Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints
Abstract Objectives To assess: (1) the prevalence of mental health and substance use in patients presenting to the emergency department (ED) through use of a computer adaptive test (CAT‐MH), (2) the correlation among CAT‐MH scores and self‐ and clinician‐reported assessments, and (3) the association...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12804 |
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| author | Lauren M. O'Reilly Azhar I. Dalal BS Serena Maag MS Matthew T. Perry BS Alex Card DO Max B. Bohrer BS Jackson Hamersly BS Setarah Mohammad Nader MD Kelli Peterson RN David G. Beiser Robert D. Gibbons Brian M. D'Onofrio Paul I. Musey |
| author_facet | Lauren M. O'Reilly Azhar I. Dalal BS Serena Maag MS Matthew T. Perry BS Alex Card DO Max B. Bohrer BS Jackson Hamersly BS Setarah Mohammad Nader MD Kelli Peterson RN David G. Beiser Robert D. Gibbons Brian M. D'Onofrio Paul I. Musey |
| author_sort | Lauren M. O'Reilly |
| collection | DOAJ |
| description | Abstract Objectives To assess: (1) the prevalence of mental health and substance use in patients presenting to the emergency department (ED) through use of a computer adaptive test (CAT‐MH), (2) the correlation among CAT‐MH scores and self‐ and clinician‐reported assessments, and (3) the association between CAT‐MH scores and ED utilization in the year prior and 30 days after enrollment. Methods This was a single‐center observational study of adult patients presenting to the ED for somatic complaints (97%) from May 2019 to March 2020. The main outcomes were computer‐adaptive‐assessed domains of suicidality, depression, anxiety, post‐traumatic stress disorder (PTSD), and substance use. We conducted Pearson correlations and logistic regression for objectives 2 and 3, respectively. Results From a sample of 794 patients, the proportion of those at moderate/severe risk was: 24.1% (suicidality), 8.3% (depression), 16.5% (anxiety), 12.3% (PTSD), and 20.4% (substance use). CAT‐MH domains were highly correlated with self‐report assessments (r = 0.49–0.79). Individuals who had 2 or more ED visits in the prior year had 62% increased odds of being in the intermediate‐high suicide risk category (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.07–2.44) compared to those with zero prior ED visits. Individuals who scored in the intermediate‐high‐suicide risk group had 63% greater odds of an ED visit within 30 days after enrollment compared to those who scored as low risk (OR, 1.63; 95% CI, 1.09, 2.44). Conclusion The CAT‐MH documented that a considerable proportion of ED patients presenting for somatic problems had mental health conditions, even if mild. Mental health problems were also associated with ED utilization. |
| format | Article |
| id | doaj-art-4a7e4d71e4cd41218c5944584b51d077 |
| institution | OA Journals |
| issn | 2688-1152 |
| language | English |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-4a7e4d71e4cd41218c5944584b51d0772025-08-20T02:17:40ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522022-10-0135n/an/a10.1002/emp2.12804Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaintsLauren M. O'Reilly0Azhar I. Dalal BS1Serena Maag MS2Matthew T. Perry BS3Alex Card DO4Max B. Bohrer BS5Jackson Hamersly BS6Setarah Mohammad Nader MD7Kelli Peterson RN8David G. Beiser9Robert D. Gibbons10Brian M. D'Onofrio11Paul I. Musey12Department of Psychological and Brain Sciences Indiana University Bloomington Indiana USADepartment of Emergency Medicine Indiana University School of Medicine Indianapolis Indiana USADepartment of Emergency Medicine Indiana University School of Medicine Indianapolis Indiana USADepartment of Emergency Medicine Indiana University School of Medicine Indianapolis Indiana USADepartment of Emergency Medicine Indiana University School of Medicine Indianapolis Indiana USADepartment of Emergency Medicine Indiana University School of Medicine Indianapolis Indiana USADepartment of Emergency Medicine Indiana University School of Medicine Indianapolis Indiana USADepartment of Emergency Medicine Indiana University School of Medicine Indianapolis Indiana USADepartment of Emergency Medicine Indiana University School of Medicine Indianapolis Indiana USASection of Emergency Medicine Department of Medicine University of Chicago Chicago Illinois USADepartments of Medicine and Public Health Science (Biostatistics) University of Chicago Chicago Illinois USADepartment of Psychological and Brain Sciences Indiana University Bloomington Indiana USADepartment of Emergency Medicine Indiana University School of Medicine Indianapolis Indiana USAAbstract Objectives To assess: (1) the prevalence of mental health and substance use in patients presenting to the emergency department (ED) through use of a computer adaptive test (CAT‐MH), (2) the correlation among CAT‐MH scores and self‐ and clinician‐reported assessments, and (3) the association between CAT‐MH scores and ED utilization in the year prior and 30 days after enrollment. Methods This was a single‐center observational study of adult patients presenting to the ED for somatic complaints (97%) from May 2019 to March 2020. The main outcomes were computer‐adaptive‐assessed domains of suicidality, depression, anxiety, post‐traumatic stress disorder (PTSD), and substance use. We conducted Pearson correlations and logistic regression for objectives 2 and 3, respectively. Results From a sample of 794 patients, the proportion of those at moderate/severe risk was: 24.1% (suicidality), 8.3% (depression), 16.5% (anxiety), 12.3% (PTSD), and 20.4% (substance use). CAT‐MH domains were highly correlated with self‐report assessments (r = 0.49–0.79). Individuals who had 2 or more ED visits in the prior year had 62% increased odds of being in the intermediate‐high suicide risk category (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.07–2.44) compared to those with zero prior ED visits. Individuals who scored in the intermediate‐high‐suicide risk group had 63% greater odds of an ED visit within 30 days after enrollment compared to those who scored as low risk (OR, 1.63; 95% CI, 1.09, 2.44). Conclusion The CAT‐MH documented that a considerable proportion of ED patients presenting for somatic problems had mental health conditions, even if mild. Mental health problems were also associated with ED utilization.https://doi.org/10.1002/emp2.12804anxietydepressionmental healthscreeningsuicideutilization |
| spellingShingle | Lauren M. O'Reilly Azhar I. Dalal BS Serena Maag MS Matthew T. Perry BS Alex Card DO Max B. Bohrer BS Jackson Hamersly BS Setarah Mohammad Nader MD Kelli Peterson RN David G. Beiser Robert D. Gibbons Brian M. D'Onofrio Paul I. Musey Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints Journal of the American College of Emergency Physicians Open anxiety depression mental health screening suicide utilization |
| title | Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
| title_full | Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
| title_fullStr | Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
| title_full_unstemmed | Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
| title_short | Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
| title_sort | computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints |
| topic | anxiety depression mental health screening suicide utilization |
| url | https://doi.org/10.1002/emp2.12804 |
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