Displaying publications 1 - 20 of 28 in total

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  1. Yan CW, Ishak F, Hee GL, Devaraj JM, Ismail K, Jalleh RP, et al.
    Med J Malaysia, 1978 Sep;33(1):34-43.
    PMID: 571513
  2. Yaacob H, Tirmzi H, Ismail K
    J Oral Med, 1983 Jan-Mar;38(1):40-2.
    PMID: 6573459
  3. Zain RB, Roswati N, Ismail K
    Singapore Dent J, 1989 Dec;14(1):29-32.
    PMID: 2487471
    Many studies have been reported on radiographic lesion sizes of periapical lesions. However no studies have been reported on prevalences of subjective radiographic features in these lesions except for the early assumption that a periapical cyst usually exhibit a radiopaque cortex. This study is conducted to evaluate the prevalences of several subjective radiographic features of periapical cysts and granulomas in the hope to identify features that maybe suggestive of either diagnosis. The results showed that a regular (circular or semi-circular) radiographic outline is likely to be a periapical cyst while an irregular radiographic outline is not indicative of either a cyst or a granuloma. The association between the regular/irregular radiographic outline and the type of periapical lesion was found to be statistically significant (p less than 0.001). The associations of two other radiographic features and the type of periapical lesion were found to be just statistically significant (p less than 0.01). These features are the symmetry/asymmetry of the radiolucency in relation to the apex and the funnel-shaped/angular-shaped extension of the radiolucency. The widely accepted criteria that the possession of a radiopaque cortex surrounding the radiolucency can discriminate between a periapical cyst and granuloma cannot be statistically supported in this study.
  4. Najafpour G, Younesi H, Syahidah Ku Ismail K
    Bioresour Technol, 2004 May;92(3):251-60.
    PMID: 14766158
    Fermentation of sugar by Saccharomyces cerevisiae, for production of ethanol in an immobilized cell reactor (ICR) was successfully carried out to improve the performance of the fermentation process. The fermentation set-up was comprised of a column packed with beads of immobilized cells. The immobilization of S. cerevisiae was simply performed by the enriched cells cultured media harvested at exponential growth phase. The fixed cell loaded ICR was carried out at initial stage of operation and the cell was entrapped by calcium alginate. The production of ethanol was steady after 24 h of operation. The concentration of ethanol was affected by the media flow rates and residence time distribution from 2 to 7 h. In addition, batch fermentation was carried out with 50 g/l glucose concentration. Subsequently, the ethanol productions and the reactor productivities of batch fermentation and immobilized cells were compared. In batch fermentation, sugar consumption and ethanol production obtained were 99.6% and 12.5% v/v after 27 h while in the ICR, 88.2% and 16.7% v/v were obtained with 6 h retention time. Nearly 5% ethanol production was achieved with high glucose concentration (150 g/l) at 6 h retention time. A yield of 38% was obtained with 150 g/l glucose. The yield was improved approximately 27% on ICR and a 24 h fermentation time was reduced to 7 h. The cell growth rate was based on the Monod rate equation. The kinetic constants (K(s) and mu(m)) of batch fermentation were 2.3 g/l and 0.35 g/lh, respectively. The maximum yield of biomass on substrate (Y(X-S)) and the maximum yield of product on substrate (Y(P-S)) in batch fermentations were 50.8% and 31.2% respectively. Productivity of the ICR were 1.3, 2.3, and 2.8 g/lh for 25, 35, 50 g/l of glucose concentration, respectively. The productivity of ethanol in batch fermentation with 50 g/l glucose was calculated as 0.29 g/lh. Maximum production of ethanol in ICR when compared to batch reactor has shown to increase approximately 10-fold. The performance of the two reactors was compared and a respective rate model was proposed. The present research has shown that high sugar concentration (150 g/l) in the ICR column was successfully converted to ethanol. The achieved results in ICR with high substrate concentration are promising for scale up operation. The proposed model can be used to design a lager scale ICR column for production of high ethanol concentration.
  5. Idris SS, Abd Rahman N, Ismail K, Alias AB, Abd Rashid Z, Aris MJ
    Bioresour Technol, 2010 Jun;101(12):4584-92.
    PMID: 20153633 DOI: 10.1016/j.biortech.2010.01.059
    This study aims to investigate the behaviour of Malaysian sub-bituminous coal (Mukah Balingian), oil palm biomass (empty fruit bunches (EFB), kernel shell (PKS) and mesocarp fibre (PMF)) and their respective blends during pyrolysis using thermogravimetric analysis (TGA). The coal/palm biomass blends were prepared at six different weight ratios and experiments were carried out under dynamic conditions using nitrogen as inert gas at various heating rates to ramp the temperature from 25 degrees C to 900 degrees C. The derivative thermogravimetric (DTG) results show that thermal decomposition of EFB, PMF and PKS exhibit one, two and three distinct evolution profiles, respectively. Apparently, the thermal profiles of the coal/oil palm biomass blends appear to correlate with the percentage of biomass added in the blends, thus, suggesting lack of interaction between the coal and palm biomass. First-order reaction model were used to determine the kinetics parameters for the pyrolysis of coal, palm biomass and their respective blends.
  6. Hamedi M, Salleh ShH, Tan TS, Ismail K, Ali J, Dee-Uam C, et al.
    Int J Nanomedicine, 2011;6:3461-72.
    PMID: 22267930 DOI: 10.2147/IJN.S26619
