Dear diary,
It has been some time since my last entry here. However, as of today, that is about to change. The office has finally received the number of complete surveys required by the Pediatric Maintenance of Certification board to complete one cycle of the implementation process of the teenage depression screen into the office procedures. In my next entry, I will discuss the results given by the MOC website and what strategies the site suggests be the next steps in the continuing implementation of the screen. But for today, I have a different sort of treat.
Below is reprinted each question from the survey, and the average score of all 21 participants on that question. For reference, the following averages are on a scale of 0 to 3, where a score of 0 indicates an answer of "Not at all," and a score of 3 (the highest score) indicates a response of "Nearly every day."
1. Feeling down, depressed, irritable, or hopeless? -- 0.57
2. Little interest or pleasure in doing things? -- 0.33
3. Trouble falling asleep, staying asleep, or sleeping too much? -- 0.71
4. Poor appetite, weight loss, or overeating? -- 0.81
5. Feeling tired, or having little energy? -- 0.76
6. Feeling bad about yourself... -- 0.66
7. Trouble concentrating on things... -- 0.71
8. Moving or speaking slowly, or the opposite? -- 0.57
9. Thoughts you were better off dead or of hurting yourself? -- 0.29
The clear standouts here are on the upper end of the range (questions 4 and 5, with scores of 0.81 and 0.76 respectively) and the lower end (questions 2 and 9, 0.33 and 0.29). This begs the question, how good are these questions at predicting the final result of the test? To help answer this question, below are the total depression scores out of 27 for each survey indicating a significant response (a 2 or 3) for each of these questions. Keep in mind that the sample sizes for each of these categories is rather small.
Question 4: average score of 0.81
Average depression score of "2" score participants: 8.5 (mild depression)
Average depression score of "3" score participants: 15 (moderately severe depression)
Average depression score of significant responses on question 4: 12.4 (moderate depression)
Question 5: average score of 0.76
Average depression score of "2" score participants: 13.5 (moderate depression)
Average depression score of "3" score participants: 13 (moderate depression)
Average depression score of significant responses on question 5: 13.33 (moderate depression)
Question 2: average score of 0.33
Average depression score of "2" score participants: 15 (moderately severe depression)
Average depression score of "3" score participants: N/A
Average depression score of significant responses on question 2: 15 (moderately severe depression)
Question 9: average score of 0.27
Average depression score of "2" score participants: 13 (moderate depression)
Average depression score of "3" score participants: N/A
Average depression score of significant responses on question 9: 13 (moderate depression)
Interestingly, we received only one response indicating a score of "2" or "3" for question 9, and three significant responses to question 2. This suggests that the lower average response scores on the 0 to 3 scale to those questions is indicative of the lower presence of these symptoms, or at least an unwillingness to share them, rather than the possibility of these questions being less commonly responded to. Therefore, these questions cannot be considered (given our limited data thus far) important indicators of overall score given that questions 2 and 9 did not receive significantly higher average depression scores of their significant responses. On the other hand, questions 4 and 5, those with the highest average response scores, showed similar levels of depression to questions 2 and 9 when the surveys containing severe scores in each were examined.
What can be said, however, is that a severe response in any of these 4 questions by itself is suggestive of an overall higher depression score. Whereas the overall average depression score was a 5.81 out of 27 (mild depression), the average score indicating a severe response in any category was 10.38 out of 27 (moderate depression), nearly double the score of those surveys not containing any severe responses. Thus, it is safe to say that a severe score for any question generally predicts a higher overall depression score, however, we at this point lack sufficient evidence to give credence to the idea of bellwether questions.
That's it for today!
Stay frosty my friends.
Friday, April 21, 2017
Friday, March 24, 2017
SRP Update
Dear diary,
This week has been a challenging one at my SRP. When I first arrived today at the location of my SRP, Camelback pediatrics, I received a number of PHQ-9 teenage depression screens to score. The process of scoring these forms is not known to everyone.
