The reliability and validity of the collateral source version of the Geriatric Depression Rating Scale administered by telephone.

OBJECTIVE: To prospectively evaluate the reliability and validity of the Collateral Source Geriatric Depression Scale (CS-GDS) administered by telephone (T-CS-GDS) in patients undergoing outpatient comprehensive geriatric assessment. SUBJECTS: Eighty-three geriatric patients evaluated in a 1-year period at the outpatient Geriatric Assessment Center of the University of Nebraska Medical Center. METHODS: The 30-item CS-GDS was completed by the collateral source of all patients on three occasions: by telephone several days before their assessment, face-to-face during their assessment visit and several days later, again by phone. During their assessment, all patients were evaluated by one of three geriatric psychiatrists who were blinded to CS-GDS results. The test retest reliability of the T-CS-GDS was measured by comparing the results of the two phone interviews. The construct validity of the T-CS-GDS was estimated by comparing the results of the initial T-CS-GDS with the CS-GDS obtained during the comprehensive assessment. The criterion validity of the T-CS-GDS was estimated by comparing the results of the T-CS-GDS with the clinical diagnosis of depression assigned by the psychiatrists. RESULTS: The individual items of the initial T-CS-GDS showed substantial concordance with the second T-CS-GDS (kappa range 0.41-0.8, mean = 0.61) and with the assessment GDS (kappa range 0.33-0.85, mean = 0.61). Twelve items showed evidence of bias when comparing the two T-CS-GDSs and four items when comparing the initial T-CS-GDS with the CS-GDS done during the assessment. The mean number of symptomatic responses was not significantly different for the T-CS-GDS vs assessment administration but did decline slightly when comparing the two T-CS-GDSs. ROC curve analysis showed good agreement between the clinical diagnosis and the T-CS-GDS. CONCLUSION: The CS-GDS appears to maintain its reliability and validity when administered via telephone and thus may be useful for a variety of epidemiologic and clinical purposes.

The reliability and validity of the Geriatric Depression Rating Scale administered by telephone.

OBJECTIVE: To evaluate prospectively the reliability and validity of the Geriatric Depression Scale administered by telephone (T-GDS) in patients undergoing outpatient comprehensive geriatric assessment. SUBJECTS: A total of 101 geriatric patients were evaluated in a 1-year period at the outpatient Geriatric Assessment Center of the University of Nebraska Medical Center. METHODS: The 30-item GDS was completed by all patients on three occasions: by telephone several days before their assessment, face-to-face during their assessment visit, and several days later, again by phone. During their assessment, all patients were evaluated by one of three geriatric psychiatrists who were blind to all GDS results. The test-retest reliability of the T-GDS was measured by comparing the results of the two phone interviews. The construct validity of the T-GDS was estimated by comparing the results of the initial T-GDS to the GDS obtained during the comprehensive assessment. The criterion validity of the T-GDS was estimated by comparing the results of the T-GDS with the clinical diagnosis of depression assigned by the psychiatrists. RESULTS: The individual items of the initial T-GDS showed substantial concordance with the second T-GDS (kappa range 0.35-0.75, mean = 0.52), and with the assessment GDS (kappa range 0.29-0.75, mean = 0.52). One item showed evidence of bias when comparing the two T-GDSs, and two items when comparing the initial T-GDS to the GDS done during the assessment. The mean number of symptomatic responses was not significantly different for the T-GDS versus assessment administration but did decline slightly when comparing the two T-GDSs. ROC curve analyses showed good agreement between the clinical diagnosis and the T-GDS. CONCLUSION: The GDS appears to maintain its reliability and validity when administered via telephone and thus may be useful for a variety of epidemiological and clinical purposes.

Venous anatomy of the pancreatic head: normal CT appearance in cadavers and patients.

OBJECTIVE: This study was conducted to define the normal CT appearance of the four pancreaticoduodenal veins (anterior and posterior superior, and anterior and posterior inferior) in the head of the pancreas in injected cadaveric specimens and to assess the frequency with which these normal vessels are seen on dynamic contrast-enhanced CT scans. MATERIALS AND METHODS: The appearance of the four pancreaticoduodenal veins was studied on CT scans of four cadavers in which the portal veins were injected in situ with radiopaque solutions. A computer-generated three-dimensional model of the pancreatic head and its venous drainage was then produced from one cadaveric examination to show the venous anatomy. After definition of the venous anatomy in the cadaveric specimen, the anterior superior pancreaticoduodenal vein, posterior superior pancreaticoduodenal vein, and gastrocolic trunk were analyzed retrospectively on dynamic bolus contrast-enhanced abdominal CT scans of 100 consecutive patients who had no evidence of pancreatic disease. RESULTS: The anterior and posterior superior pancreaticoduodenal veins were seen on 98% and 88% of scans, respectively. The veins had mean diameters of 2.1 mm. The gastrocolic trunk was seen on 89% of scans and had a mean diameter of 4.7 mm. The inferior pancreaticoduodenal veins are small and were not identified definitively. CONCLUSION: The anterior and posterior superior pancreaticoduodenal veins and gastrocolic trunk are routinely visualized on CT scans of patients without pancreatic disease. Consequently, assessment of the veins may be useful in staging pancreatic carcinoma.

Videodisc animation of 3D computer reconstructions of the human brain.

Our group is creating a database of x-, y-, z- coordinates of central nervous system structures from serial cross-sections. We produce 3D computer images of the brain and its components and record them on videodisc. Useful animations include combining objects from different databases to correct anatomical scale, rendering a surface translucent to reveal underlying components, slicing and paging brain slabs with and without protruding individual objects, and dissecting functional pathways. We are beginning to use videodisc animations of the nervous system in computer-based interactive tutorials.