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1.
Spouse Concordance for Alcohol Dependence and Heavy Drinking: Evidence from a Community Sample 总被引:2,自引:0,他引:2
Jane D. McLeod 《Alcoholism, clinical and experimental research》1993,17(6):1146-1155
Using data from a community sample of 586 married couples, levels of spouse concordance for lifetime and current alcohol dependence and heavy drinking were estimated. In addition, marital quality ratings in concordant and discordant couples were compared. Spouse concordance was significant for lifetime alcohol dependence and for both lifetime and current heavy drinking. Marital quality varied as a function of current heavy drinking and alcohol dependence such that members of couples in which neither spouse drank heavily reported better marital quality than other couples. Furthermore, although marital quality did not differ significantly between concordant and discordant couples, couples concordant for current heavy drinking consistently reported poorer marital quality than other couples. 相似文献
2.
In contrast to other reliability estimates, test-retest reliability (or reproducibility) captures not only the measurement error of an assessment instrument, but also the stability of the construct measured. Consequently, one would expect any departure from identity (Y = X) of measurement pairs (X first, and Y second measurement) to be treated as 'error' by the respective reproducibility statistic, even if 'true' changes happened, e.g. worsening of a disease due to its natural course. The Pearson correlation, still often advocated for continuous measures in test-retest reliability studies, however captures the degree of linearity (Y = bX + a): perfect relationship can be computed, even if the measurement pairs differ not only by a additive constant 'a', but also because of a multiplication of the X-values with the slope 'b'. Therefore, intraclass correlation coefficients (ICCs) have been proposed as alternative statistics for reproducibility. However, only ICCs with absolute agreement definition of concordance capture the degree of identity. ICCs with a consistency definition of concordance measure the degree of additivity (Y = X + a). ICCs are calculated from repeated measures analyses of variance (ANOVAs), and a common population variance must be is assumed for the different measurements. Given this assumption, an ICC computed from a one-way ANOVA seems to be the best choice for this purpose. Otherwise, Lin's concordance correlation coefficient is recommended as identity measure. 相似文献
3.
4.
E. Laurent A. Lemaignen G. Gras J. Druon K. Fèvre P. Abgueguen G. Le Moal E. Stindel A.-S. Domelier S. Touchais C. Arvieux L. Bernard P. Rosset L. Grammatico-Guillon 《Revue d'épidémiologie et de santé publique》2019,67(3):149-154
Background
In France, the most severe bone and joint infections (BJI), called “complex” (CBJI), are assessed in a multidisciplinary team meeting (MTM) in a reference center. However, the definition of CBJI, drawn up by the Health Ministry, is not consensual between physicians. The objective was to estimate the agreement for CBJI classification.Methods
Initially, five experts from one MTM classified twice, one-month apart, 24 cases as non-BJI, simple BJI or CBJI, using the complete medical record. Secondly, six MTMs classified the same cases using standardized information. Agreements were estimated using Fleiss and Cohen kappa (κ) coefficients.Results
Inter-expert agreement during one MTM was moderate (κ = 0.49), and fair (κ = 0.23) when the four non-BJIs were excluded. Intra-expert agreement was moderate (κ = 0.50, range 0.27–0.90), not improved with experience. The overall inter-MTM agreement was moderate (κ = 0.58), it was better between MTMs with professor (κ = 0.65) than without (κ = 0.51) and with longer median time per case (κ = 0.60) than shorter (κ = 0.47). When the four non-BJIs were excluded, the overall agreement decreased (κ = 0.40).Conclusion
The first step confirmed the heterogeneity of CBJI classification between experts. The seemingly better inter-MTM than inter-expert agreement could be an argument in favour of MTMs, which are moreover a privileged place to enhance expertise. Further studies are needed to assess these results as well as the quality of care and medico-economic outcomes after a MTM. 相似文献5.
