Development, validation and clinical utility of short-term adverse-effects of electroconvulsive therapy (SAVE) checklist

• Published in: Psychiatry research Vol. 335; p. 115839
• Main Authors: Uppinkudru, Chithra, Pathak, Harsh, Kumar K, Raj, S, Bridgit, Bagali, Kiran, Pantoji, Makarand, Ezhumalai, Nathiya, Parlikar, Rujuta, Shah, Vyoma, Balachander, Srinivas, Sreeraj, Vanteemar S, Mehta, Urvakhsh Meherwan, Sinha, Preeti, Arumugham, Shyam Sundar, Venkatasubramanian, Ganesan, Thirthalli, Jagadisha
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.05.2024
• Subjects: Checklist; Common side effects; Drug-Related Side Effects and Adverse Reactions; Electroconvulsive Therapy - adverse effects; Electroconvulsive Therapy - methods; Forecasting; Gait; Humans; Orientation; Psychiatric disorders; Recovery; Stance; Treatment Outcome; Stance; Gait; Orientation; Psychiatric disorders; Recovery; Common side effects
• DOI: 10.1016/j.psychres.2024.115839
• ISSN: 0165-1781

•SAVE checklist is the first structured tool developed for assessing the short-term non-cognitive adverse effects associated with electroconvulsive therapy (ECT).•The checklist was found to have good content validity.•The checklist was able to identify common adverse effects seen during and after the ECT procedure (up to 48 h).•It is easy to administer and can be administered in a short span of time.•It has immense utility as both a clinical and a research tool for assessing non-cognitive adverse effects. Electroconvulsive therapy (ECT) is one of the most effective treatments in psychiatry. However, it has many cognitive and non-cognitive adverse effects (AEs). There are lacunae in the literature on systematic assessment of non-cognitive AEs. There is a need for a standard, comprehensive and specific clinical tool to evaluate this. Hence, a checklist of short-term AEs of ECT (SAVE) with a 2-phase assessment was developed. Content validation was done using 15 experts’ ratings and predefined content validity ratio and index (CVR and CVI) in a two-stage modified Delphi method. The checklist had a good CVR and CVI with a final tool of 39 items. The tool was sensitive and identified the non-cognitive AEs after ECT. Cardiovascular and musculoskeletal systems displayed the highest incidence. Many participants exhibited delayed recovery in orientation, gait, and stance, highlighting a necessity for meticulous monitoring. SAVE is the first standardised tool to assess short-term ECT-related AEs systematically. This checklist likely identifies clinically significant incidences of adverse effects. Its regular use may enhance the safety of ECT and patient comfort by supporting early identification and intervention for AEs. However, given the transient nature of AEs, further studies are needed to determine their predictive validity for long-term consequences.