    The authors present a new method of recognizing different human facial gestures through their neural activities and muscle movements, which can be used in machine-interfacing applications. Human-machine interface (HMI) technology utilizes human neural activities as input controllers for the machine. Recently, much work has been done on the specific application of facial electromyography (EMG)-based HMI, which have used limited and fixed numbers of facial gestures. In this work, a multipurpose interface is suggested that can support 2-11 control commands that can be applied to various HMI systems. The significance of this work is finding the most accurate facial gestures for any application with a maximum of eleven control commands. Eleven facial gesture EMGs are recorded from ten volunteers. Detected EMGs are passed through a band-pass filter and root mean square features are extracted. Various combinations of gestures with a different number of gestures in each group are made from the existing facial gestures. Finally, all combinations are trained and classified by a Fuzzy c-means classifier. In conclusion, combinations with the highest recognition accuracy in each group are chosen. An average accuracy >90% of chosen combinations proved their ability to be used as command controllers.
  7. Idris SS, Rahman NA, Ismail K
    Bioresour Technol, 2012 Nov;123:581-91.
    PMID: 22944493 DOI: 10.1016/j.biortech.2012.07.065
    The combustion characteristics of Malaysia oil palm biomass (palm kernel shell (PKS), palm mesocarp fibre (PMF) and empty fruit bunches (EFB)), sub-bituminous coal (Mukah Balingian) and coal/biomass blends via thermogravimetric analysis (TGA) were investigated. Six weight ratios of coal/biomass blends were prepared and oxidised under dynamic conditions from temperature 25 to 1100°C at four heating rates. The thermogravimetric analysis demonstrated that the EFB and PKS evolved additional peak besides drying, devolatilisation and char oxidation steps during combustion. Ignition and burn out temperatures of blends were improved in comparison to coal. No interactions were observed between the coal and biomass during combustion. The apparent activation energy during this process was evaluated using iso-conversional model free kinetics which resulted in highest activation energy during combustion of PKS followed by PMF, EFB and MB coal. Blending oil palm biomass with coal reduces the apparent activation energy value.
  8. Rostamzadeh R, Ismail K, Bodaghi Khajeh Noubar H
    ScientificWorldJournal, 2014;2014:703650.
    PMID: 25197707 DOI: 10.1155/2014/703650
    This study presents one of the first attempts to focus on critical success factors influencing the entrepreneurial intensity of Malaysian small and medium sized enterprises (SMEs) as they attempt to expand internationally. The aim of this paper is to evaluate and prioritize the entrepreneurial intensity among the SMEs using multicriteria decision (MCDM) techniques. In this research FAHP is used for finding the weights of criteria and subcriteria. Then for the final ranking of the companies, VIKOR (in Serbian: VlseKriterijumska Optimizacija I Kompromisno Resenje) method was used. Also, as an additional tool, TOPSIS technique, is used to see the differences of two methods applied over the same data. 5 main criteria and 14 subcriteria were developed and implemented in the real-world cases. As the results showed, two ranking methods provided different ranking. Furthermore, the final findings of the research based on VIKOR and TOPSIS indicated that the firms A3 and A4 received the first rank, respectively. In addition, the firm A4 was known as the most entrepreneurial company. This research has been done in the manufacturing sector, but it could be also extended to the service sector for measurement.
  9. Kamaluddin MR, Othman A, Ismail KH, Mat Saat GA
    Malays J Pathol, 2017 Dec;39(3):217-226.
    PMID: 29279583 MyJurnal
    The horrific nature of murder using different types of weapons has been an important focal point of many criminological studies. Weapons that are used in murders seem to play dominant roles in murder investigations as they may provide information leading to arrest. The established factors for weapon usage include environmental context, demography and availability of weapons. However, there is insufficient research attention on the psychological functioning of murderers for particular weapon usage. In light of this, the current study seeks to narrow this gap of information by identifying the influences of psychological traits on weapon usage among a sample of male murderers. The present cross-sectional study was conducted among 71 male murderers incarcerated in 11 prisons within Peninsular Malaysia. The selection of the sample was based on predetermined selection criteria using a purposive sampling method. A guided self-administered questionnaire comprising sociodemography variables and four Malay validated psychometric instruments: Zuckerman-Kuhlman Personality Questionnaire-40-Cross-Culture, Self-control Scale, "How I Think" Questionnaire and Aggression Questionnaire; was used. Independent sample t-test was performed to establish the mean score differences of psychological traits between the murderers who used single and multiple weapons while Kruskal-Wallis tests were carried out to ascertain the differences between the specific types of weapons used among the murderers. Following this, one-way ANOVA was carried out to ascertain the psychological trait differences among the murderers according to the different sources of weapon. Results indicated specific psychological traits influenced the number(s), source(s) and type(s) of weapon used in committing murder. The findings have implications for the psychological profiling of unknown murderers within the Malaysian context.
  10. Ismail, K., Ghazali@Suhaimi, S.S., Abu Bakar, N., Mokhtar, K.I., Kharuddin, A.F.
    MyJurnal
    Introduction: Malocclusion is one of the most common dental problems observed. Limited data is currently
    available regarding the demographics of malocclusion observed locally.

