Somatic symptom count scores do not identify patients with symptoms unexplained by disease: a prospective cohort study of neurology outpatients.
OBJECTIVE: Somatic symptoms unexplained by disease are common in all medical settings. The process of identifying such patients requires a clinical assessment often supported by clinical tests. Such assessments are time-consuming and expensive. Consequently the observation that such patients tend to...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
BMJ Publishing Group
2014
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| _version_ | 1826278087658045440 |
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| author | Carson, A Stone, J Hansen, C Duncan, R Cavanagh, J Matthews, K Murray, G Sharpe, M |
| author_facet | Carson, A Stone, J Hansen, C Duncan, R Cavanagh, J Matthews, K Murray, G Sharpe, M |
| author_sort | Carson, A |
| collection | OXFORD |
| description | OBJECTIVE: Somatic symptoms unexplained by disease are common in all medical settings. The process of identifying such patients requires a clinical assessment often supported by clinical tests. Such assessments are time-consuming and expensive. Consequently the observation that such patients tend to report a greater number of symptom has led to the use of self-rated somatic symptom counts as a simpler and cheaper diagnostic aid and proxy measure for epidemiological surveys. However, despite their increasing popularity there is little evidence to support their validity. METHODS: We tested the score on a commonly used self-rated symptom questionnaire- the Patient Health Questionnaire (PHQ 15) (plus enhanced iterations including an additional 10 items on specific neurological symptoms and an additional 5 items on mental state) for diagnostic sensitivity and specificity against a medical assessment (with 18 months follow-up) in a prospective cohort study of 3781 newly attending patients at neurology clinics in Scotland, UK. RESULTS: We found 1144/3781 new outpatients had symptoms that were unexplained by disease. The patients with symptoms unexplained by disease reported higher symptoms count scores (PHQ 15: 5.6 (95% CI 5.4 to 5.8) vs 4.2 (4.1 to 4.4) p<0.0001). However, the PHQ15 performed little better than chance in its ability to identify patients with symptoms unexplained by disease. The findings with the enhanced scales were similar. CONCLUSIONS: Self-rated symptom count scores should not be used to identify patients with symptoms unexplained by disease. |
| first_indexed | 2024-03-06T23:38:42Z |
| format | Journal article |
| id | oxford-uuid:6e8b1b14-1011-4c3b-baf1-baf473841dcf |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:38:42Z |
| publishDate | 2014 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:6e8b1b14-1011-4c3b-baf1-baf473841dcf2022-03-26T19:25:11ZSomatic symptom count scores do not identify patients with symptoms unexplained by disease: a prospective cohort study of neurology outpatients.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6e8b1b14-1011-4c3b-baf1-baf473841dcfEnglishSymplectic Elements at OxfordBMJ Publishing Group2014Carson, AStone, JHansen, CDuncan, RCavanagh, JMatthews, KMurray, GSharpe, MOBJECTIVE: Somatic symptoms unexplained by disease are common in all medical settings. The process of identifying such patients requires a clinical assessment often supported by clinical tests. Such assessments are time-consuming and expensive. Consequently the observation that such patients tend to report a greater number of symptom has led to the use of self-rated somatic symptom counts as a simpler and cheaper diagnostic aid and proxy measure for epidemiological surveys. However, despite their increasing popularity there is little evidence to support their validity. METHODS: We tested the score on a commonly used self-rated symptom questionnaire- the Patient Health Questionnaire (PHQ 15) (plus enhanced iterations including an additional 10 items on specific neurological symptoms and an additional 5 items on mental state) for diagnostic sensitivity and specificity against a medical assessment (with 18 months follow-up) in a prospective cohort study of 3781 newly attending patients at neurology clinics in Scotland, UK. RESULTS: We found 1144/3781 new outpatients had symptoms that were unexplained by disease. The patients with symptoms unexplained by disease reported higher symptoms count scores (PHQ 15: 5.6 (95% CI 5.4 to 5.8) vs 4.2 (4.1 to 4.4) p<0.0001). However, the PHQ15 performed little better than chance in its ability to identify patients with symptoms unexplained by disease. The findings with the enhanced scales were similar. CONCLUSIONS: Self-rated symptom count scores should not be used to identify patients with symptoms unexplained by disease. |
| spellingShingle | Carson, A Stone, J Hansen, C Duncan, R Cavanagh, J Matthews, K Murray, G Sharpe, M Somatic symptom count scores do not identify patients with symptoms unexplained by disease: a prospective cohort study of neurology outpatients. |
| title | Somatic symptom count scores do not identify patients with symptoms unexplained by disease: a prospective cohort study of neurology outpatients. |
| title_full | Somatic symptom count scores do not identify patients with symptoms unexplained by disease: a prospective cohort study of neurology outpatients. |
| title_fullStr | Somatic symptom count scores do not identify patients with symptoms unexplained by disease: a prospective cohort study of neurology outpatients. |
| title_full_unstemmed | Somatic symptom count scores do not identify patients with symptoms unexplained by disease: a prospective cohort study of neurology outpatients. |
| title_short | Somatic symptom count scores do not identify patients with symptoms unexplained by disease: a prospective cohort study of neurology outpatients. |
| title_sort | somatic symptom count scores do not identify patients with symptoms unexplained by disease a prospective cohort study of neurology outpatients |
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