Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis
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A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Machine scores (provisional)
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
- Teacher spread
- 0.042 · how far apart the two teachers sit on this one work
- Validation status
score_only:v0-immature-baseline· verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it
Abstract
OBJECTIVE: To determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression. DESIGN: Individual participant data meta-analysis. DATA SOURCES: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (January 2000-February 2015). INCLUSION CRITERIA: Eligible studies compared PHQ-9 scores with major depression diagnoses from validated diagnostic interviews. Primary study data and study level data extracted from primary reports were synthesized. For PHQ-9 cut-off scores 5-15, bivariate random effects meta-analysis was used to estimate pooled sensitivity and specificity, separately, among studies that used semistructured diagnostic interviews, which are designed for administration by clinicians; fully structured interviews, which are designed for lay administration; and the Mini International Neuropsychiatric (MINI) diagnostic interviews, a brief fully structured interview. Sensitivity and specificity were examined among participant subgroups and, separately, using meta-regression, considering all subgroup variables in a single model. RESULTS: Data were obtained for 58 of 72 eligible studies (total n=17 357; major depression cases n=2312). Combined sensitivity and specificity was maximized at a cut-off score of 10 or above among studies using a semistructured interview (29 studies, 6725 participants; sensitivity 0.88, 95% confidence interval 0.83 to 0.92; specificity 0.85, 0.82 to 0.88). Across cut-off scores 5-15, sensitivity with semistructured interviews was 5-22% higher than for fully structured interviews (MINI excluded; 14 studies, 7680 participants) and 2-15% higher than for the MINI (15 studies, 2952 participants). Specificity was similar across diagnostic interviews. The PHQ-9 seems to be similarly sensitive but may be less specific for younger patients than for older patients; a cut-off score of 10 or above can be used regardless of age.. CONCLUSIONS: PHQ-9 sensitivity compared with semistructured diagnostic interviews was greater than in previous conventional meta-analyses that combined reference standards. A cut-off score of 10 or above maximized combined sensitivity and specificity overall and for subgroups. REGISTRATION: PROSPERO CRD42014010673.
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The record
- Venue
- BMJ
- Topic
- Mental Health Treatment and Access
- Field
- Psychology
- Canadian institutions
- McGill UniversityJewish General Hospital
- Funders
- Canadian Arthritis NetworkNational Institute on Minority Health and Health DisparitiesNational Center for Research ResourcesNational Institute of Diabetes and Digestive and Kidney DiseasesNational Institute of Mental HealthNational Health and Medical Research CouncilMedical Research CouncilNational Center for Medical Rehabilitation ResearchFonds de Recherche du Québec - SantéCanadian Institutes of Health ResearchNational Institute on Disability and Rehabilitation ResearchAgency for Healthcare Research and QualityCenters for Disease Control and PreventionNational Institutes of HealthNational Institute of General Medical SciencesH. Lundbeck A/SChinese Diabetes SocietyHealth Research Council of New ZealandNational Health Research InstitutesAlberta Health ServicesJewish General HospitalBundesministerium für Bildung und ForschungSafe Work AustraliaNational Heart, Lung, and Blood InstituteTehran University of Medical Sciences and Health ServicesUniversity of CalgaryMahidol UniversityEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentZonMwDeutsche RentenversicherungUniversidade de MacauEli Lilly and CompanyScleroderma Society of OntarioMinistry of Health, Labour and WelfareUniversity of WashingtonUniversität HeidelbergEuropean CommissionHotchkiss Brain Institute, University of CalgaryOhio Board of RegentsPfizer
- Keywords
- PsycINFOMeta-analysisConfidence intervalPatient Health QuestionnaireMedicineMEDLINEBivariate analysisDepression (economics)Medical diagnosisClinical psychologyDepressive symptomsPsychiatryInternal medicineMachine learningPathologyCognition
- Has abstract in OpenAlex
- yes