Evaluating a screener to quantify PTSD risk using emergency care information : a proof of concept study

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dc.contributor.authorVan der Mei, Willem F.en_ZA
dc.contributor.authorBarbano, Anna C.en_ZA
dc.contributor.authorRatanatharathorn, Andrewen_ZA
dc.contributor.authorBryant, Richard A.en_ZA
dc.contributor.authorDelahanty, Douglas L.en_ZA
dc.contributor.authorDeRoon-Cassini, Terri A.en_ZA
dc.contributor.authorLai, Betty S.en_ZA
dc.contributor.authorLowe, Sarah R.en_ZA
dc.contributor.authorMatsuoka, Yutaka J.en_ZA
dc.contributor.authorOlff, Mirandaen_ZA
dc.contributor.authorQi, Weien_ZA
dc.contributor.authorSchnyder, Ulrichen_ZA
dc.contributor.authorSeedat, Sorayaen_ZA
dc.contributor.authorKessler, Ronald C.en_ZA
dc.contributor.authorKoenen, Karestan C.en_ZA
dc.contributor.authorShalev, Arieh Y.en_ZA
dc.date.accessioned2020-03-09T06:21:41Z
dc.date.available2020-03-09T06:21:41Z
dc.date.issued2020-03-02
dc.date.updated2020-03-08T04:21:29Z
dc.descriptionCITATION: Van Der Mei, W. F., et al. 2020. Evaluating a screener to quantify PTSD risk using emergency care information : a proof of concept study. BMC Emergency Medicine, 20:16, doi:10.1186/s12873-020-00308-z.
dc.descriptionThe original publication is available at https://bmcemergmed.biomedcentral.com
dc.description.abstractBackground: Previous work has indicated that post-traumatic stress disorder (PTSD) symptoms, measured by the Clinician-Administered PTSD Scale (CAPS) within 60 days of trauma exposure, can reliably produce likelihood estimates of chronic PTSD among trauma survivors admitted to acute care centers. Administering the CAPS is burdensome, requires skilled professionals, and relies on symptoms that are not fully expressed upon acute care admission. Predicting chronic PTSD from peritraumatic responses, which are obtainable upon acute care admission, has yielded conflicting results, hence the rationale for a stepwise screening-and-prediction practice. This work explores the ability of peritraumatic responses to produce risk likelihood estimates of early CAPS-based PTSD symptoms indicative of chronic PTSD risk. It specifically evaluates the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) as a risk-likelihood estimator. Methods: We used individual participant data (IPD) from five acute care studies that used both the PDEQ and the CAPS (n = 647). Logistic regression calculated the probability of having CAPS scores ≥ 40 between 30 and 60 days after trauma exposure across the range of initial PDEQ scores, and evaluated the added contribution of age, sex, trauma type, and prior trauma exposure. Brier scores, area under the receiver-operating characteristic curve (AUC), and the mean slope of the calibration line evaluated the accuracy and precision of the predicted probabilities. Results: Twenty percent of the sample had CAPS ≥ 40. PDEQ severity significantly predicted having CAPS ≥ 40 symptoms (p < 0.001). Incremental PDEQ scores produced a reliable estimator of CAPS ≥ 40 likelihood. An individual risk estimation tool incorporating PDEQ and other significant risk indicators is provided. Conclusion: Peritraumatic reactions, measured here by the PDEQ, can reliably quantify the likelihood of acute PTSD symptoms predictive of chronic PTSD and requiring clinical attention. Using them as a screener in a stepwise chronic PTSD prediction strategy may reduce the burden of later CAPS-based assessments. Other peritraumatic metrics may perform similarly and their use requires similar validation.en_ZA
dc.description.urihttps://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-020-00308-z
dc.description.versionPublisher's version
dc.format.extent11 pages
dc.identifier.citationVan Der Mei, W. F., et al. 2020. Evaluating a screener to quantify PTSD risk using emergency care information : a proof of concept study. BMC Emergency Medicine, 20:16, doi:10.1186/s12873-020-00308-z
dc.identifier.issn1471-227X (online)
dc.identifier.otherdoi:10.1186/s12873-020-00308-z
dc.identifier.urihttp://hdl.handle.net/10019.1/107591
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)
dc.rights.holderAuthors retain copyright
dc.subjectPost-traumatic stress disorder -- Examinationen_ZA
dc.subjectEmergency medical servicesen_ZA
dc.subjectInternational Consortium to Predict PTSDen_ZA
dc.titleEvaluating a screener to quantify PTSD risk using emergency care information : a proof of concept studyen_ZA
dc.typeArticle
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