E. Marra N. Kroone E. Freriks C.L. van Dam C.J. Alberts A.A. Hogewoning S. Bruisten A. van Dijk M.M. Kroone T. Waterboer M.F. Schim van der Loeff 《The Journal of infection》2018,76(4):393-405
Background
We studied prevalence, risk factors and concordance of vaginal and anal HPV infection and L1 seropositivity among female sex workers (FSW) in Amsterdam.Methods
In 2016, FSW aged ≥18 years having a sexually transmitted infections (STI) consultation were invited to participate. Participation entailed taking vaginal and anal self-swabs. Demographics and sexual behaviour data were collected. HPV DNA was analysed using the SPF10-PCR-DEIA-LiPA25-system-v1. Serum was tested for HPV L1 antibodies using multiplex serology assays. Determinants of vaginal and anal high risk HPV (hrHPV) infection and L1 seropositivity were assessed with logistic regression analyses.Results
We included 304 FSW; median age was 29 years (IQR 25–37). Vaginal and anal hrHPV prevalence were 46% and 55%, respectively. HrHPV L1 seropositivity was 37%. Vaginal-anal hrHPV concordance was strong, but no significant association between vaginal or anal hrHPV infection and seropositivity was found. Having had anal sexual contact was not associated with anal hrHPV infection (P = 0.119).Discussion
Vaginal and anal hrHPV prevalence is high among FSW in Amsterdam, the Netherlands. Promotion of HPV vaccination, preferably at the beginning of the sex (work) career, may be a useful prevention method against hrHPV infection and disease. 相似文献6.
《Vaccine》2015,33(32):3887-3893
ObjectivesTo estimate the predictive value of self-reported hepatitis A vaccine (HepA) receipt for the presence of hepatitis A virus (HAV) antibody (anti-HAV) from either past infection or vaccination, as an indicator of HAV protection.MethodsUsing 2007–2012 National Health and Nutrition Examination Survey data, we assigned participants to 4 groups based on self-reported HepA receipt and anti-HAV results. We compared characteristics across groups and calculated three measures of agreement between self-report and serologic status (anti-HAV): percentage concordance, and positive (PPV) and negative (NPV) predictive values. Using logistic regression we investigated factors associated with agreement between self-reported vaccination status and serological results.ResultsDemographic and other characteristics varied significantly across the 4 groups. Overall agreement between self-reported HepA receipt and serological results was 63.6% (95% confidence interval [CI] 61.9–65.2); PPV and NPV of self-reported vaccination status for serological result were 47.0% (95% CI 44.2–49.8) and 69.4% (95% CI 67.0–71.8), respectively. Mexican American and foreign-born adults had the highest PPVs (71.5% [95% CI 65.9–76.5], and 75.8% [95% CI 71.4–79.7]) and the lowest NPVs (21.8% [95% CI 18.5–25.4], and 20.0% [95% CI 17.2–23.1]), respectively. Young (ages 20–29 years), US-born, and non-Hispanic White adults had the lowest PPVs (37.9% [95% CI 34.5–41.5], 39.1% [95% CI, 36.0–42.3], and 39.8% [36.1–43.7]), and the highest NPVs (76.9% [95% CI 72.2–81.0, 78.5% [95% CI 76.5–80.4)], and 80.6% [95% CI 78.2–82.8), respectively. Multivariate logistic analyses found age, race/ethnicity, education, place of birth and income to be significantly associated with agreement between self-reported vaccination status and serological results.ConclusionsWhen assessing hepatitis A protection, self-report of not having received HepA was most likely to identify persons at risk for hepatitis A infection (no anti-HAV) among young, US-born and non-Hispanic White adults, and self-report of HepA receipt was least likely to be reliable among adults with the same characteristics. 相似文献
7.
Background:
The Composite International Diagnostic Interview-3.0 (CIDI-3.0) is a fully structured lay-administered diagnostic interview for the assessment of mental disorders according to ICD-10 and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. The aim of the study was to investigate the concurrent validity of the Chinese CIDI in diagnosing mental disorders in psychiatric settings.Methods:
We recruited 208 participants, of whom 148 were patients from two psychiatric hospitals and 60 healthy people from communities. These participants were administered with CIDI by six trained lay interviewers and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I, gold standard) by two psychiatrists. Agreement between CIDI and SCID-I was assessed with sensitivity, specificity, positive predictive value and negative predictive value. Individual-level CIDI-SCID diagnostic concordance was evaluated using the area under the receiver operator characteristic curve and Cohen''s K.Results:
Substantial to excellent CIDI to SCID concordance was found for any substance use disorder (area under the receiver operator characteristic curve [AUC] = 0.926), any anxiety disorder (AUC = 0.807) and any mood disorder (AUC = 0.806). The concordance between the CIDI and the SCID for psychotic and eating disorders is moderate. However, for individual mental disorders, the CIDI-SCID concordance for bipolar disorders (AUC = 0.55) and anorexia nervosa (AUC = 0.50) was insufficient.Conclusions:
Overall, the Chinese version of CIDI-3.0 has acceptable validity in diagnosing the substance use disorder, anxiety disorder and mood disorder among Chinese adult population. However, we should be cautious when using it for bipolar disorders and anorexia nervosa. 相似文献8.