    Materials And Methods: This is a
    retrospective study where 770 patients were recruited from May 2009 till December 2014. 560 orthodontic
    study models that met the inclusion criteria were examined and the malocclusions were classified according
    to the British Standard Institute (BSI) incisor classification. Demographic pattern and their relationship were
    analysed by structural equation modelling using SPSS (version 23.0).

    Results: From 560 study models
    analysed, 72% were female. The age of the patients ranges from 7-12 years old (17.1%), 13-17 years old
    (55.9%) and >18 years old (27.0%). Majority of the patients were Malay followed by Chinese (5.7%), Indian
    (1.8%) and other races (1.8%) Treatments received were fixed appliances (FA) (60.0%), removable appliances
    (RA) (12.5%), functional appliances (FnA) (1.1%), combination of RA and FA (16.1%), combination of FnA and
    FA (2.1%) and consultation (8.2%). Types of malocclusions observed were Class I (25.7%), Class II/1(32.7%),
    Class II/2 (7.5%) and Class III (34.1%). There was significant association (p
  11. Amin L, Hashim H, Mahadi Z, Ibrahim M, Ismail K
    Biotechnol Biofuels, 2017;10:219.
    PMID: 28932261 DOI: 10.1186/s13068-017-0908-8
    BACKGROUND: Concern about the inevitable depletion of global energy resources is rising and many countries are shifting their focus to renewable energy. Biodiesel is one promising energy source that has garnered much public attention in recent years. Many believe that this alternative source of energy will be able to sustain the need for increased energy security while at the same time being friendly to the environment. Public opinion, as well as proactive measures by key players in industry, may play a decisive role in steering the direction of biodiesel development throughout the world. Past studies have suggested that public acceptance of biofuels could be shaped by critical consideration of the risk-benefit perceptions of the product, in addition to the impact on the economy and environment.

