METHODS: This was a secondary analysis of three prospective cohort studies of traumatically injured patients (N = 255). The ITSS and Automated EMR Screen were compared using receiver operating characteristic curves to predict risk of subsequent PTSD development. PTSD diagnosis at 6-month follow-up was assessed using the Clinician Administered PTSD Scale for DSM-5.
RESULTS: Just over half the sample screened positive on the ITSS (57.7%), while 67.8% screened positive on the Automated EMR Screen. The area under the curve (AUC) for the two screens was not significantly different (ITSS AUC = 0.745 versus Automated EMR Screen AUC = 0.694, p = 0.21), similar performance in PTSD risk predication within the same general trauma population. The ITSS and Automated EMR Screen had similar sensitivities (86.5%, 89.2%), and specificities (52.5%, 40.9%) respectively at their recommended cut-off points.
CONCLUSIONS: Both screens are psychometrically comparable. Therefore, trauma centers considering screening tools for PTSD risk to comply with the ACS-CoT 2023 mandate should consider their local resources and patient population. Regardless of screen selection, screening must be accompanied by a referral process to address the identified risk.
方法:这是对三个创伤患者(N=255)的前瞻性队列研究的二次分析。使用受试者工作特征曲线比较了ITSS和自动EMR屏幕,以预测随后发生PTSD的风险。使用DSM-5的临床医生管理的PTSD量表评估6个月随访时的PTSD诊断。
结果:超过一半的样本在ITSS上呈阳性(57.7%),而67.8%的人在自动EMR屏幕上呈阳性。两个屏幕的曲线下面积(AUC)没有显着差异(ITSSAUC=0.745与自动EMR屏幕AUC=0.694,p=0.21),在相同的一般创伤人群中,PTSD风险预测表现相似。ITSS和自动EMR屏幕具有相似的灵敏度(86.5%,89.2%),和特异性(52.5%,40.9%)分别在其建议的临界点。
结论:两种屏幕在心理测量上具有可比性。因此,创伤中心考虑使用符合ACS-CoT2023任务的PTSD风险筛查工具,应考虑其当地资源和患者人群.无论屏幕选择如何,筛查必须伴随转诊流程,以解决已识别的风险.