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Search Results: 1 - 10 of 10022 matches for " Simon Gilbody "
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Should methodological filters for diagnostic test accuracy studies be used in systematic reviews of psychometric instruments? a case study involving screening for postnatal depression
Rachel Mann, Simon M Gilbody
Systematic Reviews , 2012, DOI: 10.1186/2046-4053-1-9
Abstract: A reference set of six relevant studies was derived from a forward citation search via Web of Knowledge. The performance of the 'target condition and index test' method recommended by the Cochrane DTA Group was compared to two alternative strategies which included methodological filters. Outcome measures were total citations retrieved, sensitivity, precision and associated 95% confidence intervals (95%CI).The Cochrane recommended strategy and one of the filtered search strategies were equivalent in performance and both retrieved a total of 105 citations, sensitivity was 100% (95% CI 61%, 100%) and precision was 5.2% (2.6%, 11.9%). The second filtered search retrieved a total of 31 citations, sensitivity was 66.6% (30%, 90%) and precision was 12.9% (5.1%, 28.6%). This search missed the DTA study with most relevance to the DTA review.The Cochrane recommended search strategy, 'target condition and index test', method was pragmatic and sensitive. It was considered the optimum method for retrieval of relevant studies for a psychometric DTA review (in this case for postnatal depression). Potential limitations of using filtered searches during a psychometric mental health DTA review should be considered.The advent of systematic reviews has generated challenges to develop optimum methods with which to identify studies from electronic bibliographic databases [1]. There is a great deal of expertise in this matter for systematic reviews of randomised trials [2]. However the design of optimum information retrieval strategies for recent developments such as Diagnostic Test Accuracy (DTA) reviews is not yet resolved; challenges that exist when searching for DTA studies have been acknowledged and include the design of DTA search strategies and selection of appropriate filters [3-5]. DTA studies are important for the assessment of new or existing screening tests; the accuracy of a screening test is assessed by comparing the test to a 'gold standard' to examine if the screening test
Psychotherapy mediated by remote communication technologies: a meta-analytic review
Penny E Bee, Peter Bower, Karina Lovell, Simon Gilbody, David Richards, Linda Gask, Pamela Roach
BMC Psychiatry , 2008, DOI: 10.1186/1471-244x-8-60
Abstract: Systematic review (including electronic database searching and correspondence with authors) of randomised trials of individual remote psychotherapy. Electronic databases searched included MEDLINE (1966–2006), PsycInfo (1967–2006), EMBASE (1980–2006) and CINAHL databases (1982–2006). The Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDAN-CTR). All searches were conducted to include studies with a publication date to July 2006.Thirteen studies were identified, ten assessing psychotherapy by telephone, two by internet and one by videoconference. Pooled effect sizes for remote therapy versus control conditions were 0.44 for depression (95%CI 0.29 to 0.59, 7 comparisons, n = 726) and 1.15 for anxiety-related disorders (95%CI 0.81 to 1.49, 3 comparisons, n = 168). There were few comparisons of remote versus face-to-face psychotherapy.Remote therapy has the potential to overcome some of the barriers to conventional psychological therapy services. Telephone-based interventions are a particularly popular research focus and as a means of therapeutic communication may confer specific advantages in terms of their widespread availability and ease of operation. However, the available evidence is limited in quantity and quality. More rigorous trials are required to confirm these preliminary estimates of effectiveness. Future research priorities should include overcoming the methodological shortcomings of published work by conducting large-scale trials that incorporate both clinical outcome and more process-orientated measures.Psychological disorders account for over 15% of the total burden of disease within established economies, a significant proportion of which manifests in depressive and anxiety-related disorders [1]. For these disorders, effective treatment options often include non-pharmacological as well as pharmacological interventions. Consensus guidelines recommend the
Behavioural Activation for Depression; An Update of Meta-Analysis of Effectiveness and Sub Group Analysis
David Ekers, Lisa Webster, Annemieke Van Straten, Pim Cuijpers, David Richards, Simon Gilbody
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0100100
Abstract: Background Depression is a common, disabling condition for which psychological treatments are recommended. Behavioural activation has attracted increased interest in recent years. It has been over 5 years since our meta-analyses summarised the evidence supporting and this systematic review updates those findings and examines moderators of treatment effect. Method Randomised trials of behavioural activation for depression versus controls or anti-depressant medication were identified using electronic database searches, previous reviews and reference lists. Data on symptom level and study level moderators were extracted and analysed using meta-analysis, sub-group analysis and meta-regression respectively. Results Twenty six randomised controlled trials including 1524 subjects were included in this meta-analysis. A random effects meta-analysis of symptom level post treatment showed behavioural activation to be superior to controls (SMD ?0.74 CI ?0.91 to ?0.56, k = 25, N = 1088) and medication (SMD ?0.42 CI ?0.83 to-0.00, k = 4, N = 283). Study quality was low in the majority of studies and follow- up time periods short. There was no indication of publication bias and subgroup analysis showed limited association between moderators and effect size. Conclusions The results in this meta-analysis support and strengthen the evidence base indicating Behavioural Activation is an effective treatment for depression. Further high quality research with longer term follow-up is needed to strengthen the evidence base.
