Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints
OBJECTIVES: To assess: (1) the prevalence of mental health and substance use in patients presenting to the emergency department (ED) through use of a computer adaptive test (CAT‐MH), (2) the correlation among CAT‐MH scores and self‐ and clinician‐reported assessments, and (3) the association between...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9494206/ https://www.ncbi.nlm.nih.gov/pubmed/36187506 http://dx.doi.org/10.1002/emp2.12804 |
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author | O'Reilly, Lauren M. Dalal, Azhar I. Maag, Serena Perry, Matthew T. Card, Alex Bohrer, Max B. Hamersly, Jackson Mohammad Nader, Setarah Peterson, Kelli Beiser, David G. Gibbons, Robert D. D'Onofrio, Brian M. Musey, Paul I. |
author_facet | O'Reilly, Lauren M. Dalal, Azhar I. Maag, Serena Perry, Matthew T. Card, Alex Bohrer, Max B. Hamersly, Jackson Mohammad Nader, Setarah Peterson, Kelli Beiser, David G. Gibbons, Robert D. D'Onofrio, Brian M. Musey, Paul I. |
author_sort | O'Reilly, Lauren M. |
collection | PubMed |
description | OBJECTIVES: To assess: (1) the prevalence of mental health and substance use in patients presenting to the emergency department (ED) through use of a computer adaptive test (CAT‐MH), (2) the correlation among CAT‐MH scores and self‐ and clinician‐reported assessments, and (3) the association between CAT‐MH scores and ED utilization in the year prior and 30 days after enrollment. METHODS: This was a single‐center observational study of adult patients presenting to the ED for somatic complaints (97%) from May 2019 to March 2020. The main outcomes were computer‐adaptive‐assessed domains of suicidality, depression, anxiety, post‐traumatic stress disorder (PTSD), and substance use. We conducted Pearson correlations and logistic regression for objectives 2 and 3, respectively. RESULTS: From a sample of 794 patients, the proportion of those at moderate/severe risk was: 24.1% (suicidality), 8.3% (depression), 16.5% (anxiety), 12.3% (PTSD), and 20.4% (substance use). CAT‐MH domains were highly correlated with self‐report assessments (r = 0.49–0.79). Individuals who had 2 or more ED visits in the prior year had 62% increased odds of being in the intermediate‐high suicide risk category (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.07–2.44) compared to those with zero prior ED visits. Individuals who scored in the intermediate‐high‐suicide risk group had 63% greater odds of an ED visit within 30 days after enrollment compared to those who scored as low risk (OR, 1.63; 95% CI, 1.09, 2.44). CONCLUSION: The CAT‐MH documented that a considerable proportion of ED patients presenting for somatic problems had mental health conditions, even if mild. Mental health problems were also associated with ED utilization. |
format | Online Article Text |
id | pubmed-9494206 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-94942062022-09-30 Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints O'Reilly, Lauren M. Dalal, Azhar I. Maag, Serena Perry, Matthew T. Card, Alex Bohrer, Max B. Hamersly, Jackson Mohammad Nader, Setarah Peterson, Kelli Beiser, David G. Gibbons, Robert D. D'Onofrio, Brian M. Musey, Paul I. J Am Coll Emerg Physicians Open General Medicine OBJECTIVES: To assess: (1) the prevalence of mental health and substance use in patients presenting to the emergency department (ED) through use of a computer adaptive test (CAT‐MH), (2) the correlation among CAT‐MH scores and self‐ and clinician‐reported assessments, and (3) the association between CAT‐MH scores and ED utilization in the year prior and 30 days after enrollment. METHODS: This was a single‐center observational study of adult patients presenting to the ED for somatic complaints (97%) from May 2019 to March 2020. The main outcomes were computer‐adaptive‐assessed domains of suicidality, depression, anxiety, post‐traumatic stress disorder (PTSD), and substance use. We conducted Pearson correlations and logistic regression for objectives 2 and 3, respectively. RESULTS: From a sample of 794 patients, the proportion of those at moderate/severe risk was: 24.1% (suicidality), 8.3% (depression), 16.5% (anxiety), 12.3% (PTSD), and 20.4% (substance use). CAT‐MH domains were highly correlated with self‐report assessments (r = 0.49–0.79). Individuals who had 2 or more ED visits in the prior year had 62% increased odds of being in the intermediate‐high suicide risk category (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.07–2.44) compared to those with zero prior ED visits. Individuals who scored in the intermediate‐high‐suicide risk group had 63% greater odds of an ED visit within 30 days after enrollment compared to those who scored as low risk (OR, 1.63; 95% CI, 1.09, 2.44). CONCLUSION: The CAT‐MH documented that a considerable proportion of ED patients presenting for somatic problems had mental health conditions, even if mild. Mental health problems were also associated with ED utilization. John Wiley and Sons Inc. 2022-09-22 /pmc/articles/PMC9494206/ /pubmed/36187506 http://dx.doi.org/10.1002/emp2.12804 Text en © 2022 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | General Medicine O'Reilly, Lauren M. Dalal, Azhar I. Maag, Serena Perry, Matthew T. Card, Alex Bohrer, Max B. Hamersly, Jackson Mohammad Nader, Setarah Peterson, Kelli Beiser, David G. Gibbons, Robert D. D'Onofrio, Brian M. Musey, Paul I. Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
title | Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
title_full | Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
title_fullStr | Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
title_full_unstemmed | Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
title_short | Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
title_sort | computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
topic | General Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9494206/ https://www.ncbi.nlm.nih.gov/pubmed/36187506 http://dx.doi.org/10.1002/emp2.12804 |
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