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Development and validation of an ultrasonographic activity index of Crohn's disease.

OBJECTIVES: We developed and validated an ultrasonographic index of intestinal inflammatory activity for patients with Crohn's disease. METHODS: Fifty-five patients with Crohn's disease were examined by transabdominal ultrasonography. The pathological findings were classified into three types (A-C) on the basis of wall thickness and wall stratification. To calculate the index, we divided the intestine into eight segments, and the scores for each segment were summed to calculate the index (ultrasonographic activity index of Crohn's disease) as follows: 1 point for type A lesions, [wall thickness (mm) -2] x 2 for type B lesions, and [wall thickness (mm) -2] x 4 for type C lesions. Endoscopic or barium contrast findings were also scored in a similar fashion, with the following parametric scores: 10 for cobblestoning, 5 for longitudinal ulcers, 3 for aphthoid ulcers, and 1 for chronic inflammatory changes. RESULTS: A strong correlation (r2 = 0.62, P<0.01) was found between the ultrasound index and the endoscopic/radiological score, while weak correlations were found between the endoscopic/radiological score and the Crohn's disease activity index or biological indices of inflammation. CONCLUSIONS: Our results show that the ultrasonographic activity index of Crohn's disease can be of value in the ongoing assessment and treatment of patients.

Adolescent↗

Scoring atopic dermatitis in infants and young children: distinctive features of the SCORAD index.

BACKGROUND: Atopic dermatitis (AD) affects infants, children, and adults with a wide degree of severity; several scoring systems have been used in trials and clinical practice. Infants and young children have a typical distribution of the lesions, but a correlation among skin surface involvement, intensity and subjective symptoms has not been reported in age groups. AIMS OF THE STUDY: To evaluate the clinical features of AD in infants and young children, by using the SCORAD index. A simplified scoring method for clinical practice is also discussed. METHODS: The SCORAD index was assessed in 63 infants and young children with AD [mean age (+/-SD) 17.5 +/- 11.15 months]; the single parameters of the index were evaluated, and compared with each other. Serum eosinophil cationic protein (s-ECP) and urinary eosinophil protein X (u-EPX) levels were determined and correlated with the SCORAD index. RESULTS: The presence of erythema, edema/papulation, and oozing/crust was significantly high in these patients. A strong positive correlation resulted among the three SCORAD index parameters (extent-intensity: P <0.001; extent-subjective symptoms: P <0.001; intensity-subjective symptoms: P <0.001). S-ECP and u-EPX levels positively correlated to almost every single parameter of the SCORAD index as well as to its total. CONCLUSIONS: Distinctive intensity items were found in infants and young children with AD. A strong correlation resulted among the extent, intensity, and subjective symptoms; each of the three parameters was positively correlated with the total SCORAD. Immunologic parameters positively correlated to each of the SCORAD index items, which remains the gold standard for assessing disease severity in clinical trials.

Child, Preschool↗

Influence of strategic direction for NHS Scotland knowledge services on indexing policy for the NHS Scotland e-library.

OBJECTIVES: Indexing policy for the NHS Scotland e-Library needs to maximize future inter-operability with other significant health- and social-care-related resources. The strategic drive towards integration and partnership working means that the indexing system has to be widely acceptable to the full range of disciplines within the integrated health-care family. METHODS: Indexes identified by various means and then shortlisted using predefined criteria. RESULTS: Three subject indexes have been chosen--Medical Subject Headings (MeSH), CareData and the Government Category List (GCL), plus mapping between natural language and MeSH terms. This decision was a reasonable compromise between the strategy-driven aim of seamless access for all 'partners in care', and practical constraints of time/manpower. Other authority files (e.g. geographical area, language) are also standards based, and customised to reflect the information needs of an increasingly integrated health-care system. CONCLUSIONS: No single index could provide the scope required to meet the widening range of NHS information need. The influence of high-level strategic aims and objectives have extended their reach to influence indexing policy for the e-Library. Our indexing policy will continue to evolve and contribute to a knowledge management infrastructure capable of supporting current and future NHS Scotland information needs and strategy. Layperson terminology was identified as a gap; additional measures to address this gap are highlighted.