Psychological Distress during Pregnancy in a Multi-Ethnic Community: Findings from the Born in Bradford Cohort Study
Stephanie L. Prady, Kate E. Pickett, Tim Croudace, Lesley Fairley, Karen Bloor, Simon Gilbody, Kathleen E. Kiernan, John Wright
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0060693
Abstract: Purpose Antenatal anxiety and depression are predictive of future mental distress, which has negative effects on children. Ethnic minority women are more likely to have a lower socio-economic status (SES) but it is unclear whether SES is an independent risk factor for mental health in pregnancy. We described the association between maternal mental distress and socio-demographic factors in a multi-ethnic cohort located in an economically deprived city in the UK. Methods We defined eight distinct ethno-language groups (total N = 8,454) and classified a threshold of distress as the 75th centile of within-group GHQ-28 scores, which we used as the outcome for univariate and multivariate logistic regression for each ethnic group and for the sample overall. Results Financial concerns were strongly and independently associated with worse mental health for six out of the eight ethnic groups, and for the cohort overall. In some groups, factors such as working status, education and family structure were associated with worse mental health, but for others these factors were of little importance. Conclusions The diversity between and within ethnic groups in this sample underlines the need to take into consideration individual social, migration and economic circumstances and their potential effect on mental health in ethnically diverse areas.
Techniques in splintage and support during reconstruction of the tibia
M. Mooney,J. Gilbody
Strategies in Trauma and Limb Reconstruction , 2006, DOI: 10.1007/s11751-006-0008-y
Abstract: The aim of this article is to help clinicians and allied professionals understand problems that may arise with use of external fixators in limb reconstruction and trauma, and in particular describe how preventative strategies can be implemented. The indications for splinting and orthotic use with external fixators can be broadly subdivided into those that facilitate functional loading and those that maintain joint integrity and function. Specific techniques to accompany use of external fixators in fracture management and limb reconstruction are described. In particular, problems concerning knee, ankle and foot support together with leg length issues are covered and proposals for dealing with joint subluxation, forefoot deformity and toe clawing, regenerate deformity after fixator removal and oedema control are discussed. The solutions described and illustrated are intended to assist those who use external fixators but do not have regular therapist input for support in the after-care of their patients.
The psychometric properties of the subscales of the GHQ-28 in a multi-ethnic maternal sample: results from the Born in Bradford cohort
Stephanie L Prady, Jeremy NV Miles, Kate E Pickett, Lesley Fairley, Karen Bloor, Simon Gilbody, Kathleen Kiernan, Rachel Mann, John Wright
BMC Psychiatry , 2013, DOI: 10.1186/1471-244x-13-55
Abstract: We used confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) to examine the subscale structure of the GHQ-28 in an ethnically diverse community cohort of pregnant women in the UK (N = 5,089). We defined five groups according to ethnicity and language of administration, and also conducted a CFA between four groups of 1,095 women who completed the GHQ-28 both during and after pregnancy.After item reduction, 17 of the 28 items were considered to relate to the same four underlying concepts in each group; however, there was variation in the response to individual items by women of different ethnic origin and this rendered between group comparisons problematic. The EFA revealed that these measurement difficulties might be related to variation in the underlying concepts being measured by the factors.We found little evidence to recommend the use of the GHQ-28 subscales in routine clinical or epidemiological assessment of maternal women in populations of diverse ethnicity.
