Spurious precision : variability in procedural validity of diagnostic procedures in psychotic disorders and implications for research and treatment

Very few studies have quantified the level of agreement among alternative diagnostic procedures that use a common set of fixed operational criteria. The authors examined the procedural validity of four independent methods of assigning DSM-III-R diagnoses of psychotic disorders. METHOD: The research was conducted as a satellite study to the DSM-IV Field Trial for Schizophrenia and Related Psychotic Disorders. The setting was the National Health and Medical Research Council Schizophrenia Research Unit's Early Psychosis Prevention and Intervention Centre, which focuses on first-episode psychosis. Consecutively admitted patients (N = 50) were assessed by independent raters who used four different procedures to determine a DSM-III-R diagnosis. These procedures were 1) the diagnostic instrument developed for the DSM-IV field trial, 2) the Royal Park Multidiagnostic Instrument for Psychosis, 3) the Munich Diagnostic Checklists, and 4) a consensus DSM-III-R diagnosis assigned by a team of clinician researchers who were expert in the use of diagnostic criteria. RESULTS: Concordance between pairs of diagnostic procedures was only moderate. Corresponding levels of percent agreement, however, ranged from 66% to 76%, with converse misclassification rates of 24%-34% (assuming one procedure to be "correct"). CONCLUSIONS: These findings have significant research and clinical implications. Despite the introduction of operationally defined diagnoses, there remained an appreciable level of differential classification or misclassification arising from variability in the method of assigning the diagnostic criteria rather than the criteria themselves. Such misclassification may impede neurobiological research and have harmful clinical effects on patients with first-episode psychosis.

Assessing the intake of obesity-related foods and beverages in young children: comparison of a simple population survey with 24 hr-recall

Background: With an increasing focus on obesity prevention there is a need for simple, valid tools to assess dietary indicators that may be the targets of  intervention programs. The objective of this study was to determine the relative  validity of previous day dietary intake using a newly developed parent-proxy  questionnaire (EPAQ) for two to five year old children.

Methods: A convenience sample of participants (n = 90) recruited through preschools and the community in Geelong, Australia provided dietary data for their child via EPAQ and interviewer administered 24-hour dietary recall (24 hr-recall). Comparison of mean food and beverage group servings between the  EPAQ and 24 hr-recall was conducted and Spearman rank correlations were computed to examine the association between the two methods.

Results: Mean servings of food/beverage groups were comparable between methods for all groups except water, and significant correlations were found between the servings of food and beverages using the EPAQ and 24-hr recall methods (ranging from 0.57 to 0.88).

Conclusion: The EPAQ is a simple and useful population-level tool for  estimating the intake of obesity-related foods and beverages in children aged two to five years. When compared with 24-hour recall data, the EPAQ produced an acceptable level of relative validity and this short survey has application for population monitoring and the evaluation of population-based obesity prevention interventions for young children.

Patient recall of receiving lifestyle advice for overweight and hypertension from their general practitioner

Background
Overweight, obesity and hypertension can be prevented through improvements in lifestyle including nutrition and physical activity. General practitioners (GPs) in Australia have access to over 90% of the population in the course of a year and therefore, the general practice setting may be ideal to assist patients with lifestyle change for weight management and hypertension. The present study aimed to determine the proportion of overweight/obese patients that recalled receiving advice by their GP to make lifestyle changes for weight loss. Recall of advice received by hypertensive patients to reduce salt intake was also measured.

Methods
A face to face survey was conducted on a representative sample (urban, suburban and rural) of South Australian residents. Respondents provided information on height and weight (self-report), whether they had received lifestyle advice from their GP for weight loss, and for those with self reported hypertension if they had received advice to reduce dietary salt.

Results
The sample included 2947 South Australian adult residents (58% female; BMI (mean (SD)), 26.6 (5.3) kg/m2; age, 50.7 (18.0) years). Ninety-six percent had visited their GP in the past 12 months. Forty-one percent of males and 25% of females were overweight and 19% of males and 20% of females were obese. Twenty-seven percent of overweight/obese respondents reported receiving lifestyle advice for weight loss purposes. Of the 33% who reported they had hypertension, 34% reported receiving advice to reduce salt intake.

Conclusions
Less than 1/3 of overweight/obese patients reported that they had received lifestyle advice that could assist with weight loss from their GP. About a third of respondents with hypertension reported that they received advice to reduce salt intake. There are potentially missed opportunities in which GPs could provide re-enforcement of benefits of lifestyle changes with respect to weight and blood pressure control.