    RESULTS: The purpose of this study was to identify the relevant factors influencing stakeholders' attitudes towards biodiesel derived from crops such as palm oil for vehicle use, as well as to analyse the interrelationships of these factors in an attitude model. A survey of 509 respondents, consisting of various stakeholder groups in the Klang Valley region of Malaysia, was undertaken. The results of the study have substantiated the premise that the most important direct predictor of attitude to biodiesel is the perceived benefits (β = 0.80, p 

  12. Levis B, Benedetti A, Riehm KE, Saadat N, Levis AW, Azar M, et al.
    Br J Psychiatry, 2018 06;212(6):377-385.
    PMID: 29717691 DOI: 10.1192/bjp.2018.54
    BACKGROUND: Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.AimsTo evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.

    METHOD: Data collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.

    RESULTS: A total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15-3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98-10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7-15) (OR = 0.96; 95% CI = 0.56-1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26-0.97).

    CONCLUSIONS: The MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.Declaration of interestDrs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

  13. Amin L, Hashim H, Mahadi Z, Che Ngah A, Ismail K
    Xenotransplantation, 2018 11;25(6):e12430.
    PMID: 29932474 DOI: 10.1111/xen.12430
    BACKGROUND: Advances in xenotransplantation have the potential to resolve the issue of organ shortages. Despite this, the procedure is expected to meet with a degree of resistance from the public. The purpose of this study was to identify the relevant factors influencing stakeholders' attitudes towards xenotransplantation.

    METHODS: A multidimensional survey instrument measuring attitudes to xenotransplantation, including the factors that predict such attitudes, was developed based on earlier studies and validated. It was then completed by 469 respondents who were stratified in accordance with stakeholder groups in Malaysia. A single-step SEM analysis was then conducted to estimate the measurement and create a structural model using IBM SPSS Amos version 20 with a maximum-likelihood function.

    RESULTS: The attitudes of Malaysian stakeholders towards xenotransplantation were moderately positive (mean score of 4.20). The most important direct predictor of attitude to xenotransplantation was perceived benefit (β = 0.59, P 

  14. Amin L, Hashim H, Mahadi Z, Ismail K
    BMC Med Res Methodol, 2018 12 05;18(1):163.
    PMID: 30518344 DOI: 10.1186/s12874-018-0619-2
    BACKGROUND: The demand in biobanking for the collection and maintenance of biological specimens and personal data from civilians to improve the prevention, diagnosis and treatment of diseases has increased notably. Despite the advancement, certain issues, specifically those related to privacy and data protection, have been critically discussed. The purposes of this study are to assess the willingness of stakeholders to participate in biobanking and to determine its predictors.

    METHODS: A survey of 469 respondents from various stakeholder groups in the Klang Valley region of Malaysia was carried out. Based on previous research, a multi-dimensional instrument measuring willingness to participate in biobanking, and its predictors, was constructed and validated. A single step Structural Equation Modelling was performed to analyse the measurements and structural model using the International Business Machines Corporation Software Package for Social Sciences, Analysis of Moment Structures (IBM SPSS Amos) version 20 with a maximum likelihood function.

