BMJ: So many depression screening scales, are you using it right?

Depression causes more healthy lifespan losses than any other disease
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The US Preventive Services Task Force recommends screening to identify unrecognized patients with depression

Depression causes more healthy lifespan losses than any other disease

Nine items of Patient Health Questionnaire-9 (PHQ-9) are recommended for screening by the US Preventive Services Task Force and other agencies

Researchers searched through Ovid's Medline, Medline In-Process and other non-indexed citations, PsycINFO, Web of Science until May 9, 2018.
Eligible research uses effective semi-structured diagnostic interviews, fully structured interviews or Mini International Neuropsychiatric Interview (MINI; short interview designed for non-professional management ) manages PHQ-9 and classifies current major depression status
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Results 44,503 participants were obtained from 100 of 127 eligible studies (27,146 more after the update) (42 additional studies; 79% eligible studies; 86% eligible participants)
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In the study using the semi-structured interview reference standard, when the standard cutoff value ≥ 10, the sensitivity and specificity (95% CI) of the set of PHQ-9 were 0.

In the study using the semi-structured interview reference standard, when the standard cutoff value ≥ 10, the sensitivity and specificity (95% CI) of the set of PHQ-9 were 0.

The ROC curve shows the sensitivity and specificity of each cut-off value and each reference standard category
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At the same time, the specificity of different reference standards is similar, but the sensitivity of the study using semi-structured interviews is 7-24% higher than that of the study using fully structured reference standards (median 21%), which is higher than that of MINI with different cut-off values 2-14% higher (median 11%)
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Among different reference standards and cut-off values, male specificity is 0-10% higher (median 3%), and those over 60 years old are 0-12 higher (median 5%)

In summary, researchers and clinicians can use knowledge conversion tools to determine the results of different PHQ-9 cut-off values ​​in different clinical environments
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In summary, researchers and clinicians can use knowledge conversion tools to determine the results of different PHQ-9 cut-off values ​​in different clinical environments
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In summary, researchers and clinicians can use knowledge conversion tools to determine the results of different PHQ-9 cut-off values ​​in different clinical environments

references:

Accuracy of the Patient Health Questionnaire-9 for screening to detect major depression: updated systematic review and individual participant data meta-analysis.

Accuracy of the Patient Health Questionnaire-9 for screening to detect major depression: updated systematic review and individual participant data meta-analysis.
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