ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 102
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Identifying eating disorders in primary care: Development
and validation of a co-designed screening tool for ultrahigh-risk and early-stage illness
Ms Emma Bryant1, Karen Spielman2, Amy Burton3,4, Shu Ong1, Jane Miskovic-Wheatley1, Eyza
Koreshe1, Ms Sally Corry1, Stephen Touyz1, Ross Crosby5, Jessica Livney1,6, Sarah Maguire1
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Insideout Institute for Eating Disorders, University of Sydney, 2Paddington Family Practice, NSW,
School of Psychology, Faculty of Science, The University of Sydney, 4Graduate School of Health,
University of Technology Sydney, 5Sanford Center for Biobehavioral Research, Sanford Research,
Fargo, ND, 6Georgetown University, Washington DC
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Eating disorders (EDs) are among the deadliest of the mental disorders; however, detection and
early intervention rates remain extremely low. Early intervention significantly improves ED prognosis;
however, large numbers of people with the illness are not being identified or managed in primary
care. The findings of two studies will be presented: the original psychometric validation of a codesigned digital screening tool and the extension of that validation for face-to-face use by primary
care physicians. The original study used a mixed cross-sectional and repeated-measures longitudinal
survey design with 1346 participants aged 14–74 years (73.8% female, 22.6% male). The InsideOut
Institute Screener (IOI-S) was strongly correlated with existing standardised measures the EDE-Q
(rs = 0.88) and SCOFF (rs = 0.75), providing support for the concurrent and convergent validity of
the scale. The IOI-S demonstrated high internal consistency (a = 0.908) and excellent two-week
test–retest reliability (0.968; 95% CI: 0.959, 0.975; P = < 0.1). It accurately distinguished likely EDs
(sensitivity = 82.8%, specificity = 89.7% [AUC = 0.944]) and two stepped levels of risk. The extended
study recruited 83 individuals aged 14–81 years in general practice and headspace youth mental
health centres in NSW and the Northern Territory. Test–retest reliability between digital self-report and
clinician delivery was measured by two-way mixed-effects model intraclass correlation coefficient
(ICC). The screener performed equally well when delivered face to face, with a significantly positive
ICC between successive iterations of 0.980. The IOI-S is an adaptive six-item screening tool designed
to ‘start a conversation’ and determine risk using gentle language conceived by individuals with lived
experience. In conjunction with increased practitioner education and improved treatment referral
pathways, broad implementation and use of the screener in primary care settings can support early
identification and intervention for those with EDs.
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