SDDS-PCSymptom Driven Diagnostic System for Primary Care
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De un total de 500 pacientes se identifico a 100 de ellos con la condicion de interes (definido por el SDDS-PC), y se encontro que 86 fueron correctamente identificados por el tamizaje de las 2 preguntas (verdaderos positivos); la sensibilidad de la prueba fue del 86%.
Evaluacion de la sensibilidad y especificidad Symptom Driven Diagnostic System for Primary Care (SDDS-PC) Dos preguntas Positivo Negativo Total Positivo 86 20 106 Negativo 14 380 394 Total 100 400 500 Prevalencia de la enfermedad=(100/500)=20%; Sensibilidad=(86/100) = 86%; Especificidad=(380/400)=95%; VPP= (86/106)= 81%; VPN=(380/394)= 96%.
One example of a computer-based tool is the Symptom Driven Diagnostic System for Primary Care (SDDS-PC).[53] Because depression is known to be a chronic recurring disease,[54] more emphasis will be placed on using tools with longitudinal tracking capabilities (eg, the ability to detect relapse and recurrence).
The SDDS-PC: a novel diagnostic procedure for mental disorders in primary care.
While the operating characteristics of these instruments appear sound,[24] and the SDDS-PC has a predictive value rivaling other common screening tests,[24] results of feedback have been disappointing and a clinically relevant effect on outcomes is lacking.[1,2,17,22] Rowe et al[14] suggest targeting screening to individuals with defined risk factors, but Mulrow's analysis[24] suggests that doing so would only marginally increase the predictive value of screening.
The mental health symptoms included an abbreviated 18-item version of the Center for Epidemiology Studies Depression Scale (CES-D)[20] and the SDDS-PC screen for multiple mental disorders.[19] The validity of the SDDS-PC screen as a first instrument to help identify common mental disorders in primary care has been previously discussed in the literature.[19]
The rate of psychological management was also significantly higher among patients who were positive for all four of these conditions on the SDDS-PC screening questionnaire.
The hypothesized explanatory variables included patient age, sex, race, marital status, education, missing work for emotional reasons, problems getting along with partner, visits with family or friends during the past month, disability payments, overall emotional health, and positive result on the SDDS-PC screen for major depression, panic disorder, alcohol abuse/dependence, or obsessive-compulsive disorder.