The scoring of these screens is not very difficult, and requires only a rudimentary knowledge of addition to complete. The forms have 9 questions (hence, PHQ-9), and the subjects are given a graded scale from 0-3 with which to answer each question, with a 0 indicating that the symptom described in a given question is felt rarely or never, and a 3 indicating it is almost constant (see my previous post for an in-depth look at the questions we administered!). To obtain the total depression score, one must add all of the answers together.
For example, a hypothetical patients fills out his PHQ-9 form below:
In order to obtain his final depression score, we must do some addition, and add the scores.
3 + 2 + 0 + 0 + 3 + 1 +2 + 3 + 2 = 16
Next, we read the chart below and assess the level of the patient's depression.
This week has been a challenging one at my SRP. When I first arrived today at the location of my SRP, Camelback pediatrics, I received a number of PHQ-9 teenage depression screens to score. The process of scoring these forms is not known to everyone.
The scoring of these screens is not very difficult, and requires only a rudimentary knowledge of addition to complete. The forms have 9 questions (hence, PHQ-9), and the subjects are given a graded scale from 0-3 with which to answer each question, with a 0 indicating that the symptom described in a given question is felt rarely or never, and a 3 indicating it is almost constant (see my previous post for an in-depth look at the questions we administered!). To obtain the total depression score, one must add all of the answers together.
For example, a hypothetical patients fills out his PHQ-9 form below:
3 + 2 + 0 + 0 + 3 + 1 +2 + 3 + 2 = 16
Next, we read the chart below and assess the level of the patient's depression.
From the chart above, we see that our hypothetical patient has moderately severe depression. Success! The form has been scored.
That's all for today my friends!
Stay frosty! - Ted ;)
Friday, March 3, 2017
SRP = Some Real Purpose?
Dear diary,
Today is an important day in the history of my SRP. Perhaps, no, certainly the most important orbit of earth around the moon since I embarked on this journey a number of weeks ago, for this is the day we have chosen our adolescent depression screen!
Below is a picture of said screen. Examine it closely, friends, for this document will form the BASIS (killer pun!) of all of my future work here at SRP.
Today is an important day in the history of my SRP. Perhaps, no, certainly the most important orbit of earth around the moon since I embarked on this journey a number of weeks ago, for this is the day we have chosen our adolescent depression screen!
Below is a picture of said screen. Examine it closely, friends, for this document will form the BASIS (killer pun!) of all of my future work here at SRP.
The name of this form is PHQ-9. Originally a screen for many different sorts of mental ailments, the PHQ-9 form has been specifically adapted to screen for depression in adolescents! Check by next week for new information concerning how the test is scored!
Stay frosty! - Ted ;)
Abstract (I was supposed to post this earlier whoops)
Dear diary,
Depression is a common problem which plagues thousands of teens each year. As many as 20% of teens will experience depression, but only 30% of those cases are detected. Pediatric offices, such as Camelback Pediatrics where this project will occur, are extremely important in the detection and treatment of teenage depression. Detection of this disorder is typically achieved through an oral or written survey. The effects of depression can be long-lasting and difficult to resolve, so early detection and assistance is important. Following extensive research on the topic of teenage depression, the doctors of Camelback Pediatrics, in conjunction with their Maintenance of Certification (MOC) project are researching and enhancing aspects of these necessary procedures. Once confirmed and updated, depression disorders can be better detected and addressed medically.
Stay frosty! - Ted ;)
Depression is a common problem which plagues thousands of teens each year. As many as 20% of teens will experience depression, but only 30% of those cases are detected. Pediatric offices, such as Camelback Pediatrics where this project will occur, are extremely important in the detection and treatment of teenage depression. Detection of this disorder is typically achieved through an oral or written survey. The effects of depression can be long-lasting and difficult to resolve, so early detection and assistance is important. Following extensive research on the topic of teenage depression, the doctors of Camelback Pediatrics, in conjunction with their Maintenance of Certification (MOC) project are researching and enhancing aspects of these necessary procedures. Once confirmed and updated, depression disorders can be better detected and addressed medically.
