Publications by authors named "Ziegelstein R"
Article Synopsis
- The study investigates how using small datasets to select an optimal cutoff score for the Patient Health Questionnaire-9 (PHQ-9) can lead to inaccurate results.
- Researchers evaluated whether data-driven methods for cutoff selection resulted in scores that were significantly different from the true population optimal score and if these methods produced biased accuracy estimates.
- Findings showed that many small studies frequently failed to identify the correct optimal cutoff score, particularly in smaller samples, leading to an overestimation of test sensitivity.
Article Synopsis
- The Geriatric Depression Scale (GDS-15), commonly used to gauge depression in older adults, shows that a score of ≥5 identifies higher prevalence (34.2%) compared to the Structured Clinical Interview (SCID) which shows a lower prevalence (14.8%).
- An analysis of data from 14 studies involving over 3,600 participants found that using GDS-15 with a cutoff of ≥8 aligns much closer to SCID results, with only a minor difference (-0.3%).
- While GDS-15 ≥5 greatly overestimates depression prevalence, the suggested cutoff of ≥8 might be more accurate but has too much variation to be reliably implemented; hence, validated diagnostic
Objectives: To use individual participant data meta-analysis (IPDMA) to estimate the minimal detectable change (MDC) of the Geriatric Depression Scale-15 (GDS-15) and to examine whether MDC may differ based on participant characteristics and study-level variables.
Study Design And Setting: This was a secondary analysis of data from an IPDMA on the depression screening accuracy of the GDS. Datasets from studies published in any language were eligible for the present study if they included GDS-15 scores for participants aged 60 or older.
Article Synopsis
- * Statistically significant differential item functioning (DIF) was found for most questionnaire items, but this had minimal impact on total scores.
- * Researchers and clinicians can choose the administration method based on what works best for patients, considering preferences, feasibility, or cost, as score differences were negligible.
Article Synopsis
- The Johns Hopkins Physician-Scientist Training Program (PSTP) aims to address issues in training and retaining physician-scientists by offering seminars, mentorship, and funding opportunities to residents and fellows.
- A study evaluating the PSTP from 2017-2020 found that 41% of its scholars were women, with a significant portion identifying as minorities, and many scholars receiving research support.
- Most graduates remained in academia, indicating that the PSTP effectively provides the resources and mentor connections necessary to foster careers as physician-scientists.
Purpose: To determine whether students' self-reported race/ethnicity and sex were associated with grades earned in 7 core clerkships. A person-centered approach was used to group students based on observed clerkship grade patterns. Predictors of group membership and predictive bias by race/ethnicity and sex were investigated.
View Article and Find Full Text PDFThe recent decisions of several medical schools to no longer participate in the rankings published annually by U.S. News & World Report have added greater visibility to the issues surrounding medical school rankings than ever before.
View Article and Find Full Text PDFObjectives: 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.
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.
Objective: As part of a quality improvement project, we developed and employed an observation checklist to measure patient-centered behaviors during daily rounds to assess the frequency of patient-centered behaviors among a patient-centered care (PCC) team and standard team (ST) rounds.
Patients And Methods: On four general medicine service (GMS) teaching teams at an urban academic medical center in which housestaff rotate, we utilized an observation checklist to assess the occurrence of eight behaviors on inpatient daily rounds. The checklist covered domains of patient-centered communication, etiquette-based behaviors, and shared decision-making.
Shortened versions of self-reported questionnaires may be used to reduce respondent burden. When shortened screening tools are used, it is desirable to maintain equivalent diagnostic accuracy to full-length forms. This manuscript presents a case study that illustrates how external data and individual participant data meta-analysis can be used to assess the equivalence in diagnostic accuracy between a shortened and full-length form.
View Article and Find Full Text PDFThe promise of precision medicine is based on the use of new technologies to better characterize patients by defining individuals in the areas of genomics, proteomics, metabolomics and other aspects of biologic variability. Wise application of modern technology can similarly transform health visits with patients, allowing for better characterization of the patient's individual life circumstances than possible in a traditional office visit. The use of, and experience with, telemedicine have increased significantly during the COVID-19 pandemic.
View Article and Find Full Text PDFIntroduction: Genetic differences between races have been hypothesized to contribute to differences in outcome from acute coronary syndromes (ACS). Our objective was to assess racial differences in genetic variations in the platelet serotonin transporter (5HTT) and receptor in patients with ACS.
Materials And Methods: 127 consecutive patients, African Americans (AA) = 27; Caucasian (C) =100, admitted with ACS were evaluated for platelet function by serotonin (5HT) induced platelet activation.
Background: A novel patient-centered curricular experience was implemented in an internal medicine residency program in 2007. There is little published evidence that what is taught in residency affects practice after graduation.
Objective: We sought to evaluate whether graduates perceived any long-term effects of participation in this patient-centered curriculum.