Abstracting and Indexing↗

An index of clinical oral disorder in elders (CODE).

Attempts to construct an index of oral health or disorder suitable for older adults have been limited in clinical scope or based on the judgement of very few individuals. Consequently, we present here a multidimensional index of Clinical Oral Disorder in Elders (CODE) based on a breadth of clinical measures relevant to elders. The data for the index are derived from a clinical examination of jaw function, dentures, mucosa, teeth, and periodontium. Weighting or ranking for each disorder within the context of an elderly person was established as mild, moderate or severe by experienced dental clinicians and dental hygienists. Subsequently, the index was constructed by transforming the weights into a numerical value for each clinical measure. Individual scores can relate to the heaviest weight identified during the examination or to the sum of the weights assigned throughout the examination, and the average score during a series of examinations will reflect the clinical status of a particular population. Clinical applications in elderly residential-care populations indicate that the index can be constructed efficiently and with reasonable reliability. We suggest, therefore, that the CODE index is suitable for descriptive and comparative research by providing a clinical format for measuring oral disorder in disabled elders, and, when combined with a psychosocial index, it should be very comprehensive indicator of oral dysfunction in older adults.

Aged↗

Introducing the Significant Caries Index together with a proposal for a new global oral health goal for 12-year-olds.

AIM: To describe a new index, the 'Significant Caries Index' (SiC Index) with the intention of focusing attention on those individuals with the highest caries scores in each population. METHOD: Attention is drawn to the skewed distribution of dental caries within a given population, indicating that there are still large groups of individuals who have considerably more caries than the WHO/FDI target level of DMFT 3 by the year 2000. The index is calculated as follows: individuals are sorted according to their DMFT values. The one third of the population with the highest caries score is selected and the mean DMFT for this subgroup is calculated. This value constitutes the SiC Index. RESULTS: The SiC Index can be easily calculated and used as a measure for future oral health goals. CONCLUSION: The SiC Index should be less than 3 DMFT in the 12-year-olds in a given population and it is hoped that this global oral health goal is reached at the latest by the year 2015.

Child↗

Citation indexing and evaluation of scientific papers.

