Direct observation of depression screening: identifying diagnostic error and improving accuracy through unannounced standardized patients

Schwartz, Alan; Peskin, Steven; Spiro, Alan; Weiner, Saul J.

doi:10.1515/dx-2019-0110

Cited by 14 publications

(13 citation statements)

References 14 publications

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“…Various reports have highlighted that delirium is under-recognised, underdetected and undertreated [1][2][3]. However, a plethora of publications have asserted similar claims for other common mental disorders that include anxiety disorders [4,5], sleep disorders [6,7], eating disorders [8], Attention Deficit Hyperactivity Disorder (ADHD) [9], depression [10] and schizophrenia [11]. These reports emphasise that each condition is undetected, underdiagnosed and undertreated and highlight the need for research that focuses upon improving awareness and detection.…”

Section: Introductionmentioning

confidence: 99%

Towards understanding the nature and need of delirium guidelines across nations and cultures

et al. 2021

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Background Delirium is associated with a variety of adverse healthcare outcomes but is highly predictable, preventable and treatable. For this reason, numerous guidelines have been developed for delirium recognition, prevention and management across different countries and disciplines. Although research is adduced as evidence for these guidelines, a constant finding is the lack of implementation if they exist at all. Implementation is a human behaviour that can be influenced by various factors including culture at a micro-and macro-level. Hofstede's model proposes that national cultures vary along six consistent dimensions. Aim Using this model, we examined the nature of delirium guidelines across countries in relation to Hofstede's six cultural dimensions. Methods Data collected for each country on: the six dimensions of Hofstede's model, number of delirium guidelines approved by a National professional body of each country (through searching databases), the annual old-age dependency ratio for each country. Results Sixty-four countries had the completed six dimensions of Hofstede's model. Twenty of them (31%) had one or more delirium guidelines. The total number of different delirium guidelines was 45. Countries with formal delirium guidelines have significantly lower power distance among their members, are more individualistic societies, have lower levels of uncertainty avoidance and higher old-age dependency ratio compared to those without delirium guidelines. Discussion/conclusion The development and implementation of delirium guidelines vary across countries. Specific combinations of cultural dimensions influence the production of delirium guidelines. Understanding these important cultural differences can facilitate more widespread acceptance and implementation of guidelines.

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Section: Introductionmentioning

confidence: 99%

Towards understanding the nature and need of delirium guidelines across nations and cultures

et al. 2021

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“…Current diagnoses, which are typically viewed as the “golden standard” (such as low mood, no interest, thought retardation, no motivation, thinking of suicide), depend on interview and self-rated questionnaires ( Davison et al, 2009 ). Even though the criteria of diagnostic manuals, like DSM and ICD, is getting more and more detailed, some reports suggested that the diagnosis of depression is substantially underdiagnosed in primary care ( Schwartz et al, 2019 ), or the rate of diagnosis of depression in non-depressed patients was estimated to be as high as 26.5% ( Aragones et al, 2011 ). Some papers even suggested that clinician-based standardized diagnoses are not feasible, even not as good as self-reported questionnaire ( Fisher et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Screening Depressive Disorders With Tree-Drawing Test

Liu

Liang

et al. 2020

Front. Psychol.

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Objective: Diagnosis of psychiatric disease is still a major issue. Two key reasons are-there are variations in the opinions of the medical doctors and the presentation of a disease among the patients. Here we introduce a kind of mental projective test, tree-drawing test, trying to extract and analyze objective indexes in tree-drawing test in patients with depression. Methods: The tree-drawing test was administered to 43 patients with major depressive disorders, 48 sub-threshold subjects, and 59 healthy subjects. Features of the drawing trees were analyzed using a kind of computer image recognition and data acquisition software. Quantitative indexes collected from pictures drawn by patients with major depression, patients with sub-threshold depression, and control subjects were compared using the ANOVA test. Results: Five quantitative features (canopy area, canopy height, canopy width, trunk width, and total area of trees) were found to be statistically significant among the groups, while seven other features (trunk area, trunk height, root width, root height, root area, ratio of crown to trunk height, and ratio of crown to trunk area) showed no statistical significance. Further analysis with LSD-t test revealed that six quantitative indexes were significantly related to the depression symptoms, and six others were not statistically significant. Eleven quantitative indexes were not statistically significant when the depressive symptoms were compared with the subthreshold depression group, and the only index with statistical significance was canopy width. Conclusion: Five quantitative indexes in the drawing tree are statistically significant in the depression patients were compared with those of the control subjects. Quantitative indexes of the tree-drawing test are of great value in assisting with the diagnosis of psychiatric disorders.

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“…In clinical skills training, SSP communicates with students from the perspective of patients, which can help students improve humanistic care for patients from psychological, social, cultural and other aspects, and is conducive to the cultivation of patient-centered thinking [22]. SP's feedback should become a key tool [23]. The teacher doesn't give guidance to the students when they take the examination.…”

Section: Assessment and Competitionmentioning

confidence: 99%

Training and Application of Student Standardized Patients for Dental Education

Zheng¹,

Cui²,

Zhong³

et al. 2021

IJVETR

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Background Stomatology is a discipline closely combined with theory and practice, and pays attention to students' operation abilities and clinical skills. Current dental education is encountering the situation of more theory than practice. The evaluation and application of standardized patients (SP) are gradually increasing in medical education. Objective This paper intends to describe the advantages of student standardized patients (SSP), how to construct and apply SSP for dental education. Method Recruit SP of stomatology students, and select appropriate cases based on the actual cases and common dental diseases. SSP training is conducted by experienced clinical teachers. SSP is trained to describe the disease in patient's language and give a reasonable response to enquiry and examination. Result Qualified SSP can be applied in inquiry, physical examination, teaching and evaluation of common dental diseases. SSP not only provide students with repeated practice, but also enable students to understand theoretical knowledge and cultivate clinical thinking more effectively in real clinical reception. This model of SSP application could stimulate learning enthusiasm of on-campus dental student, improve student clinical skills and thinking abilities, as well as reduce education expenses. Conclusion Using SSP is beneficial to help students construct clinical thinking, learn communication skills and build a harmonious doctor-patient relationship.

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Direct observation of depression screening: identifying diagnostic error and improving accuracy through unannounced standardized patients

Cited by 14 publications

References 14 publications

Towards understanding the nature and need of delirium guidelines across nations and cultures

Towards understanding the nature and need of delirium guidelines across nations and cultures

Screening Depressive Disorders With Tree-Drawing Test

Training and Application of Student Standardized Patients for Dental Education

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