Stay frosty! - Ted ;)
Monday, February 27, 2017
SRP Progress
Dear diary,
Last week at my SRP was a somewhat eventful one. I made more phone calls for the nurses as described in my previous blog post, however, this was not my only task for this week.
After I had finished the phone calls, I spoke with the office manager for more work. She gave me a book of ADHD forms to alphabetize. The interesting part about this was that I was required to first sort the forms by letter to place into different tabs, and then alphabetize them a second time within each tab. This job did not take me very long since I am an efficient alphabetizer.
During my day of SRP, I also looked into the procedures in place for adolescent depression screening at Camelback Pediatrics. Currently, the office does not screen for adolescent depression. This week at my SRP I will be researching methods used by other valley pediatric offices to screen for adolescent depression, as well as the signs, symptoms and causes of the disorder, and presenting my findings to the doctors.
Stay frosty! - Ted ;)
Last week at my SRP was a somewhat eventful one. I made more phone calls for the nurses as described in my previous blog post, however, this was not my only task for this week.
After I had finished the phone calls, I spoke with the office manager for more work. She gave me a book of ADHD forms to alphabetize. The interesting part about this was that I was required to first sort the forms by letter to place into different tabs, and then alphabetize them a second time within each tab. This job did not take me very long since I am an efficient alphabetizer.
During my day of SRP, I also looked into the procedures in place for adolescent depression screening at Camelback Pediatrics. Currently, the office does not screen for adolescent depression. This week at my SRP I will be researching methods used by other valley pediatric offices to screen for adolescent depression, as well as the signs, symptoms and causes of the disorder, and presenting my findings to the doctors.
Stay frosty! - Ted ;)
Thursday, February 16, 2017
SRP is taking off!
Dear Diary,
Today I got my first real assignment at Camelback Pediatrics. When a pediatrician at the office needs to refer a patient to a specialist, they use what is referred to as a referral sheet. These referral sheets along with all the necessary information is then faxed to the office of the pediatric specialist. My job today was to call these offices and ensure that the faxes came through.
If the office did receive the fax, I recorded the name of the person to whom I spoke, and whether or not the patient had scheduled a visit yet. If a visit had been scheduled, my work was complete. If a visit had yet to be scheduled, I would thank the office representative, and then call the parent of the patient and give them the proper phone number to schedule a visit for their child.
If the office did not receive the fax, this when things got interesting. Most of the time when this occurred, either the fax had not yet been processed electronically, or the fax had not gone through. In either of these cases, I wrote this information down and passed it on to the nurses. In one of my about 40 or so phone calls, the hospital had received the fax, but had no record of the patient in their system. This presented a real puzzle until the office representative found out that the hospital would not accept the patient's insurance, so they would not be caring for that child. Another twist came when I contacted the parent of a patient, only to find that they had scheduled an appointment with a different hospital than the one I had just spoken to. What a day!
Stay frosty! - Ted ;)
Today I got my first real assignment at Camelback Pediatrics. When a pediatrician at the office needs to refer a patient to a specialist, they use what is referred to as a referral sheet. These referral sheets along with all the necessary information is then faxed to the office of the pediatric specialist. My job today was to call these offices and ensure that the faxes came through.
If the office did receive the fax, I recorded the name of the person to whom I spoke, and whether or not the patient had scheduled a visit yet. If a visit had been scheduled, my work was complete. If a visit had yet to be scheduled, I would thank the office representative, and then call the parent of the patient and give them the proper phone number to schedule a visit for their child.
If the office did not receive the fax, this when things got interesting. Most of the time when this occurred, either the fax had not yet been processed electronically, or the fax had not gone through. In either of these cases, I wrote this information down and passed it on to the nurses. In one of my about 40 or so phone calls, the hospital had received the fax, but had no record of the patient in their system. This presented a real puzzle until the office representative found out that the hospital would not accept the patient's insurance, so they would not be caring for that child. Another twist came when I contacted the parent of a patient, only to find that they had scheduled an appointment with a different hospital than the one I had just spoken to. What a day!
Stay frosty! - Ted ;)
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