Psychometric Properties of Vietnamese Versions of the Clinician-Rated and Self-Reported Quick Inventory of Depressive Symptomatology and the Patient Health Questionnaire.

OBJECTIVE: Major depressive disorder (MDD) is the second-most prevalent mental health condition in Vietnam. This study aims to validate the Vietnamese versions of the self-reported and clinician-rated Quick Inventory of Depressive Symptomatology (QIDS-SR and QIDS-C, respectively) and the Patient Health Questionnaire (PHQ-9), and to assess the correlations between the QIDS-SR, QIDS-C, and PHQ-9. METHODS: 506 participants with MDD (mean age, 46.3 years; 55.5% women) were assessed using the Structured Clinical Interview for DSM-5. The internal consistency, diagnostic efficiency, and concurrent validity of the Vietnamese versions of QIDS-SR, QIDS-C, and PHQ-9 were determined using the Cronbach's alpha, receiver operating characteristic curve, and Pearson correlation coefficient, respectively. RESULTS: The Vietnamese versions of QIDS-SR, QIDS-C, and PHQ-9 demonstrated acceptable validity, with an area under the receiver operating characteristic curve of 0.901, 0.967, and 0.864, respectively. Sensitivity and specificity, respectively, were 87.8% and 77.8% for QIDS-SR and 97.6% and 86.2% for QIDS-C at the cut-off score of 6, and were 82.9% and 70.1% for PHQ-9 at the cut-off score of 4. Cronbach's alphas for QIDS-SR, QIDS-C, and PHQ-9 were 0.709, 0.813, and 0.745, respectively. The PHQ-9 highly correlated with the QIDS-SR (r = 0.77, p < 0.001) and the QIDS-C (r = 0.75, p < 0.001). CONCLUSION: The Vietnamese versions of the QIDS-SR, QIDS-C, and PHQ-9 are valid and reliable tools for screening of MDD in primary healthcare settings.

The effect of income-based mandates on the demand for private hospital insurance and its dynamics.

We examine the effect of an income-based mandate on the demand for private hospital insurance and its dynamics in Australia. The mandate, known as the Medicare Levy Surcharge (MLS), is a levy on taxable income that applies to high-income individuals who choose not to buy private hospital insurance. Our identification strategy exploits changes in MLS liability arising from both year-to-year income fluctuations, and a reform where income thresholds were increased significantly. Using data from the Household, Income and Labour Dynamics in Australia longitudinal survey, we estimate dynamic panel data models that account for persistence in the decision to purchase insurance stemming from unobserved heterogeneity and state dependence. Our results indicate that being subject to the MLS penalty in a given year increases the probability of purchasing private hospital insurance by between 2 to 3 percent in that year. If subject to the penalty permanently, this probability grows further over the following years, reaching 13 percent after a decade. We also find evidence of a marked asymmetric effect of the MLS, where the effect of the penalty is about twice as large for individuals becoming liable compared with those going from being liable to not being liable. Our results further show that the mandate has a larger effect on individuals who are younger.

Automated perimetry: a report by the American Academy of Ophthalmology.

OBJECTIVE: The purpose of this document is to summarize and evaluate the effectiveness of new automated perimetry tests and algorithms in diagnosing glaucoma and detecting disease progression. METHODS: A literature search on automated perimetry retrieved over 300 citations from 1994 to 2001, of which 71 were selected as relevant to this assessment. The quality of the evidence obtained from these studies was assessed by the methodologist. RESULTS: The four automated perimetry techniques described in this assessment are short wavelength automated perimetry (SWAP), frequency doubling technology perimetry (FDT), high-pass resolution perimetry (HPRP), and motion automated perimetry (MAP). The algorithms described are Swedish interactive threshold algorithm (SITA) and SITA fast. With the exception of SWAP, these techniques and algorithms reduce testing time and inconsistent patient performance when compared with conventional full threshold testing. CONCLUSIONS: Short wavelength automated perimetry detected visual field loss earlier than standard threshold automated perimetry, with a sensitivity and specificity of about 88% and 92% respectively. However, it is a lengthy, demanding test, is sensitive to media opacities, and has a greater magnitude of long-term fluctuation compared with standard threshold automated perimetry, which make it difficult to assess disease progression accurately. When compared to standard threshold automated perimetry, FDT perimetry showed sensitivity and specificity greater than 97% for detecting moderate and advanced glaucoma, and sensitivity of 85% and specificity of 90% for early glaucoma. As FDT perimetry has a short testing time and is resistant to blur and pupil size, it may be a useful screening tool. In a longitudinal study, high-pass resolution perimetry was more effective than standard threshold automated perimetry in monitoring progressive glaucomatous loss, detecting progression at a median of 12 months earlier in 54% of patients studied. Motion automated perimetry demonstrated usefulness in detecting early glaucomatous visual loss in a longitudinal study. Studies on SITA demonstrated greater sensitivity and reproducibility and less intertest variability when compared to standard full threshold testing and a 50% reduction in testing times. A study comparing standard full threshold, SITA, and SITA fast found a sensitivity of 95% for the first two techniques and 93% for SITA fast. Long-term follow-up studies are needed to assess the ability of these techniques to detect progression of glaucoma over time.