Translating research into practice in Leeds and Bradford (TRiPLaB): a protocol for a programme of research
Andria Hanbury, Carl Thompson, Paul M Wilson, Kate Farley, Duncan Chambers, Erica Warren, John Bibby, Russell Mannion, Ian S Watt, Simon Gilbody
Implementation Science , 2010, DOI: 10.1186/1748-5908-5-37
Abstract: TRiPLaB is built around a three-stage, sequential, approach using separate, longitudinal case studies conducted with collaborating NHS organisations, TRiPLaB will select robust innovations to implement, conduct a theory-informed exploration of the local context using a variety of data collection and analytic methods, and synthesise the information collected to identify the key factors influencing the uptake and adoption of targeted innovations. This synthesis will inform the development of tailored, multifaceted, interventions designed to increase the translation of research findings into practice. Mixed research methods, including time series analysis, quasi-experimental comparison, and qualitative process evaluation, will be used to evaluate the impact of the implementation strategies deployed.TRiPLaB is a theory-informed, systematic, mixed methods approach to developing and evaluating tailored implementation strategies aimed at increasing the translation of research-based findings into practice in one UK health economy. Through active collaboration with its local NHS, TRiPLaB aims to improve the quality of health services for the people of Leeds and Bradford and to contribute to research knowledge regarding the interaction between context and adoption behaviour in health services.In response to the recommendation of the Chief Medical Officer's Clinical Effectiveness Group that the NHS should better utilise higher education to support initiatives to enhance the effectiveness and efficiency of clinical care [1], the National Institute for Health Research (NIHR) announced a strategy of increasing partnerships between higher education and the NHS in local health economies. One means of developing these partnerships is Collaborations in Leadership and Applied Health Research and Care or CLAHRCs. The NIHR has funded nine CLAHRCs, each with an emphasis on research that makes an impact locally and with a strong, disciplined, and strategic approach to implementing that re
What work has to be done to implement collaborative care for depression? Process evaluation of a trial utilizing the Normalization Process Model
Linda Gask, Peter Bower, Karina Lovell, Diane Escott, Janine Archer, Simon Gilbody, Annette J Lankshear, Angela E Simpson, David A Richards
Implementation Science , 2010, DOI: 10.1186/1748-5908-5-15
Abstract: Application of the NPM to qualitative data collected in both focus groups and one-to-one interviews before and after an exploratory randomised controlled trial of a collaborative model of care for depression.Findings are presented as they relate to the four factors of the NPM (interactional workability, relational integration, skill-set workability, and contextual integration) and a number of necessary tasks are identified. Using the model, it was possible to observe that predictions about necessary work to implement collaborative care that could be made from analysis of the pre-trial data relating to the four different factors of the NPM were indeed borne out in the post-trial data. However, additional insights were gained from the post-trial interview participants who, unlike those interviewed before the trial, had direct experience of a novel intervention. The professional freedom enjoyed by more senior mental health workers may work both for and against normalisation of collaborative care as those who wish to adopt new ways of working have the freedom to change their practice but are not obliged to do so.The NPM provides a useful structure for both guiding and analysing the process by which an intervention is optimized for testing in a larger scale trial or for subsequent full-scale implementation.There is now a considerable evidence base for collaborative care as a 'technology' in the broadest sense for improving quality of care depression in the community [1,2], but an acknowledged gap between demonstrated efficacy of this novel intervention in randomised controlled trials and implementation in everyday practice [3]. Gunn and her colleagues [4] have described collaborative care for depression as a 'system level' intervention with four key characteristics:1. A multi-professional approach to patient care: This requires that a general practitioner (GP) or family physician and at least one other health professional (e.g., nurse, psychologist, psychiatrist, pharmac
A randomised evaluation of CollAborative care and active surveillance for Screen-Positive EldeRs with sub-threshold depression (CASPER): study protocol for a randomized controlled trial