Evaluation by means of citation patterns can be successful only insofar as published papers and their bibliographies reflect scientific activity and nothing else. Such an innocent descrip tion is becoming less and less tenable. The present scientific explosion gave rise to more than a proportional pub lication explosion, which not only re flects the scientific explosion but has its own dynamics and vicious circles. Publication of results is probably the main means of accomplishing the al most impossible task of accounting for time and money spent on research. Inevitably, this puts a premium on quantity at the expense of quality, and, as with any other type of inflation, the problem worsens: the more papers are written, the less they count for and the greater is the pressure to publish more. What makes matters worse is the fact that the sheer volume of the"litera ture" makes it increasingly difficult to separate what is worthwhile from the rest. Critical reviews have become somewhat of a rarity, and editorial judgment is usually relegated to ref erees, who are contemporaries and, per haps, competitors of the authors-a situation which has its own undesirable implications (11, 18). It requires little imagination to discover other vicious circles, all arising from distortion of the primary reasons for publishing the results of scientific inquiry. There are, it is true, signs of ad justment to this crisis, partly due to some easing of the pressure to pub lish at all costs, and partly due to the readers' changing attitudes toward the flood of publications. An increasing amount of research is now being car ried out in the form of collective proj ects in large institutions where publica tion is no longer the standard method of accounting for individual work. At the same time there is apparent an in creasing tendency for scientific journals to polarize into the relatively few leading ones which carry important informa tion and the many subsidiary journals which serve as vehicles for interim lo cal accounting and, in a way, sub stitute for detailed intradepartmental re ports. This division is a result not of some arbitrary decree but of normal competition between journals, as a re sult of which, however, the strong usual ly get stronger and the weak get weaker. Were it not for these changes and also for a striking improvement in abstracting, indexing, and alerting serv ices, most research workers would have found long ago that, even in their own specialized fields, new information is accumulating faster than it can be sorted out. These developments can pro vide only a temporary reprieve, so long as there remains a strong incentive to publish the greatest possible number of papers. A new scale of values based on citations is by no means infallible or, in many cases, even fair, but at least it provides an alternative to the existing one, which is at the root of the crisis. It might, of course, be asked whether wide acceptance of such new stand ards would not lead to deliberate abuses. A little reflection shows that the system is less open to manipula tion than might appear. First, the ref erees are expected to see to it that the submitted papers cite work which is pertinent to the subject. An increased awareness of the usefulness of citation indexing as a tool for retrieval and evaluation will make this aspect of refereeing more important, and what now passes for minor carelessness or discourtesy could easily come to be regarded as serious malpractice. Sec ond, as noted above, careful selection of references is in the author's own interest, because it helps him to reach his readers. There is, therefore, some room for hope that healthy feedback in the system will tend to keep it viable. At the basis of this hope lies the supposition that, in the long run, only good work can ensure recognition. As Martyn (2) has pointed out, as an information-retrieval method, cita tion indexing is rather "noisy." The word noisy may apply even more to the problem of evaluation. Whereas in information retrieval much of the unwanted information can be filtered out by suitable search strategy (2, 6), this is not so easy to do for the pur pose of evaluation, because a simple descendence relationship between papers is still an ideal far removed from actuality (7). The situation would be much better if we could at will exclude all citations which do not indi cate real indebtedness. A scheme of citation relationship indicators, first men tioned by Garfield (12) and elaborated by Lipetz (17), would be a help, but, even if it were technically feasible, to provide such indicators would greatly add to the production costs of the Index. Another possible way to minimize the effects of "noise" is to increase the size of the samples on which the reckon ing is based. Now that research has be come a rather popular occupation, it seems that a kind of public vote may have to be accepted as a factor in evaluation. Since this is the case, there is something to be said for extending the "franchise" to minimize acciden tal effects. An index which attempted to process all scientific publications would be several times the size of the present Index, and, what is more, it would not necessarily be an improve ment as a tool for information retrieval because most of the significant work is already concentrated in the present Index. Whether this attempt will ever be considered worthwhile remains pri marily a matter of policy and eco nomics. In the meantime there is an urgent need for more experience with the existing services. It is not the purpose of this article to advocate evaluation of scientific work by some kind of public opinion poll; its purpose is to recognize a pos sible trend in this direction. Any judg ment by public acclaim is subject to obvious fallacies, but we must not be carried away by the analogy to the Stock Exchange or to electoral prac tices. The fact that, in this case, the "public" consists of authors whose con tributions are generally linked creates quite a new pattern of organization. In this discussion some of the aspects of this pattern have been explored through analogy to idealized genetic or mechani cal network models, but the very uniqueness of the system, with its many self-organizing ramifications, makes it a new field which deserves close study, since these developments may have pro found effects on the future of scientific communication.

Abstracting and Indexing↗

Relation between insulin-like growth factor-I, body mass index, and clinical status in cystic fibrosis.

OBJECTIVES: Despite improved nutrition and intensive treatment, subjects with cystic fibrosis have difficulty in maintaining anabolism during intercurrent infections, which can result in reduced body mass index and impaired skeletal growth. Insulin-like growth factor-I (IGF-I) and its binding protein IGFBP3 are sensitive to changes in nutritional status. The aim of this study was to determine the relation between circulating concentrations of these peptides, body mass index, and clinical status in cystic fibrosis. METHODS: Serum concentrations of IGF-I and IGFBP3 were measured in 197 subjects (108 males, 89 females; mean age 9.69 years, range 0.41-17.9 years) and these data were analysed with respect to body mass index, pubertal stage, and clinical status as assessed by Shwachman score and forced expiratory volume in one second (FEV1). RESULTS: The mean height SD score of the children studied was -0.2 (SD 1.14) and the body mass index SD score -0.26 (1.4). The body mass index SD score declined with increasing age (r = -0.18) and paralleled changes in IGF-I concentrations, which also declined. The IGF-I SD score (calculated from control data) correlated with age (r = -0.53). The abnormalities were most obvious during late puberty, when IGF-I and IGFBP3 concentrations were significantly reduced compared with those in control subjects matched for pubertal stage. The IGF-I SD score correlated with height SD score (r = 0.14) and the decline in IGF-I concentrations with the fall in body mass index SD score (r = 0.42). IGF-I SD scores also correlated with the Shwachman score (r = 0.33) and FEV1 (r = 0.17). CONCLUSIONS: The close relation between declining IGF-I and IGFBP3 concentrations and body mass index in patients with cystic fibrosis may simply reflect poor nutritional status and insulin hyposecretion. Nevertheless, IGF-I deficiency could also contribute towards the catabolism observed in these patients, and IGF-I SD scores correlated with other measures of clinical status such as the Shwachman score and FEV1.

