The Literature
To study the impact of depression screening on prenatal and postnatal motherhood and effects on early interventions, a rigorous selection criterion was applied in collecting relevant data for analysis to answer key questions (KQ) on the impact of early interventions. The study was assessed against predetermined benchmarks to ensure good quality and reliable results. To attain high-quality data, data validation, and verification techniques were used in the research. The study addressed major and minor depressions, and relevant diagnostic criteria were used. Standardized ratings were based on fair, average, and good scale. The target population was fairly treated with adequate representation.
Parental screenings on EPDS with different specificities were done through sensitivity analysis but showed defective results. Performance ratings were done, and results for depressions were documented.
Methods
According to Gaynes, Gavin, Meltzer-Brody, Lohr, Swinson, Gartlehner, Brody, and Miller (2005), standardized procedures were followed in conducting the literature review and writing the abstract. The report affirms these methods and reviews, developed by Healthcare service and quality (AHRQ) in collaboration with Evidence-based practice centers, to be critical in the study. The framework consisted of active participation in conference calls and message exchanges and discussions through emails. According to Gaynes et al. (2005), the study consisted of refining and analyzing key questions, reviewing key literature issues, and determining inclusion and exclusion methodologies, using evidence-based tables to categorize information. Analysis of the proposed methodologies for synthesizing data and the use of appropriate data analysis techniques to interpret preliminary information played a key role in the study.
Search Strategy
According to Gaynes, Gavin, Meltzer-Brody, Lohr, Swinson, Gartlehner, Brody, and Miller (2005), relevant and explicit research studies were identified and a set of exclusion and inclusion criteria were used in the study. Each key question was addressed through a list that was generated to identify relevant studies. These arrangements were made to provide the highest quality results and to eliminate any potential threat of interference from confounding variables, and overcome the risk of biases. Each question was uniquely addressed except for those questions that required uniform criteria.
The report asserts that each key question was addressed using original data and published on a time frame to ensure relevance to established standards and published manuals about the research (Gaynes et al., 2005).
The studies were conducted with sample populations from the USA, United Kingdom, Other European countries, Scandinavian states, and the Commonwealth states. Impacts of limitations on the studies were identified, and their effects were mitigated upon by introducing new modifications to the inclusion criteria. Studies published before 1980 were excluded. Women with insignificant signs of depression were excluded from whom the impact of the results of their studies could hardly be differentiated from those suffering from maternity blues and many other complications. According to the literature report, key questions on major depressions had to be answered by conducting investigation either on single women with slight depressions during their pregnancies or a group with varying depressions. The report further asserts certain exclusions of key questions (kQ1) on perinatal depressions while women with depression disorders that had been identified were excluded from key questions two and three.
The inclusion criteria for key question one (KQ1) were studies that were expected to yield reliable information and incidences of perinatal cases. Clinical trials were included in the study, along with case-controlled comparisons with the statistical prevalence of depression among the sample study of pregnant women. Women of relatively comparative ages in the perinatal and post perinatal periods were considered in the study.
Accessing Literature
A systematic research study was integrated into the evidence-based study for accessing and retrieving data from electronic databases. Indexing was based on Author name, and article names were used to access and retrieve relevant data and information. The research report indicated that mass screening of history subjects was done, and an analysis of the effects of treatments was conducted. Of the total searches conducted, 837 unduplicated were identified, of which 9 were identified through handpicking, and 846 from discussions with TEAG. Other systematic reviews done included searches with perinatal and depressions, as the keywords.
Though 50 searches fell short of meeting the inclusion and exclusion criteria, these results were identified to be influenced by the absence of established benchmarks against which they could be tested. This resulted in the elimination of 26 studies. In addition to that, various reasons identified for the exclusion criteria included lack of sensitivity and specificity, lack of depression outcome figures, and restrictions on certain subgroups. The exclusion criteria included generalizations of US adolescent population subgroups and the degree of uniqueness of other subgroups warranting special considerations from the rest of the population.
A total of 59 studies were included in the study, although less than that figure met the inclusion criteria (Gaynes et al., 2005).
Data Collection and Analysis
According to Gynes et al. (2005), the report indicated that eligible articles were the source of the required data used to create evidence-based tables for the research study design about answering the key questions about the study. For data validation and verification, two trained members checked through the records, one checked the articles, and the other checked entries in evidence tables for accuracies.
According to the report, each study varied in dimension depending on the key questions through some elements that were common across all key questions. Factors considered in collecting information were age, diagnostics, and racial and ethnic characteristic distributions. Information was provided on the clinical interview form. In addition to that, a word processing application was used to process the data for Meta-analysis.
Meta-analysis
Meta-analysis was done with different estimates based on each key question to arrive at a single estimate figure. These were conducted to identify characteristic behaviors for answering key question 2 though no Meta-analysis was conducted on key question 3 as the screening instruments could yield conflicting results due to their diversity. These studies were conducted within appropriate time frames.
Quality of Used Articles
The report affirms that various articles used in the study process were rated on a standard scale developed by Cochrane Methods Working Groups. However slight modifications were done to the standards for assessing key questions 2 and 3. These rating criteria were core determining factors in assessing the degree of quality of the report, its clarity, external and internal consistencies, and the degree of accuracy of each key question. However, each article though not used or used was included in the analysis phase for both quantitative and qualitative studies.
Overall Evidence and External Peer Review
Collective evidence was also factored in the review process. The four basic approaches integrated into the study included (1) the volume of studies, (2) sample sizes, (3) The degree of quality of each sample, and (4) Sample size representations.
Arrays of external expertise from diverse and related professions were called in to systematically review the study. In addition to that, internal reviews by internal staff and federal agencies were conducted with relevant documentations done.
Findings
According to the report, an evaluation was conducted on the research findings to identify and verify internal, external, and the degree of precision of the study and other findings. Prevalence figures were established during pregnancy and postpartum periods. In addition to that, the report brought to light preventive measures for curbing the prevalence rate of depression among women from different age groups. In addition to that, prevalence rates could be reduced through 48.2% retained depression symptoms. Prevention groups, however, showed significant reductions in depression rates.
EPDS was identified to be the most commonly used tool in postpartum studies. High sensitivity was reported on a 0.94 scale with a 0.98 low sensitivity on depression was reported with a 0.40 t0 0.63 scale.
Conclusion
According to the 15 reviewed articles, screening and treatment strategies studies were done on women with significant risks of postpartum depressions. However, a greater number of studies focused on intervention mechanisms. Psychological studies were also done on several participants in addition to studying mother and child behavioral activities. Data validation and verification and the quality of information checked against set standards. Prevalence rates were noted among women from different settings, and prevention was earmarked as the best strategy to reduce prevalence problems.
References
Gaynes, B. N., Gavin, N., Meltzer-Brody, S., Lohr, K. N., Swinson, T., Gartlehner,
G., Brody, S., Miller, W. C. Perinatal Depression: Prevalence, Screening Accuracy, and Screening Outcomes. (2005). Web.
Gaynes, B. N, Gavin, N, Meltzer-Brody, S., Lohr, K.,
N., Swinson, T, Gartlehner, G., Brody, S., Miller, W. C. Screening Accuracy. (2005). Web.