Do the Guidelines for Adolescent Preventive Services (GAPS) facilitate mental health diagnosis?
Do the Guidelines for Adolescent Preventive Services (GAPS) facilitate mental health diagnosis?
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DOI：
10.1177/2150131914520711
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发表时间：
2014-04-01
影响因子：
3.6
通讯作者：
Jenkins PL
中科院分区：
文献类型：
--
作者：
Gadomski AM;Scribani MB;Krupa N;Jenkins PL
GAPS综合筛查问卷是否增加了精神健康和药物滥用（MH/SA）疾病的检测或缩短了诊断时间？分析一个行政数据库和一项先前的实施研究，以比较MH/SA诊断在GAPS前（1994年5月至1998年4月）和GAPS后（1999年5月至2003年4月）的变化。在纽约的农村健康网络。8 112名青少年（13至15岁）。从1999年5月开始，在年度访问中例行进行GAPS问卷调查。对索引年度访视后的门诊访视中反映MH/SA疾病的诊断代码进行计数。基于人口的比率是使用学校入学数据得出的。使用时间序列，MH/SA的诊断率进行了比较前和后GAPS。使用生存分析，构建了年龄在13-15岁之间的青少年的历史队列，这些青少年在GAPS之前或之后进行了年度访问，以比较两个4年随访期内MH/SA诊断的时间。使用合并的数据库，使用297份GAPS问卷完成了用于MH/SA诊断的GAPS的敏感性、特异性和比例风险分析。MH/SA诊断率在GAPS前后没有显著变化（p=0.13）。GAPS后（7.0个月）和GAPS前（9.0个月，对数秩p=0.30）的MH/SA诊断时间无差异。> 3项阳性的GAPS与任何MH/SA诊断的风险增加相关（H.R. 1.97，p = 0.007）。即使与过去或最终的MH/SA诊断有关，GAPS筛查也不会改变MH/SA诊断的发生率或时间。N=250
Do the GAPS comprehensive screening questionnaires increase detection or shorten time to diagnosis of mental health and substance abuse (MH/SA) disorders? Analyses of an administrative database and a prior implementation study to compare change in MH/SA diagnoses pre-GAPS (May 1994 to April 1998) to post-GAPS (May 1999 to April 2003). Rural health network in NY. 8,112 adolescents (13 to 15 years). GAPS questionnaires routinely administered at annual visits starting May 1999. Diagnostic codes reflecting MH/SA disorders for outpatient visits subsequent to an index annual visit were enumerated. Population based rates were derived using school enrollment data. Using time series, the rate of MH/SA diagnoses was compared pre- and post-GAPS. Using survival analysis, historical cohorts of adolescents ages 13–15 years who had an annual visit pre- or post-GAPS were constructed to compare the time to MH/SA diagnosis over two 4-year follow up periods. Using a merged database, a sensitivity, specificity, and proportional hazard analysis of the GAPS for MH/SA diagnosis was completed using 297 GAPS questionnaires. The rate of MH/SA diagnosis did not change significantly pre- and post-GAPS (p=0.13). There was no difference in time to MH/SA diagnosis post-GAPS (7.0 months) and pre-GAPS (9.0 months, log rank p=0.30). A GAPS with > 3 items positive was associated with an increased risk of any MH/SA diagnosis (H.R. 1.97, p = 0.007). Even though related to past or eventual MH/SA diagnosis, GAPS screening did not change the rate of or time to MH/SA diagnosis. N=250