Adolescent↗

Development and validation of an endoscopic index of the severity for Crohn's disease: a prospective multicentre study. Groupe d'Etudes Thérapeutiques des Affections Inflammatoires du Tube Digestif (GETAID).

The aim of this study was to develop and validate an endoscopic index for assessing the severity of Crohn's disease. Endoscopic findings were prospectively collected by a multicentre group in 75 patients with Crohn's colitis according to a previously validated procedure. The presence of nine preselected lesions was recorded in the following segments (1) rectum, (2) sigmoid and left colon, (3) transverse colon, (4) right colon, and (5) ileum. In addition the extent of the diseased and ulcerated areas were estimated in each segment. These segmental data were recorded on a standard form, together with the endoscopist's global estimate of lesion severity. A stepwise multiple regression was used to derive an index which was correlated with the endoscopist's global evaluation of lesion severity. Four mucosal lesions: deep and superficial ulcerations, ulcerated and non-ulcerated stenosis, and both estimates of extent involved were selected and weighted to obtain a Crohn's Disease Endoscopic Index of Severity which correlated with the endoscopist's global appraisal of lesion severity (r = 0.83). This index was then prospectively shown to be valid in a further series of 113 colonoscopies (r = 0.81). The index was calculated in 54 patients with active Crohn's disease, before and at the end of a course of corticosteroids: index variations correctly reflected changes in colitis severity as evaluated by the endoscopists (r = 0.72). For endoscopists familiar with the data collection procedure, this Crohn's Disease Endoscopic Index of Severity should be of value in the follow up of patients, especially in clinical trials.

Colonoscopy↗

Trends in body mass index in young adults in England and Scotland from 1973 to 1988.

STUDY OBJECTIVE: The aim was to determine whether the mean body mass index of young adults in England and Scotland had increased during the years 1973 to 1988. DESIGN: The study was an analysis of reported heights and weights for parents of children participating in a mixed longitudinal study of children's growth. SETTING: 20 study areas (16 in England and four in Scotland) were selected by stratified random sampling. SUBJECTS: Subjects were parents of 5229 children who were new entrants to the study in the years 1973-6 and 1982-8. After excluding cases containing missing values on continuous variables, data for 4568 (87%) women (mean age 30 years) and 4029 (77%) men (mean age approximately 32 years) were analyzed. MEASUREMENTS AND MAIN RESULTS: Changes in weight for height over time were determined using body mass index as dependent variable, adjusting for age, social class, family size, and study area. In women, mean body mass index showed an annual increase of 0.10 (95% CI 0.03 to 0.17%) per year of study. Body mass index also increased with increasing age and family size and was greatest for women with husbands in manual occupations. The secular trend in body mass index in women was not explained by changes in the distribution of these variables. The proportion of women with BMI greater than 25 kg/m2 increased over the study period. In men the secular trend in body mass index was not quite significant in this age group [annual increase 0.05% (-0.01 to 0.12%)]. CONCLUSIONS: There has been an increase in the body mass index of young women in England and Scotland over the years 1973 to 1988. This increase was not explained by changes in the age, parity, social class of the subjects sampled. Evidence of a trend in men was not found.