    RESULTS: Malaysian stakeholders in the Klang Valley were found to be cautious of biobanks. Although they perceived the biobanks as moderately beneficial (mean score of 4.65) and were moderately willing to participate in biobanking (mean score of 4.10), they professed moderate concern about data and specimen protection issues (mean score of 4.33). Willingness to participate in biobanking was predominantly determined by four direct predictors: specific application-linked perceptions of their benefits (β = 0.35, p 
  15. Jawad AH, Norrahma SSA, Hameed BH, Ismail K
    Int J Biol Macromol, 2019 Aug 15;135:569-581.
    PMID: 31150675 DOI: 10.1016/j.ijbiomac.2019.05.127
    In this work, chitosan (Chi) was cross-linked with glyoxal (Gly) and deposited onto glass plate to be a superior adsorbent film for two structurally different reactive orange 16 (RO-16) and methyl orange (MO) dyes by using non-conventional adsorption system without filtration process. The characterizations indicate that the cross-linked chitosan-glyoxal (Chi-Gly) film has a low swelling index, high adherence strength on glass plate, amine group (NH2) content was 32.52%, and pHpzc of ∼6.0 indicating a negative surface charge occurs above pHpzc. The adsorption isotherm data of RO-16 and MO by Chi-Gly film were in agreement with Langmuir isotherm, with maximum adsorption capacities of 1554.3 mg/g and 1451.9 mg/g, respectively. The pseudo-first-order kinetic model best described the kinetic data. The adsorption process was spontaneous and exothermic in nature at Chi-Gly film thickness of 8.55 μm, and pH ~3. The mechanism of adsorption included mainly electrostatic attractions, dipole-dipole hydrogen bonding interactions, n-π stacking attractions, and Yoshida H-bonding. This study reveals that immobilized Chi-Gly film as a good candidate for adsorption of reactive and acid dyes as it does not require any filtration process and adsorbent recovery during and post-adsorption process.
  16. Malek NNA, Jawad AH, Abdulhameed AS, Ismail K, Hameed BH
    Int J Biol Macromol, 2020 Mar 01;146:530-539.
    PMID: 31917215 DOI: 10.1016/j.ijbiomac.2020.01.020
    In this study, a new magnetic Schiff's base-chitosan-glyoxal/fly ash/Fe3O4 biocomposite (Chi-Gly/FA/Fe3O4) was successfully synthesized by direct compositing of magnetic chitosan (Chi) with fly ash (FA) powder particles, and followed by Schiff's base formation via cross-linking reaction with glyoxal (Gly). Various techniques such as BET, XRD, FTIR, and SEM-EDX were utilized to characterize of Chi-Gly/FA/Fe3O4 biocomposite. The effectiveness of Chi-Gly/FA/Fe3O4 as an adsorbent was evaluated for the removal anionic azo dye such as reactive orange 16 (RO16) from aqueous environment. The effect of adsorption process parameters namely adsorbent dose (A: 0.02-0.1 g), solution pH (B: 4-10), temperature (C: 30-50 °C), and contact time (D: 5-20 min) were optimized via Box-Behnken design (BBD) in response surface methodology (RSM). The adsorption process followed the pseudo-second order (PSO) kinetic, and Freundlich isotherm models. The maximum adsorption capacity of Chi-Gly/FA/Fe3O4 biocomposite for RO16 dye was recorded to be 112.5 mg/g at 40 °C. The RO16 dye adsorption mechanism was attributed to various interactions such as electrostatic, n-π, H-bonding, and Yoshida H-bonding. Furthermore, the Chi-Gly/FA/Fe3O4 biocomposite exhibited a high ability to separate from the aqueous solution after adsorption process by external magnetic field.
  17. Levin LA, Wei CL, Dunn DC, Amon DJ, Ashford OS, Cheung WWL, et al.
    Glob Chang Biol, 2020 09;26(9):4664-4678.
    PMID: 32531093 DOI: 10.1111/gcb.15223
    Climate change manifestation in the ocean, through warming, oxygen loss, increasing acidification, and changing particulate organic carbon flux (one metric of altered food supply), is projected to affect most deep-ocean ecosystems concomitantly with increasing direct human disturbance. Climate drivers will alter deep-sea biodiversity and associated ecosystem services, and may interact with disturbance from resource extraction activities or even climate geoengineering. We suggest that to ensure the effective management of increasing use of the deep ocean (e.g., for bottom fishing, oil and gas extraction, and deep-seabed mining), environmental management and developing regulations must consider climate change. Strategic planning, impact assessment and monitoring, spatial management, application of the precautionary approach, and full-cost accounting of extraction activities should embrace climate consciousness. Coupled climate and biological modeling approaches applied in the water and on the seafloor can help accomplish this goal. For example, Earth-System Model projections of climate-change parameters at the seafloor reveal heterogeneity in projected climate hazard and time of emergence (beyond natural variability) in regions targeted for deep-seabed mining. Models that combine climate-induced changes in ocean circulation with particle tracking predict altered transport of early life stages (larvae) under climate change. Habitat suitability models can help assess the consequences of altered larval dispersal, predict climate refugia, and identify vulnerable regions for multiple species under climate change. Engaging the deep observing community can support the necessary data provisioning to mainstream climate into the development of environmental management plans. To illustrate this approach, we focus on deep-seabed mining and the International Seabed Authority, whose mandates include regulation of all mineral-related activities in international waters and protecting the marine environment from the harmful effects of mining. However, achieving deep-ocean sustainability under the UN Sustainable Development Goals will require integration of climate consideration across all policy sectors.
  18. Attias E, Thomas D, Sherman D, Ismail K, Constable S
    Sci Adv, 2020 Nov;6(48).
    PMID: 33239299 DOI: 10.1126/sciadv.abd4866
    Conventional hydrogeologic framework models used to compute ocean island sustainable yields and aquifer storage neglect the complexity of the nearshore and offshore submarine environment. However, the onshore aquifer at the island of Hawai'i exhibits a notable volumetric discrepancy between high-elevation freshwater recharge and coastal discharge. In this study, we present a novel transport mechanism of freshwater moving from onshore to offshore through a multilayer formation of water-saturated layered basalts with interbedded low-permeability layers of ash/soil. Marine electromagnetic imaging reveals ∼35 km of laterally continuous resistive layers that extend to at least 4 km from west of Hawai'i's coastline, containing about 3.5 km3 of freshened water. We propose that this newly found transport mechanism of fresh groundwater may be the governing mechanism in other volcanic islands. In such a scenario, volcanic islands worldwide can use these renewable offshore reservoirs, considered more resilient to climate change-driven droughts, as new water resources.
  19. He C, Levis B, Riehm KE, Saadat N, Levis AW, Azar M, et al.
    Psychother Psychosom, 2020;89(1):25-37.
    PMID: 31593971 DOI: 10.1159/000502294
    BACKGROUND: Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9 diagnostic algorithm. Many primary studies publish results for only one approach, and previous meta-analyses of the algorithm approach included only a subset of primary studies that collected data and could have published results.

