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The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis Publisher Pubmed



He C9, 13 ; Levis B9 ; Riehm KE9 ; Saadat N9 ; Levis AW9, 13 ; Azar M9, 13 ; Rice DB9, 15 ; Krishnan A10 ; Wu Y10, 14, 17 ; Sun Y10 ; Imran M10 ; Boruff J19, 20 ; Cuijpers P21, 22 ; Gilbody S23, 24 Show All Authors
Authors
  1. He C9, 13
  2. Levis B9
  3. Riehm KE9
  4. Saadat N9
  5. Levis AW9, 13
  6. Azar M9, 13
  7. Rice DB9, 15
  8. Krishnan A10
  9. Wu Y10, 14, 17
  10. Sun Y10
  11. Imran M10
  12. Boruff J19, 20
  13. Cuijpers P21, 22
  14. Gilbody S23, 24
  15. Ioannidis JPA25, 26
  16. Kloda LA27, 28
  17. Mcmillan D24
  18. Patten SB29, 30, 31, 32
  19. Shrier I10, 14
  20. Ziegelstein RC34
  21. Akena DH36
  22. Arroll B38, 39
  23. Ayalon L40
  24. Baradaran HR44, 48
  25. Baron M10, 46
  26. Beraldi A49, 50
  27. Bombardier CH51, 52
  28. Butterworth P53, 54, 58
  29. Carter G59, 60
  30. Chagas MHN63
  31. Chan JCN10, 63, 65
  32. Cholera R14
  33. Clover K16, 18
  34. Conwell Y20
  35. De Manvan Ginkel JM22
  36. Fann JR24
  37. Fischer FH26
  38. Fung D28, 30, 32, 33
  39. Gelaye B35
  40. Goodyearsmith F37
  41. Greeno CG38
  42. Hall BJ40, 44
  43. Harrison PA45, 46
  44. Harter M47, 48
  45. Hegerl U50, 57
  46. Hides L52
  47. Hobfoll SE54, 55, 56
  48. Hudson M10, 46
  49. Hyphantis TN58
  50. Inagaki M60
  51. Ismail K61, 62
  52. Jette N30, 32, 63
  53. Khamseh ME44
  54. Kiely KM65, 66
  55. Kwan Y67
  56. Lamers F68
  57. Liu SI34, 69, 70, 71
  58. Lotrakul M72
  59. Loureiro SR63, 64
  60. Lowe B73
  61. Marsh L74
  62. Mcguire A75
  63. Mohdsidik S76
  64. Munhoz TN77
  65. Muramatsu K78
  66. Osorio FL63, 79
  67. Patel V80, 81
  68. Pence BW82
  69. Persoons P83, 84
  70. Picardi A85
  71. Reuter K86
  72. Rooney AG87
  73. Da Silva Dos Santos IS77
  74. Shaaban J88
  75. Sidebottom A11
  76. Simning A20
  77. Stafford L41, 55
  78. Sung S28, 34
  79. Tan PLL67
  80. Turner A12, 42, 43
  81. Van Weert HCPM56
  82. White J5
  83. Whooley MA2, 4, 6
  84. Winkley K7
  85. Yamada M1
  86. Thombs BD3, 9, 14, 16, 18, 46
  87. Benedetti A8, 14, 46, 89
Show Affiliations
Authors Affiliations
  1. 1. Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
  2. 2. Department of Medicine, Veterans Affairs Medical Center, San Francisco, CA, United States
  3. 3. Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
  4. 4. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
  5. 5. Monash University, Melbourne, VIC, Australia
  6. 6. Department of Medicine, University of California San Francisco, San Francisco, CA, United States
  7. 7. Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
  8. 8. Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, QC, Canada
  9. 9. Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
  10. 10. Hong Kong Institute of Diabetes and Obesity, Hong Kong SAR, Hong Kong
  11. 11. Allina Health, Minneapolis, MN, United States
  12. 12. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
  13. 13. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
  14. 14. Department of Pediatrics, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, United States
  15. 15. Department of Psychology, McGill University, Montreal, QC, Canada
  16. 16. Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, NSW, Australia
  17. 17. Department of Psychiatry, McGill University, Montreal, QC, Canada
  18. 18. Psycho-Oncology Service, Calvary Mater Newcastle, Newcastle, NSW, Australia
  19. 19. Schulich Library of Physical Sciences, Life Sciences and Engineering, McGill University, Montreal, QC, Canada
  20. 20. Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
  21. 21. Department of Clinical, Neuro- A Nd Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
  22. 22. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
  23. 23. Hull York Medical School, Department of Health Sciences, University of York, Heslington, United Kingdom
  24. 24. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
  25. 25. Department of Medicine, Department of Health Research and Policy, Department of Biomedical Data Science, Department of Statistics, Stanford University, Stanford, CA, United States
  26. 26. Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charite-Universitatsmedizin Berlin, Berlin, Germany
  27. 27. Department of Library, Concordia University, Montreal, QC, Canada
  28. 28. Department of Child and Adolescent Psychiatry, Institute of Mental Health, Singapore, Singapore
  29. 29. Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
  30. 30. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  31. 31. Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
  32. 32. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
  33. 33. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
  34. 34. Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
  35. 35. Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda
  36. 36. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