Age Factors↗

Body mass index and cardiovascular mortality at different levels of blood pressure: a prospective study of Norwegian men and women.

STUDY OBJECTIVE: The study investigated the joint effect of body mass index and systolic blood pressure on cardiovascular and total mortality. DESIGN: This was a prospective cohort study. The main outcome measures were age adjusted mortality and relative risks estimated from survival models. SETTING: The population of the city of Bergen, Norway. PARTICIPANTS: Subjects were 21,145 men and 30,330 women aged 30-79 years at the time of examination in 1963. MAIN RESULTS: Both cause specific and all cause mortality increased with systolic blood pressure within each category of body mass index. Stroke mortality was not significantly associated with body mass index when adjusted for systolic blood pressure in either age group of men or women. Coronary heart disease mortality increased on average 30% per 5 kg/m2 increase in body mass index in men and women aged 30-59 years at baseline. Adjusted for systolic blood pressure, the relative risks were reduced to 1.20 (95% confidence interval (CI) 1.12, 1.29) in men and 1.10 (95% CI 1.03, 1.18) in women. They were similar at each level of systolic blood pressure. For coronary heart disease mortality in men and women aged 60-79 years at measurement a negative interaction between body mass index and systolic blood pressure was suggested in the first five years. Excluding the first five years, adjusted relative risks per 5 kg/m2, were 1.05 (95% CI 0.96, 1.15) in men and 1.11 (95% CI 1.04, 1.17) in women in the older age group. There was an upturn in cardiovascular mortality at low levels of body mass index in both age groups of women, but not in men. CONCLUSIONS: Hypertension is an important risk factor for cardiovascular and all cause mortality even in the obese. Body mass index is generally a weak predictor of cardiovascular mortality in this population. It is a stronger risk factor of coronary death in men when measured at a younger age. Thin people with hypertension are not at particularly high risk of death from coronary heart disease compared with their obese counterparts, except possibly in the first few years after measurement in the elderly. Being underweight is associated with increased risk of death from all cardiovascular causes in women, but not in men.

Adult↗

Searching biomedical databases on complementary medicine: the use of controlled vocabulary among authors, indexers and investigators.

BACKGROUND: The optimal retrieval of a literature search in biomedicine depends on the appropriate use of Medical Subject Headings (MeSH), descriptors and keywords among authors and indexers. We hypothesized that authors, investigators and indexers in four biomedical databases are not consistent in their use of terminology in Complementary and Alternative Medicine (CAM). METHODS: Based on a research question addressing the validity of spinal palpation for the diagnosis of neuromuscular dysfunction, we developed four search concepts with their respective controlled vocabulary and key terms. We calculated the frequency of MeSH, descriptors, and keywords used by authors in titles and abstracts in comparison to standard practices in semantic and analytic indexing in MEDLINE, MANTIS, CINAHL, and Web of Science. RESULTS: Multiple searches resulted in the final selection of 38 relevant studies that were indexed at least in one of the four selected databases. Of the four search concepts, validity showed the greatest inconsistency in terminology among authors, indexers and investigators. The use of spinal terms showed the greatest consistency. Of the 22 neuromuscular dysfunction terms provided by the investigators, 11 were not contained in the controlled vocabulary and six were never used by authors or indexers. Most authors did not seem familiar with the controlled vocabulary for validity in the area of neuromuscular dysfunction. Recently, standard glossaries have been developed to assist in the research development of manual medicine. CONCLUSIONS: Searching biomedical databases for CAM is challenging due to inconsistent use of controlled vocabulary and indexing procedures in different databases. A standard terminology should be used by investigators in conducting their search strategies and authors when writing titles, abstracts and submitting keywords for publications.

Abstracting and Indexing↗

Base rate of a WMS-R malingering index in a sample of non-compensation-seeking men infected with HIV-1.

