Muller Ashley Elizabeth, Himmels Jan Peter William, Van de Velde Stijn
Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213, Oslo, Norway.
BMC Med Res Methodol. 2021 Apr 23;21(1):82. doi: 10.1186/s12874-021-01262-5.
The COVID-19 pandemic has become a source of fear across the world. Measuring the level or significance of fear in different populations may help identify populations and areas in need of public health and education campaigns. We were interested in diagnostic tests developed to assess or diagnose COVID-19-related fear or phobia.
We performed a systematic review of studies that examined instruments diagnosing or assessing fear or phobia of COVID-19 (PROSPERO registration: CRD42020197100). We utilized the Norwegian Institute of Public Health's Live map of covid-19 evidence, a database of pre-screened and pre-categorized studies. The Live map of covid-19 evidence identified references published since 1 December 2019 in MEDLINE, Embase, and the Centers for Disease Control and Prevention. Following biweekly searches, two researchers independently categorized all studies according to topic (seven main topics, 52 subordinate topics), population (41 available groups), study design, and publication type. For this review, we assessed for eligibility all studies that had been categorized to the topic "Experiences and perceptions, consequences; social, political, economic aspects" as of 25 September 2020, in addition to hand-searching included studies' reference lists. We meta-analyzed correlation coefficients of fear scores to the most common reference tests (self-reports of anxiety, depression, and stress), and reported additional concurrent validity to other reference tests such as specific phobias. We assessed study quality using the QUADAS-2 for the minority of studies that presented diagnostic accuracy statistics.
We found 18 studies that validated fear instruments. Fifteen validated the Fear of COVID-19 scale (FCV-19S). We found no studies that proposed a diagnosis of fear of COVID-19 or a threshold of significant/clinical versus non-significant/subclinical fear. Study quality was low, with the most common potential biases related to sampling strategy and un-blinded data analysis. The FSV-19S total score correlated strongly with severe phobia (r = 0.703, 95%CI 0.634-0.761) in one study, and moderately with anxiety in a meta-analysis.
The accuracy of the FSV-19S needs to be measured further using fear-related reference instruments, and future studies need to provide cut-off scores and normative values. Further evaluation of the remaining three instruments is required.
新冠疫情已成为全球恐惧的来源。衡量不同人群中恐惧的程度或重要性，可能有助于确定需要公共卫生和教育活动的人群及地区。我们对为评估或诊断与新冠相关的恐惧或恐惧症而开发的诊断测试感兴趣。
我们对研究新冠恐惧或恐惧症诊断或评估工具的研究进行了系统综述（PROSPERO注册编号：CRD42020197100）。我们利用了挪威公共卫生研究所的新冠证据动态地图，这是一个经过预筛选和预分类的研究数据库。新冠证据动态地图确定了自2019年12月1日以来在MEDLINE、Embase和美国疾病控制与预防中心发表的参考文献。经过每两周一次的检索，两名研究人员根据主题（七个主要主题，52个子主题）、人群（41个可用组）、研究设计和出版物类型对所有研究进行了独立分类。对于本综述，截至2020年9月25日，我们除了人工检索纳入研究的参考文献列表外，还评估了所有被归类到“经历与认知、后果；社会、政治、经济方面”主题的研究的合格性。我们对恐惧分数与最常见参考测试（焦虑、抑郁和压力的自我报告）的相关系数进行了荟萃分析，并报告了与其他参考测试（如特定恐惧症）的额外同时效度。对于少数提供诊断准确性统计数据的研究，我们使用QUADAS - 2评估了研究质量。
我们发现18项验证恐惧工具的研究。15项验证了新冠恐惧量表（FCV - 19S）。我们没有发现提出新冠恐惧诊断或显著/临床恐惧与非显著/亚临床恐惧阈值的研究。研究质量较低，最常见的潜在偏倚与抽样策略和非盲态数据分析有关。在一项研究中，FSV - 19S总分与严重恐惧症密切相关（r = 0.703，95%CI 0.634 - 0.761），在荟萃分析中与焦虑中度相关。
需要使用与恐惧相关的参考工具进一步测量FSV - 19S的准确性，未来的研究需要提供临界值分数和常模值。需要对其余三种工具进行进一步评估。
