| アブストラクト | BACKGROUND: Early detection could reduce the duration of untreated psychosis. GPs are a vital part of the psychosis care pathway, but find it difficult to detect the early features. An accurate risk prediction tool, P Risk, was developed to detect these. AIM: To externally validate P Risk. DESIGN AND SETTING: This retrospective cohort study used a validation dataset of 1 647 934 UK Clinical Practice Research Datalink (CPRD) primary care records linked to secondary care records. METHOD: The same predictors (age; sex; ethnicity; social deprivation; consultations for suicidal behaviour, depression/anxiety, and substance misuse; history of consultations for suicidal behaviour; smoking history; substance misuse; prescribed medications for depression/anxiety/post-traumatic stress disorder/obsessive compulsive disorder; and total number of consultations) were used as for the development of P Risk. Predictive risk, sensitivity, specificity, and likelihood ratios were calculated for various risk thresholds. Discrimination (Harrell's C-index) and calibration were calculated. Results were compared between the development (CPRD GOLD) and validation (CPRD Aurum) datasets. RESULTS: Psychosis risk increased with values of the P Risk prognostic index. Incidence was highest in younger age groups and, in the main, higher in males. Harrell's C was 0.79 (95% confidence interval = 0.78 to 0.79) in the validation dataset and 0.77 in the development dataset. A risk threshold of 1.0% gave sensitivity of 65.9% and specificity of 86.6%. CONCLUSION: Further testing is required, but P Risk has the potential to be used in primary care to detect future risk of psychosis. |
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| ジャーナル名 | The British journal of general practice : the journal of the Royal College of General Practitioners |
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| Pubmed追加日 | 2024/7/16 |
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| 投稿者 | Sullivan, Sarah A; Morris, Richard; Kounali, Daphne; Kessler, David; Hamilton, Willie; Lewis, Glyn; Lilford, Philippa; Nazareth, Irwin |
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| 組織名 | Centre for Academic Mental Health, and National Institute for Health and Care;Research Bristol Biomedical Research Centre, University of Bristol, Bristol.;Centre for Academic Primary Care, Population Health Sciences Institute,;University of Bristol, Bristol.;Centre for Academic Mental Health, University of Bristol and Oxford Clinical;Trials Unit, Botnar Research Centre, University of Oxford, Oxford.;University of Exeter Medical School, Exeter.;Division of Psychiatry, University College London, London, and National Institute;for Health and Care Research Biomedical Research Centre.;Avon and Wiltshire Mental Health Partnership Trust.;Division of Psychiatry, University College London, London. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39009415/ |
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