Natasha Mitchell, Catherine Hewitt, Joy Adamson, Steve Parrott, David Torgerson, David Ekers, John Holmes, Helen Lester, Dean McMillan, David Richards, Karen Spilsbury, Christine Godfrey, Simon Gilbody
Trials , 2011, DOI: 10.1186/1745-6215-12-225
Abstract: The CASPER study has been designed to assemble an epidemiological cohort of people over 75 years of age (the CASPER cohort), from which we will identify those eligible to participate in a trial of collaborative care for sub-threshold depression (the CASPER trial).We aim to undertake a pragmatic randomised controlled multi-centre trial evaluating the effectiveness and cost-effectiveness of collaborative care; a low intensity psychological intervention in addition to usual general practitioner care versus usual general practitioner care alone. General practitioners from practices based in the North of England will be asked to identify potentially eligible patients over the age of 75 years. Patients will be sent a letter inviting them to participate in the study.We aim to recruit approximately 540 participants for the CASPER trial. A diagnostic interview will be carried out to ascertain trial eligibility with the major depressive episode module of the Mini International Neuropsychiatric Interview (M.I.N.I.), eligible participants randomised to either the intervention or usual care. The primary outcome will be measured with the Patient Health Questionnaire-9 (PHQ-9) and additional quality of life measures will be collected. Data will be collected at baseline, 4 and 12 months for both trial and cohort participants.ISRCTN: ISRCTN02202951Depression accounts for the greatest burden of disease amongst all mental health problems, and is expected to become the second-highest amongst all general health problems by 2020 [1]. By the age of 75, 1 in 7 older people meets formal diagnostic criteria for depression. Projected demographic changes mean that population strategies to tackle depression will increasingly have to address the specific needs of older people [2]. Amongst older people, depressive syndromes often affect people with chronic medical illnesses [3], cognitive impairment, social isolation or disability. Beyond personal suffering and family disruption, depression worse
Qualitative Meta-Synthesis of User Experience of Computerised Therapy for Depression and Anxiety
Sarah E. Knowles, Gill Toms, Caroline Sanders, Penny Bee, Karina Lovell, Stefan Rennick-Egglestone, David Coyle, Catriona M. Kennedy, Elizabeth Littlewood, David Kessler, Simon Gilbody, Peter Bower
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0084323
Abstract: Objective Computerised therapies play an integral role in efforts to improve access to psychological treatment for patients with depression and anxiety. However, despite recognised problems with uptake, there has been a lack of investigation into the barriers and facilitators of engagement. We aimed to systematically review and synthesise findings from qualitative studies of computerised therapies, in order to identify factors impacting on engagement. Method Systematic review and meta-synthesis of qualitative studies of user experiences of computer delivered therapy for depression and/or anxiety. Results 8 studies were included in the review. All except one were of desktop based cognitive behavioural treatments. Black and minority ethnic and older participants were underrepresented, and only one study addressed users with a co-morbid physical health problem. Through synthesis, we identified two key overarching concepts, regarding the need for treatments to be sensitive to the individual, and the dialectal nature of user experience, with different degrees of support and anonymity experienced as both positive and negative. We propose that these factors can be conceptually understood as the ‘non-specific’ or ‘common’ factors of computerised therapy, analogous to but distinct from the common factors of traditional face-to-face therapies. Conclusion Experience of computerised therapy could be improved through personalisation and sensitisation of content to individual users, recognising the need for users to experience a sense of ‘self’ in the treatment which is currently absent. Exploiting the common factors of computerised therapy, through enhancing perceived connection and collaboration, could offer a way of reconciling tensions due to the dialectal nature of user experience. Future research should explore whether the findings are generalisable to other patient groups, to other delivery formats (such as mobile technology) and other treatment modalities beyond cognitive behaviour therapy. The proposed model could aid the development of enhancements to current packages to improve uptake and support engagement.
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