    OBJECTIVE: To use an individual participant data meta-analysis to evaluate the accuracy of two PHQ-9 diagnostic algorithms for detecting major depression and compare accuracy between the algorithms and the standard PHQ-9 cutoff score of ≥10.

    METHODS: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, Web of Science (January 1, 2000, to February 7, 2015). Eligible studies that classified current major depression status using a validated diagnostic interview.

    RESULTS: Data were included for 54 of 72 identified eligible studies (n participants = 16,688, n cases = 2,091). Among studies that used a semi-structured interview, pooled sensitivity and specificity (95% confidence interval) were 0.57 (0.49, 0.64) and 0.95 (0.94, 0.97) for the original algorithm and 0.61 (0.54, 0.68) and 0.95 (0.93, 0.96) for a modified algorithm. Algorithm sensitivity was 0.22-0.24 lower compared to fully structured interviews and 0.06-0.07 lower compared to the Mini International Neuropsychiatric Interview. Specificity was similar across reference standards. For PHQ-9 cutoff of ≥10 compared to semi-structured interviews, sensitivity and specificity (95% confidence interval) were 0.88 (0.82-0.92) and 0.86 (0.82-0.88).

    CONCLUSIONS: The cutoff score approach appears to be a better option than a PHQ-9 algorithm for detecting major depression.

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