The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis.
Journal: Psychotherapy and psychosomatics
Volume: 89
Issue: 1
Year of Publication: 2020
Affiliated Institutions: Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada. Schulich Library of Physical Sciences, Life Sciences and Engineering, McGill University, Montreal, Québec, Canada. Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands. Hull York Medical School and the Department of Health Sciences, University of York, Heslington, United Kingdom. Department of Medicine, Department of Health Research and Policy, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, California, USA. Library, Concordia University, Montréal, Québec, Canada. Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda. Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand. Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. Kbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen, Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Lehrkrankenhaus der Technischen Universität München, Munich, Germany. Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA. Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia. Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia. Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA. Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany. Department of Child and Adolescent Psychiatry, Institute of Mental Health, Singapore, Singapore. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. Global and Community Mental Health Research Group, Department of Psychology, Faculty of Social Sciences, University of Macau, Macau SAR, China. City of Minneapolis Health Department, Minneapolis, Minnesota, USA. Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-Universität Frankfurt, German Depression Foundation, Frankfurt, Germany. School of Psychology, University of Queensland, Brisbane, Queensland, Australia. STAR-Stress, Anxiety and Resilience Consultants, Chicago, Illinois, USA. Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece. Department of Psychiatry, Faculty of Medicine, Shimane University, Shimane, Japan. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London Weston Education Centre, London, United Kingdom. School of Psychology, University of New South Wales, Sydney, New South Wales, Australia. Department of Psychological Medicine, Tan Tock Seng Hospital, Singapore, Singapore. Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands. Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore. Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Baylor College of Medicine Houston and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA. Department of Nursing, St. Joseph's College, Standish, Maine, USA. Cancer Resource and Education Centre, and Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia. Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil. Department of Clinical Psychology, Graduate School of Niigata Seiryo University, Niigata, Japan. Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA. Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. Department of Adult Psychiatry, University Hospitals Leuven, Leuven, Belgium. Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy. Practice for Psychotherapy and Psycho-Oncology, Freiburg, Germany. Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburg, Edinburgh, United Kingdom. Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia. Allina Health, Minneapolis, Minnesota, USA. Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria, Australia. School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia. Department of General Practice, Amsterdam Institute for General Practice and Public Health, Amsterdam University Medical Centers, Amsterdam, The Netherlands. Monash University, Melbourne, Victoria, Australia. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA. Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom. Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan. Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada, brett.thombs@mcgill.ca. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
Abstract summary
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.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.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.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).The cutoff score approach appears to be a better option than a PHQ-9 algorithm for detecting major depression.Authors & Co-authors: He Chen C Levis Brooke B Riehm Kira E KE Saadat Nazanin N Levis Alexander W AW Azar Marleine M Rice Danielle B DB Krishnan Ankur A Wu Yin Y Sun Ying Y Imran Mahrukh M Boruff Jill J Cuijpers Pim P Gilbody Simon S Ioannidis John P A JPA Kloda Lorie A LA McMillan Dean D Patten Scott B SB Shrier Ian I Ziegelstein Roy C RC Akena Dickens H DH Arroll Bruce B Ayalon Liat L Baradaran Hamid R HR Baron Murray M Beraldi Anna A Bombardier Charles H CH Butterworth Peter P Carter Gregory G Chagas Marcos Hortes Nisihara MHN Chan Juliana C N JCN Cholera Rushina R Clover Kerrie K Conwell Yeates Y de Man-van Ginkel Janneke M JM Fann Jesse R JR Fischer Felix H FH Fung Daniel D Gelaye Bizu B Goodyear-Smith Felicity F Greeno Catherine G CG Hall Brian J BJ Harrison Patricia A PA Härter Martin M Hegerl Ulrich U Hides Leanne L Hobfoll Stevan E SE Hudson Marie M Hyphantis Thomas N TN Inagaki Masatoshi M Ismail Khalida K Jetté Nathalie N Khamseh Mohammad E ME Kiely Kim M KM Kwan Yunxin Y Lamers Femke F Liu Shen-Ing SI Lotrakul Manote M Loureiro Sonia R SR Löwe Bernd B Marsh Laura L McGuire Anthony A Mohd-Sidik Sherina S Munhoz Tiago N TN Muramatsu Kumiko K Osório Flávia L FL Patel Vikram V Pence Brian W BW Persoons Philippe P Picardi Angelo A Reuter Katrin K Rooney Alasdair G AG da Silva Dos Santos Iná S IS Shaaban Juwita J Sidebottom Abbey A Simning Adam A Stafford Lesley L Sung Sharon S Tan Pei Lin Lynnette PLL Turner Alyna A van Weert Henk C P M HCPM White Jennifer J Whooley Mary A MA Winkley Kirsty K Yamada Mitsuhiko M Thombs Brett D BD Benedetti Andrea A
Study Outcome
Source Link: Visit source
Statistics
Citations : Raffle A, Gray M. Screening: evidence and practice. London (UK): Oxford University Press; 2007.Authors : 87
Identifiers
Doi : 10.1159/000502294SSN : 1423-0348