Evaluating and improving morpho-syntactic classification over multiple corpora using pre-trained, "off-the-shelf", parts-of-speech tagging tools

This paper evaluates six commonly available parts-of-speech tagging tools over corpora other than those upon which they were originally trained. In particular this investigation measures the performance of the selected tools over varying styles and genres of text without retraining, under the assumption that domain specific training data is not always available. An investigation is performed to determine whether improved results can be achieved by combining the set of tagging tools into ensembles that use voting schemes to determine the best tag for each word. It is found that while accuracy drops due to non-domain specific training, and tag-mapping between corpora, accuracy remains very high, with the support vector machine-based tagger, and the decision tree-based tagger performing best over different corpora. It is also found that an ensemble containing a support vector machine-based tagger, a probabilistic tagger, a decision-tree based tagger and a rule-based tagger produces the largest increase in accuracy and the largest reduction in error across different corpora, using the Precision-Recall voting scheme.

Evaluating and improving morpho-syntactic classification over multiple corpora using pre-trained, “off-the-shelf”, parts-of-speech tagging tools

his paper evaluates six commonly available parts-of-speech tagging tools over corpora other than those upon which they were originally trained. In particular this investigation measures the performance of the selected tools over varying styles and genres of text without retraining, under the assumption that domain specific training data is not always available. An investigation is performed to determine whether improved results can be achieved by combining the set of tagging tools into ensembles that use voting schemes to determine the best tag for each word. It is found that while accuracy drops due to non-domain specific training, and tag-mapping between corpora, accuracy remains very high, with the support vector machine-based tagger, and the decision tree-based tagger performing best over different corpora. It is also found that an ensemble containing a support vector machine-based tagger, a probabilistic tagger, a decision-tree based tagger and a rule-based tagger produces the largest increase in accuracy and the largest reduction in error across different corpora, using the Precision-Recall voting scheme.

Context reinstatement effects in children’s cued recall of strongly and weakly associated word pairs

Typically, asking people to reinstate the context of events increases their recall of those events; however, research findings have been mixed with children. We tested whether the principle underlying context reinstatement applies to children as it does to adults. This underlying principle, encoding specificity, suggests that the greater the overlap between study context cues and retrieval context cues, the more information that people should recall. In the current experiment, four age groups (7-year-olds, 9-year-olds, 11-year-olds and adults) took part in an encoding specificity procedure. At study, participants saw cue– target word pairs in which the cue word was either a strong or a weak associate of the target word (e.g., ice–COLD; blow–COLD). During an immediate cued recall test, participants were presented with the same strong or weak cue words and new, extra-list cue words. Overall, children and adults recalled more targets when they were presented with the same cue words at study and test, regardless of whether the cues were strong or weak. This finding suggests that encoding specificity applies to children as well as adults. We discuss the implications of these results.

Retrieval of episodic versus generic information : does the order of recall affect the amount and accuracy of details reported by children about repeated events?

Children (N = 157) 4 to 8 years old participated 1 time (single) or 4 times (repeated) in an interactive event. Across each condition, half were questioned a week later about the only or a specific occurrence of the event (depth first) and then about what usually happens. Half were prompted in the reverse order (breadth first). Children with repeated experience who first were asked about what usually happens reported more eventrelated information overall than those asked about an occurrence first. All children used episodic language when describing an occurrence; however, children with repeated-event experience used episodic language less often when describing what usually happens than did those with a single experience. Accuracy rates did not differ between conditions. Implications for theories of repeated-event memory are discussed.

Quantifying the positive effects of sponsor level, length, prominence and relatedness on recall and residual recall rates over time

This study is the first multi-year examination of the relative influence of the four main variables said to influence sponsorship recall. Sponsor recall data were collected from season ticket holders (STHs) of 10 professional sports teams, over periods ranging from 3 to 5 years per team. Across those teams and over that time, 309 sponsor–team relationships were examined, and sponsor recall data from over 117,000 individual STHs were collected. Sponsorship length and level were shown to have the strongest impact on recall, followed by relatedness and prominence. These variables affected both the recall of current sponsors and the decay rates of residual recall following the end of a sponsorship. The average rates of sponsor recall growth and decline have been derived from these data, giving managers a tool by which to benchmark sport sponsorship recall performance.

Mental context reinstatement or drawing: which better enhances children's recall of witnessed events and protects against suggestive questions?

The aim of this experiment was to examine the effectiveness of two techniques in enhancing children's recall of an event that they experienced approximately a week earlier. Younger (5–6 years) and older (8–9 years) children were interviewed about a magic show event in one of three conditions. Before recalling the event, some children were instructed to mentally reinstate the context of the event (MCR group), others were asked to draw the context of the event (DCR group), and others received no reinstatement instructions (NCR). Results showed that these instructions had no impact on children's free recall or responses to open-ended prompts. However, reinstatement instructions impacted children's responses to suggestive questions: those in the DCR group gave more accurate responses than those in the NCR group. These findings provide preliminary support for the use of drawing as a potentially protective exercise that lessens the impact of biased questions with child witnesses.