HIV-1 infected persons who are pursuing disability benefits are increasingly seeking neuropsychological assessment for purposes of corroborating functional impairment. Thus, research on the utility of measures of symptom validity among these patients is needed. Recently, Mittenberg, Azrin, Millsaps, and Heilbronner (1993) proposed a malingering index score for the WechslerMemoryScale-Revised that is derived by subtracting the Attention/Concentration Index (ACI) score from the General Memory Index Score (GMI). This study is a cross-validation of the specificity of the GMI-ACI Malingering Index in a sample of 55 non-compensation-seeking HIV-positive (HIV+) patients. An overall false-positive rate of 7% was observed for the GMI-ACI Malingering Index. However, further analyses showed that GMI-ACI Malingering Index scores were correlated with GMI scores such that false-positive errors were substantially higher (18%) among patients who obtained above-average GMI scores. These findings suggest a cautious approach to application of the GMI-ACI Malingering Index, particularly among patients who obtain above-average GMI scores.

Adult↗

Body mass index as a measure of adiposity in children and adolescents: relationship to adiposity by dual energy x-ray absorptiometry and to cardiovascular risk factors.

Body mass index is widely used as a measure of adiposity in adults, but its use in children and adolescents is controversial. We assessed body mass index as a measure of adiposity in children and adolescents between the ages of 5 and 20 yr examined as part of the NIH survey of health in the Pima Indian population. Body mass index (measured in 985 subjects and analyzed in 3 age groups: 5-9, 10-14, and 15-19 yr, in both sexes) was compared cross-sectionally to percent fat and fat mass derived from dual energy x-ray absorptiometry and to fasting and 2-h plasma glucose, systolic and diastolic blood pressures, cholesterol, high density lipoprotein cholesterol, fasting insulin, and triglycerides. Body mass index was strongly correlated in all age groups to both percent fat (r = 0.83-0.94; for each group, P < 0.0001) and fat mass (r = 0.96-0.98; P < 0.0001). The relationship of body mass index to percent fat was different in males and females; differences were more marked in older age groups. Body mass index, percent fat, and fat mass showed similar degrees of correlation to metabolic measures in childhood. Body mass index is strongly associated with measures of adiposity derived from dual energy x-ray absorptiometry. Both measures show similar associations with cardiovascular risk factors in Pima Indian children.

Absorptiometry, Photon↗

Does endothelial dysfunction correlate better with waist-to-hip ratio than with body mass index or waist circumference among obese patients?

PURPOSE: Obesity is associated with cardiovascular disease, affecting large arteries and the microcirculation. Waist circumference and body mass index are routinely employed as measures for assessing obesity-related health risk, whereas waist-to-hip ratio is not. We aimed to investigate the association between brachial vascular reactivity and body mass index, waist circumference, and waist-to-hip ratio. METHODS: Eighty-five volunteers (21 men/66 women), aged between 20 and 55 years, underwent determination of waist circumference, body mass index, waist-to-hip ratio, and endothelial function by venous occlusion plethysmography. Forearm blood flow was measured in response to intrabrachial artery infusions of 3 different concentrations of endothelium-dependent (acetylcholine 7.5, 15, and 30 mg/min) and endothelium-independent (sodium nitroprusside 2, 4, and 8 mg/min) vasodilators. RESULTS: There was an inverse correlation of body mass index and waist circumference with forearm blood flow increments after acetylcholine and sodium nitroprusside infusions, while waist-to-hip ratio showed an inverse correlation with forearm blood flow increments only after acetylcholine. When subjects older than 40 years (n = 25) were excluded from the analysis, the inverse correlation of body mass index with forearm blood flow increments after acetylcholine infusion no longer existed, while waist circumference and waist-to-hip ratio showed the same results observed before. CONCLUSION: The waist-to-hip ratio is probably a better estimator of endothelial dysfunction and possibly of cardiovascular risk than body mass index. These findings underscore the importance of routinely collecting hip circumference as an obesity index and risk estimator.

Adult↗

Stiffness index of the calcaneus measured by quantitative ultrasound and menopause among Japanese women: The Hizen-Oshima Study.

