (EPDS) more than on any other method. We aimed to determine if any EPDS cutoff can accurately and consistently estimate depression prevalence in individual studies.
Methods: We analyzed datasets that compared EPDS scores to Structured Clinical Interview for DSM (SCID) major depression status.
Objectives: Validated diagnostic interviews are required to classify depression status and estimate prevalence of disorder, but screening tools are often used instead. We used individual participant data meta-analysis to compare prevalence based on standard Hospital Anxiety and Depression Scale - depression subscale (HADS-D) cutoffs of ≥8 and ≥11 versus Structured Clinical Interview for DSM (SCID) major depression and determined if an alternative HADS-D cutoff could more accurately estimate prevalence.
Methods: We searched Medline, Medline In-Process & Other Non-Indexed Citations via Ovid, PsycINFO, and Web of Science (inception-July 11, 2016) for studies comparing HADS-D scores to SCID major depression status.
Objective: Contagious disease outbreaks and related restrictions can lead to negative psychological outcomes, particularly in vulnerable populations at risk due to pre-existing medical conditions. No randomised controlled trials (RCTs) have tested interventions to reduce mental health consequences of contagious disease outbreaks. The primary objective of the Scleroderma Patient-centered Intervention Network COVID-19 Home-isolation Activities Together (SPIN-CHAT) Trial is to evaluate the effect of a videoconference-based program on symptoms of anxiety.
View Article and Find Full Text PDFArticle Synopsis
- - The PHQ-9 is a 9-question tool for identifying and assessing the severity of depression, while the shorter PHQ-2 focuses on the frequency of depressed mood and anhedonia and can serve as an initial screening step.
- - A study combining data from various sources aimed to evaluate the accuracy of the PHQ-2 alone and alongside the PHQ-9 in detecting major depression through comparisons with validated diagnostic interviews.
- - Results showed that the PHQ-2 has good sensitivity (91%) but lower specificity (67%) at a score cutoff of 2, with improved performance at a cutoff of 3, indicating it can effectively help in initial screenings for depression when used with interviews.
Objectives: The objectives were to determine the proportion of eligible randomized controlled trials (RCTs) that contributed data to individual participant data meta-analyses (IPDMAs) and explore associated factors.
Study Design And Setting: IPDMAs with ≥10 eligible RCTs were identified by searching MEDLINE, EMBASE, CINAHL, and Cochrane May 1, 2015 to February 13, 2017. Mixed-effect logistic regression was used to identify factors associated with data contribution.
Objectives: Depression symptom questionnaires are not for diagnostic classification. Patient Health Questionnaire-9 (PHQ-9) scores ≥10 are nonetheless often used to estimate depression prevalence. We compared PHQ-9 ≥10 prevalence to Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) major depression prevalence and assessed whether an alternative PHQ-9 cutoff could more accurately estimate prevalence.
View Article and Find Full Text PDFObjective: Two previous individual participant data meta-analyses (IPDMAs) found that different diagnostic interviews classify different proportions of people as having major depression overall or by symptom levels. We compared the odds of major depression classification across diagnostic interviews among studies that administered the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D).
Methods: Data accrued for an IPDMA on HADS-D diagnostic accuracy were analysed.
Background: Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9 diagnostic algorithm. Many primary studies publish results for only one approach, and previous meta-analyses of the algorithm approach included only a subset of primary studies that collected data and could have published results.
Objective: To use an individual participant data meta-analysis to evaluate the accuracy of two PHQ-9 diagnostic algorithms for detecting major depression and compare accuracy between the algorithms and the standard PHQ-9 cutoff score of ≥10.
Objectives: A previous individual participant data meta-analysis (IPDMA) identified differences in major depression classification rates between different diagnostic interviews, controlling for depressive symptoms on the basis of the Patient Health Questionnaire-9. We aimed to determine whether similar results would be seen in a different population, using studies that administered the Edinburgh Postnatal Depression Scale (EPDS) in pregnancy or postpartum.
Methods: Data accrued for an EPDS diagnostic accuracy IPDMA were analysed.