Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data

Why is this work in the frame?

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

Full frame distilled prediction

Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

Candidate categories

Meta-epidemiology (narrow)

Consensus categories

none

Domain

Candidate signal: noneConsensus signal: none

Study design

Candidate signal: Systematic reviewConsensus signal: none

Genre

Candidate signal: ReviewConsensus signal: Review

Teacher disagreement score

0.516

Threshold uncertainty score

1.000

Validation status

machine_predicted_unvalidated · codex-gemma-dda1882f352a

Codex and Gemma teacher scores by category

Machine scores (provisional)

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

0.242 · 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 evaluate the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression in pregnant and postpartum women. DESIGN: Individual participant data meta-analysis. DATA SOURCES: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (from inception to 3 October 2018). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Eligible datasets included EPDS scores and major depression classification based on validated diagnostic interviews. Bivariate random effects meta-analysis was used to estimate EPDS sensitivity and specificity compared with semi-structured, fully structured (Mini International Neuropsychiatric Interview (MINI) excluded), and MINI diagnostic interviews separately using individual participant data. One stage meta-regression was used to examine accuracy by reference standard categories and participant characteristics. RESULTS: Individual participant data were obtained from 58 of 83 eligible studies (70%; 15 557 of 22 788 eligible participants (68%), 2069 with major depression). Combined sensitivity and specificity was maximised at a cut-off value of 11 or higher across reference standards. Among studies with a semi-structured interview (36 studies, 9066 participants, 1330 with major depression), sensitivity and specificity were 0.85 (95% confidence interval 0.79 to 0.90) and 0.84 (0.79 to 0.88) for a cut-off value of 10 or higher, 0.81 (0.75 to 0.87) and 0.88 (0.85 to 0.91) for a cut-off value of 11 or higher, and 0.66 (0.58 to 0.74) and 0.95 (0.92 to 0.96) for a cut-off value of 13 or higher, respectively. Accuracy was similar across reference standards and subgroups, including for pregnant and postpartum women. CONCLUSIONS: An EPDS cut-off value of 11 or higher maximised combined sensitivity and specificity; a cut-off value of 13 or higher was less sensitive but more specific. To identify pregnant and postpartum women with higher symptom levels, a cut-off of 13 or higher could be used. Lower cut-off values could be used if the intention is to avoid false negatives and identify most patients who meet diagnostic criteria. REGISTRATION: PROSPERO (CRD42015024785).

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The record

Venue

BMJ

Topic

Maternal Mental Health During Pregnancy and Postpartum

Field

Medicine

Canadian institutions

McGill University Health CentreMcGill UniversityJewish General Hospital

Funders

Fondo Nacional de Desarrollo Científico y TecnológicoNational Institute of Mental HealthUniversitätsklinikum Hamburg-EppendorfFaculty of Medicine, Chulalongkorn UniversityFonds de Recherche du Québec - SantéUniversity of SouthamptonCanadian Institutes of Health ResearchPatrick and Catherine Weldon Donaghue Medical Research FoundationFeinberg School of MedicineNational Science FoundationChina Medical UniversityUniversidade do MinhoUniversity of Cape TownMedical Research CouncilUppsala UniversitetMinistério da SaúdeDuke Global Health Institute, Duke UniversityUniversité de GenèveSveučilište u ZagrebuIngham Institute for Applied Medical ResearchWerner Otto StiftungFundação de Amparo à Pesquisa do Estado de Minas GeraisUniversità degli Studi di FirenzeSapienza Università di RomaUniversity of OxfordChina Medical University HospitalMcGill UniversityConselho Nacional de Desenvolvimento Científico e TecnológicoUniversity of BristolDeakin UniversityDepartment of Families, Housing, Community Services and Indigenous AffairsYale UniversityUniversity of New South WalesSchweizerischer Nationalfonds zur Förderung der Wissenschaftlichen ForschungNational Institute for Health and Care ResearchNational Research FoundationUniversidad de Santiago de ChileAustralian GovernmentFaculty of Medicine, McGill UniversityDepartment of Health and Social CareMcGill University Health CentreInstitute of Psychiatry, Psychology and Neuroscience, King’s College LondonProgramme Grants for Applied ResearchMonash UniversityWellcome TrustSzegedi TudományegyetemChulalongkorn UniversityUniversity of ConnecticutKing's College LondonHarry Crossley FoundationNational Health and Medical Research CouncilFundação de Amparo à Pesquisa do Estado de São Paulo

Keywords

Edinburgh Postnatal Depression ScaleMeta-analysisPsycINFOConfidence intervalMedicinePostpartum depressionDepression (economics)MEDLINEBivariate analysisClinical psychologyPsychiatryPsychologyDepressive symptomsPregnancyInternal medicineStatisticsCognition

Has abstract in OpenAlex

yes

API

/api/v1/works/W3093810429