Quantitative ultrasound (QUS) is a recently developed technique for evaluating fracture risk that can assess both bone mass and architecture. Although numerous studies have shown that menopause is associated with accelerated loss of bone mineral density, there are only a few studies on the association of QUS parameter (stiffness index) with menopausal status, especially among Japanese population. We examined age-specific changes in stiffness index, and relation with age, body mass index (BMI) and menopausal status among 506 community-dwelling Japanese women aged 40-89 years. Mean age at menopause (standard deviation) among 459 women with natural menopause was 49.4 (4.0) years. Stiffness index significantly decreased with increasing age. Stiffness index among 80-89 years age group was 40% lower, compared with that of 40-49 years age group. The greatest decline among adjacent ten-year age groups in stiffness index (15%) was found between 40-49 and 50-59 years of age. Multiple regression analysis showed that menopause related with decreased stiffness index, independent of age and BMI. Our findings indicate that menopause influences loss of bone mass and induces deterioration of bone trabecular microstructure.

Adult↗

The gingival bleeding time index.

Recent studies have supported an emphasis on gingival bleeding indices for detection of inflammation. The purposes of the present study were: (1) to evaluate the relationships between the time necessary for stimulated gingival bleeding to occur and both gingival fluid flow and Löe's gingival index, and (2) to develop a clinical index based on gingival bleeding time. In the first part of the study, the elapsed time for gingival bleeding to first occur after sulcular stimulation was correlated with the gingival index and fluid flow on 150 gingival units. A high correlation was found between bleeding time with both the gingival index and exudate flow. A bleeding time index based on a scattergram of the data obtained in part I of the study was then formulated and evaluated in a similar fashion on an additional 172 gingival units. Results indicate a high correlation between the bleeding time index and the other indices. It is concluded that the bleeding time index may be used by itself as an accurate and objective clinical tool to evaluate gingival inflammation.

Gingival Crevicular Fluid↗

Comparison of Body Mass Index by self-reported versus measured height and weight.

This study compared differences between self-reported and measured height and weight and subsequent Body Mass Index. College students (N=62) were asked to complete a health questionnaire as accurately as possible. Height and weight were self-reported without the knowledge that these variables would be subsequently measured. Self-reported and measured heights, weights, and calculated Body Mass Indexes were statistically compared. Analysis indicated that measured height was significantly less than self-reported height for men, but weight was not significantly different. Calculated Body Mass Index for men was not significantly different, however, self-reported Body Mass Index resulted in placement in the Normal range (18.5 to 24.9) category and measured Body Mass Index placement in the Overweight category (25.0 to 29.9). Women's self-reported and measured heights were not significantly different; however, self-reported weight was significantly less than measured. Further, significantly different Body Mass Indexes were found for women. It was concluded that self-reported height and weight might be viewed with caution in Body Mass Index assessment for convenience samples of college-age subjects.

Adult↗

A National Depression Index for Australia.

OBJECTIVE: To develop a National Depression Index for measuring the depression status of the Australian population. DESIGN: Cross-sectional data were analysed from two random samples of the Australian adult population - the National Survey of Mental Health and Wellbeing (2000) and the National Health Survey (2001). PARTICIPANTS: The National Survey of Mental Health and Wellbeing (2000) - 10 641 participants; and the National Health Survey (2001) - 17 918 participants. MAIN OUTCOME MEASURES: Selected items from the Kessler Psychological Distress Scale (K10); and diagnoses of a major depressive episode according to DSM-IV criteria using a computerised interview. RESULTS: Six items from the K10 that were most closely related to the DSM-IV diagnosis of "major depressive episode" were identified. Scores on an index calculated from these items were rescaled to form an index reflecting relative risk of depression and having a value of 100 for the Australian adult population. Taking into account sex, employment status and income, index values were higher in younger people, females, unemployed people and those socioeconomically disadvantaged. This pattern provides additional support for the validity of the index, as well as establishing benchmark levels to which index values from future surveys and in other groups may be compared. CONCLUSIONS: The proposed National Depression Index is a valid indicator of depression and level of depressive symptoms. It is suitable for monitoring depression at the population level. The scaling characteristics of the measure ensure that it can be interpreted by members of the general public.

Adolescent↗