Reliability and validity of a modified phq-9 item inventory (Phq-12) as a screening instrument for assessing depression in Asian Indians (Cures - 65).

Objectives: To evaluate the validity and reliability of the modified Patient Health Questionnaire(PHQ) 12 item instrument as a screening tool for assessing depression compared to the PHQ -9 in a representative south Indian urban population. Methods: The Chennai Urban Rural Epidemiology Study [CURES] is a large cross-sectional study conducted in Chennai, South India. In Phase 1 of CURES(urban component), 26,001 individuals aged ≥ 20 years individuals were selected by a systematic sampling technique of whom one hundred subjects were randomly selected, using computergenerated numbers, for this validation study. Two self-reported questionnaires (modified PHQ-12 item and PHQ-9 item) were administered to the subjects to compare their effectiveness in detecting depression. Reliability and validity were assessed and Receiver Operating Characteristic (ROC) curves were plotted. Pearson’s correlation was used to compare the two questionnaires. Results: The mean age of the study was 38.6±11.6 years and 48% were males. Pearson’s correlation coefficient between the modified PHQ-12 and the PHQ-9 item was 0.913 [p<0.0001]. Factor Analysis revealed that the modified PHQ-12 item scale can be used as a unidimensional scale and had excellent internal consistency(Cronbach’s alpha:0.88). A cut point of >4 calculated using the ROC curves for the modified PHQ-12 item had the highest sensitivity (92.0%) and specificity (90.7%) using PHQ-9 as the gold standard. The positive predictive value was 76.7%, and the negative predictive value, 97.1% and the area under the ROC curve, 0.979 (95% Confidence Interval: 0.929 - 0.997, p<0.0001). Conclusion: The modified PHQ-12 item is a valid and reliable instrument for large scale population based screening of depression in Asian Indians and a cut point score of greater than 4 gave the highest sensitivity and specificity. ©

Evaluation of One Touch HORIZON--a highly affordable glucose monitor.

BACKGROUND AND OBJECTIVE: Despite the growing evidence on the benefits of self-monitoring in diabetes, the use of these meters has been low in developing countries, particularly India. Cost seems to be the major constraint. The aim of the present study is to evaluate the accuracy of One Touch HORIZON an affordable glucose meter with laboratory assessment of blood glucose. METHODS: 100 subjects with diabetes over the age of 18 years were recruited from the MV Diabetes Specialities Centre, Chennai. All the study subjects had their fasting blood tested for glucose in One Touch HORIZON by finger prick. Fasting blood glucose was also assessed in YSI 2300 STATPLUS (Yellow Springs Instruments, Ohio, USA) glucose analyzer. The Parke's Error Grid model was used to assess the accuracy of the meter against YSI plasma glucose values. RESULTS: Of the total 100 study subjects, 97 were Type 2 diabetic subjects and three were Type 1 diabetic subjects. 62% of the study subjects were males. 89% did not perform SMBG and only 2% of the diabetic subjects performed SMBG daily. The Parke's Error Grid analysis revealed 97% of results to be in Zone A when patient performed the test, 99 - 100% in Zone A when clinical staff performed the test indicating excellent accuracy and precision. CONCLUSION: One Touch HORIZON meter is an affordable meter with good accuracy and precision, specifically designed to cater to the needs of diabetic patients in developing countries.