Ernesto Magallón-Neri José Eugenio De la Fuente Gloria Canalda Maria Forns Raquel García Esther González Anais Lara Josefina Castro-Fornieles 《Psychiatry research》2014
The study aimed to compare methods of identification of Personality Disorders (PD) in adolescent patients with psychiatric disorders. A sample of 120 Spanish adolescents with clinical disorders was assessed using the International Personality Disorder Examination (IPDE) interview, its Screening Questionnaires (IPDE-SQ) comprising the ICD-10 and DSM-IV modules, and also the Temperament Character Inventory (TCI) to identify risk of PD. The IPDE-SQ identified a risk of PD around 92–97% of the sample; 61.7% when adjusting the stricter cut-off points. The TCI showed a PD risk of 20%, whereas the prevalence of PD identified by the IPDE clinical interview was around 36–38%. The differences between the IPDE, IPDE-SQ and TCI were significant, and a low agreement among instruments was obtained. Large discrepancy between self-report instruments in identifying PD with regard to the clinical interview raises several questions concerning the use of these instruments in clinical settings on adolescents with psychiatric disorders. 相似文献
9.
Objectives: To explore consumers’ attitudes towards, and expectations of, adherence support services in primary health care, specifically
in community pharmacy; and to explore consumers’ attitudes towards the concept of concordance. Setting: An exploratory qualitative study conducted in Metropolitan Sydney, Australia. Method: Three focus group discussions with consumers on chronic therapy (n = 22) and two focus groups with consumer representatives (n = 15) were conducted in 2002. Consumer representatives were peer educators volunteering in an association which promotes
quality use of medicines among elderly patients. All discussions were audio-taped, transcribed verbatim and thematically content
analysed. Main outcome measures: Consumers’ experiences with adherence support services delivered by general practitioners and pharmacists, their expectations
towards general practitioners’ and pharmacists’ role in adherence support; and attitudes towards concordance in consultations.
Results: Participants expected an increased provision of medicine information and a reduction in the number of medications taken
as the main strategies to promote adherence. They believed that once understandable information had been delivered, it was
their responsibility to take their medications as prescribed. Yet participants frequently complained about the information
received, especially from doctors. Only a subgroup of participants expected pharmacists to be involved in adherence support
services. These participants generally relied on pharmacists for medicine information and were satisfied with the communication
process when interacting with the pharmacists. All participants were positive about concordance, because they valued two-way
communication and increased consideration of their needs and beliefs by healthcare professionals. However, they were hesitant
about being involved in a shared treatment decision-making process. Many participants focused on concordance with doctors
and identified barriers to the establishment of concordance: time pressures, financial constraints, the gap of competence
and power between patients and doctors. Conclusions: Pharmacists should consider consumers’ needs for information and establishing concordance, as well as their expectations
of the pharmacy profession, in delivering concordance based adherence support services. Given participants’ high demand for
medicine information, an opportunity might exist for pharmacists to influence consumers’ expectations by offering information
which is tailored towards their needs. 相似文献
10.
Amadou Jallow Sofia K?lvemark Sporrong Lilian Walther-Jallow Peter M. Persson Urban Hellgren ?rjan Ericsson 《Pharmacy World & Science》2007,29(4):422-429
Objective The main objective of this study was to identify and compare the common problems and difficulties associated with combination
antiretroviral therapy (CART) as experienced by three major groups of HIV infected individuals (homo- or bisexuals, former
injecting drug users and origins of Sub-Saharan Africa) in Sweden.
Methods Based on the results from in-depth interviews with 15 representatives from the three major groups, a questionnaire was designed
for use in a problem detection study (PDS). The study was conducted with 195 HIV-positive patients residing in the major cities
of Sweden.
Results The overall response rate was 79%. The problems identified in all three groups were negative attitudes from the public, worries
about disease progression or therapy failure, medication or drug-related problems and problems in connection to pharmacy visits.
A specific problem in the homo- or bisexual group was drug-related problems such as adverse effects, drug interactions and
pill burden. For former injecting drug users, the specific problem was disease-related conflicts with relatives and the problem
of coping with the social and psychological burden caused by the HIV infection. The African group termed the risk of exposing
their medication at the pharmacy as a specific problem, as this could reveal their HIV status.
Conclusions Our findings regarding problems with CART in three patient groups in Sweden may be of use to tailor pharmacy care to HIV infected
individuals.
General strategies to improve adherence need to be complemented with approaches that will address the specific needs for the
different patient groups affected by HIV. Further studies on group-specific interventions that promote concordance and adherence
to CART will be necessary to minimize therapy failure and viral resistance. 相似文献