  37. 37. Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
  38. 38. School of Social Work, University of Pittsburgh, Pittsburgh, PA, United States
  39. 39. Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
  40. 40. Global and Community Mental Health Research Group, Department of Psychology, Faculty of Social Sciences, University of Macau, Macao
  41. 41. Centre for Women's Mental Health, Royal Women's Hospital, Parkville, VIC, Australia
  42. 42. IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia
  43. 43. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
  44. 44. Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
  45. 45. Department of Medicine, McGill University, Montreal, QC, Canada
  46. 46. City of Minneapolis Health Department, Minneapolis, MN, United States
  47. 47. Ageing Clinical and Experimental Research Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
  48. 48. Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  49. 49. Kbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen, Klinik fur Psychiatrie, Psychotherapie und Psychosomatik, Lehrkrankenhaus der Technischen Universitat Munchen, Munich, Germany
  50. 50. Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-Universitat Frankfurt, German Depression Foundation, Frankfurt, Germany
  51. 51. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
  52. 52. School of Psychology, University of Queensland, Brisbane, QLD, Australia
  53. 53. Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, ACT, Australia
  54. 54. STAR-Stress, Anxiety and Resilience Consultants, Chicago, IL, United States
  55. 55. Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
  56. 56. Department of General Practice, Amsterdam Institute for General Practice and Public Health, Amsterdam University Medical Centers, Amsterdam, Netherlands
  57. 57. Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, VIC, Australia
  58. 58. Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
  59. 59. Centre for Brain and Mental Health Research, University-of-Newcastle, Newcastle, NSW, Australia
  60. 60. Department of Psychiatry, Faculty of Medicine, Shimane University, Shimane, Japan
  61. 61. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London Weston Education Centre, London, United Kingdom
  62. 62. Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
  63. 63. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
  64. 64. Asia Diabetes Foundation, Prince of Wales Hospital, Hong Kong SAR, Hong Kong
  65. 65. School of Psychology, University of New South Wales, Sydney, NSW, Australia
  66. 66. Neuroscience Research Australia, Sydney, NSW, Australia
  67. 67. Department of Psychological Medicine, Tan Tock Seng Hospital, Singapore, Singapore
  68. 68. Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
  69. 69. Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
  70. 70. Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
  71. 71. Department of Medicine, Mackay Medical College, Taipei, Taiwan
  72. 72. Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  73. 73. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  74. 74. Baylor College of Medicine Houston, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States
  75. 75. Department of Nursing, St. Joseph's College, Standish, ME, United States
  76. 76. Cancer Resource and Education Centre, Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
  77. 77. Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
  78. 78. Department of Clinical Psychology, Graduate School, Niigata Seiryo University, Niigata, Japan
  79. 79. National Institute of Science and Technology, Translational Medicine, Ribeirao Preto, Brazil
  80. 80. Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
  81. 81. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States
  82. 82. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
  83. 83. Department of Adult Psychiatry, University Hospitals Leuven, Leuven, Belgium
  84. 84. Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium
  85. 85. Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy
  86. 86. Practice for Psychotherapy and Psycho-Oncology, Freiburg, Germany
  87. 87. Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburg, Edinburgh, United Kingdom
  88. 88. Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
  89. 89. Centre for Outcomes Research and Evaluation, Research Institute, McGill University Health Centre, 5252 Boulevard de Maisonneuve, Montreal, H4A3S5, QC, Canada

Source: Psychotherapy and Psychosomatics Published:2020


Abstract

Background: 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. Objective: 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. Methods: 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. Results: 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). Conclusions: The cutoff score approach appears to be a better option than a PHQ-9 algorithm for detecting major depression. © 2019 S. Karger AG, Basel. All rights reserved.
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