PMID- 36764261
OWN - NLM
STAT- MEDLINE
DCOM- 20230308
LR  - 20240302
IS  - 1873-7714 (Electronic)
IS  - 0163-8343 (Print)
IS  - 0163-8343 (Linking)
VI  - 81
DP  - 2023 Mar-Apr
TI  - Development and validation of a brief screener for posttraumatic stress disorder 
      risk in emergency medical settings.
PG  - 46-50
LID - S0163-8343(23)00018-X [pii]
LID - 10.1016/j.genhosppsych.2023.01.012 [doi]
AB  - OBJECTIVE: Predicting risk of posttraumatic stress disorder (PTSD) in the acute 
      care setting is challenging given the pace and acute care demands in the 
      emergency department (ED) and the infeasibility of using time-consuming 
      assessments. Currently, no accurate brief screening for long-term PTSD risk is 
      routinely used in the ED. One instrument widely used in the ED is the 27-item 
      Immediate Stress Reaction Checklist (ISRC). The aim of this study was to develop 
      a short screener using a machine learning approach and to investigate whether 
      accurate PTSD prediction in the ED can be achieved with substantially fewer items 
      than the IRSC. METHOD: This prospective longitudinal cohort study examined the 
      development and validation of a brief screening instrument in two independent 
      samples, a model development sample (N = 253) and an external validation sample 
      (N = 93). We used a feature selection algorithm to identify a minimal subset of 
      features of the ISRC and tested this subset in a predictive model to investigate 
      if we can accurately predict long-term PTSD outcomes. RESULTS: We were able to 
      identify a reduced subset of 5 highly predictive features of the ISRC in the 
      model development sample (AUC = 0.80), and we were able to validate those 
      findings in the external validation sample (AUC = 0.84) to discriminate 
      non-remitting vs. resilient trajectories. CONCLUSION: This study developed and 
      validated a brief 5-item screener in the ED setting, which may help to improve 
      the diagnostic process of PTSD in the acute care setting and help ED clinicians 
      plan follow-up care when patients are still in contact with the healthcare 
      system. This could reduce the burden on patients and decrease the risk of chronic 
      PTSD.
CI  - Copyright (c) 2023. Published by Elsevier Inc.
FAU - Schultebraucks, K
AU  - Schultebraucks K
AD  - Department of Psychiatry, NYU Grossman School of Medicine, New York, USA; 
      Department of Population Health, NYU Grossman School of Medicine, New York, USA. 
      Electronic address: ks3796@cumc.columbia.edu.
FAU - Stevens, J S
AU  - Stevens JS
AD  - Department of Psychiatry and Behavioral Sciences, Emory University School of 
      Medicine, Atlanta, GA, USA; Center for Visual and Neurocognitive Rehabilitation, 
      Atlanta Veterans' Affairs Health Care System, Atlanta, GA, USA.
FAU - Michopoulos, V
AU  - Michopoulos V
AD  - Department of Psychiatry and Behavioral Sciences, Emory University School of 
      Medicine, Atlanta, GA, USA.
FAU - Maples-Keller, J
AU  - Maples-Keller J
AD  - Department of Psychiatry and Behavioral Sciences, Emory University School of 
      Medicine, Atlanta, GA, USA.
FAU - Lyu, J
AU  - Lyu J
AD  - Department of Biostatistics, Columbia University, Mailman School of Public 
      Health, New York, NY, USA.
FAU - Smith, R N
AU  - Smith RN
AD  - Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA; 
      Department of Behavioral, Social and Health Education Sciences, Emory University 
      School of Public Health, Atlanta, GA, USA.
FAU - Rothbaum, B O
AU  - Rothbaum BO
AD  - Department of Psychiatry and Behavioral Sciences, Emory University School of 
      Medicine, Atlanta, GA, USA.
FAU - Ressler, K J
AU  - Ressler KJ
AD  - Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean 
      Hospital, Belmont, MA, USA.
FAU - Galatzer-Levy, I R
AU  - Galatzer-Levy IR
AD  - Department of Psychiatry, NYU Grossman School of Medicine, New York, USA.
FAU - Powers, A
AU  - Powers A
AD  - Department of Psychiatry and Behavioral Sciences, Emory University School of 
      Medicine, Atlanta, GA, USA.
LA  - eng
GR  - R01 HL156134/HL/NHLBI NIH HHS/United States
GR  - K23 AT009713/AT/NCCIH NIH HHS/United States
GR  - R01 MH129856/MH/NIMH NIH HHS/United States
GR  - R01 MH094757/MH/NIMH NIH HHS/United States
GR  - K01 MH102415/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20230128
PL  - United States
TA  - Gen Hosp Psychiatry
JT  - General hospital psychiatry
JID - 7905527
SB  - IM
MH  - Humans
MH  - *Stress Disorders, Post-Traumatic/diagnosis/epidemiology
MH  - Prospective Studies
MH  - Longitudinal Studies
MH  - Emergency Service, Hospital
PMC - PMC10866012
MID - NIHMS1963218
OTO - NOTNLM
OT  - Acute trauma
OT  - Emergency department
OT  - Machine learning
OT  - Posttraumatic stress disorder
OT  - Screener
EDAT- 2023/02/11 06:00
MHDA- 2023/03/09 06:00
PMCR- 2024/03/01
CRDT- 2023/02/10 18:21
PHST- 2022/10/21 00:00 [received]
PHST- 2023/01/24 00:00 [revised]
PHST- 2023/01/25 00:00 [accepted]
PHST- 2023/02/11 06:00 [pubmed]
PHST- 2023/03/09 06:00 [medline]
PHST- 2023/02/10 18:21 [entrez]
PHST- 2024/03/01 00:00 [pmc-release]
AID - S0163-8343(23)00018-X [pii]
AID - 10.1016/j.genhosppsych.2023.01.012 [doi]
PST - ppublish
SO  - Gen Hosp Psychiatry. 2023 Mar-Apr;81:46-50. doi: 
      10.1016/j.genhosppsych.2023.01.012. Epub 2023 Jan 28.