‘Optimal’ cutoff selection in studies of depression screening tool accuracy using the PHQ-9, EPDS, or HADS-D: A meta-research study

IF 2.4 3区医学 Q2 PSYCHIATRY

International Journal of Methods in Psychiatric Research Pub Date : 2022-12-03 DOI:10.1002/mpr.1956

Eliana Brehaut, Dipika Neupane, Brooke Levis, Yin Wu, Ying Sun, John P. A. Ioannidis, Sarah Markham, Pim Cuijpers, Scott B. Patten, Andrea Benedetti, Brett D. Thombs

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引用次数: 2

Abstract

Objectives

Optimal cutoff thresholds are selected to separate ‘positive’ from ‘negative’ screening results. We evaluated how depression screening tool studies select optimal cutoffs.

Methods

We included studies from previously conducted meta-analyses of Patient Health Questionnaire-9, Edinburgh Postnatal Depression Scale, or Hospital Anxiety and Depression Scale—Depression accuracy. Outcomes included whether an optimal cutoff was selected, method used, recommendations made, and reporting guideline and protocol citation.

Results

Of 212 included studies, 172 (81%) attempted to identify an optimal cutoff, and 147 of these 172 (85%) reported one or more methods. Methods were heterogeneous with Youden's J (N = 35, 23%) most common. Only 23 of 147 (16%) studies described a rationale for their method. Rationales focused on balancing sensitivity and specificity without describing why desirable. 131 of 172 studies (76%) identified an optimal cutoff other than the standard; most did not make use recommendations (N = 56; 43%) or recommended using a non-standard cutoff (N = 53; 40%). Only 4 studies cited a reporting guideline, and 4 described a protocol with optimal cutoff selection methods, but none used the protocol method in the published study.

Conclusions

Research is needed to guide how selection of cutoffs for depression screening tools can be standardized and reflect clinical considerations.

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使用PHQ-9、EPDS或HADS-D研究抑郁症筛查工具准确性的“最佳”截止点选择：一项荟萃研究。

目标：选择最佳的截止阈值来区分“阳性”和“阴性”筛查结果。我们评估了抑郁症筛查工具研究如何选择最佳临界值。方法：我们纳入了先前进行的患者健康问卷-9、爱丁堡产后抑郁量表或医院焦虑和抑郁量表抑郁准确性的荟萃分析研究。结果包括是否选择了最佳截止点、使用的方法、提出的建议以及报告指南和方案引用。结果：在212项纳入的研究中，172项（81%）试图确定最佳截止点，其中147项（85%）报告了一种或多种方法。方法是异质性的，尤登J（N=35，23%）最常见。147项研究中只有23项（16%）描述了其方法的基本原理。理性侧重于平衡敏感性和特异性，而没有描述为什么需要。172项研究中有131项（76%）确定了标准以外的最佳截止值；大多数人没有提出使用建议（N=56；43%）或建议使用非标准截止值（N=53；40%）。只有4项研究引用了报告指南，4项研究描述了具有最佳截止选择方法的方案，但在已发表的研究中没有使用方案方法。结论：需要进行研究，以指导如何标准化抑郁症筛查工具的选择，并反映临床考虑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Methods in Psychiatric Research 医学-精神病学

CiteScore

5.20

自引率

6.50%

发文量

审稿时长

>12 weeks

期刊介绍： The International Journal of Methods in Psychiatric Research (MPR) publishes high-standard original research of a technical, methodological, experimental and clinical nature, contributing to the theory, methodology, practice and evaluation of mental and behavioural disorders. The journal targets in particular detailed methodological and design papers from major national and international multicentre studies. There is a close working relationship with the US National Institute of Mental Health, the World Health Organisation (WHO) Diagnostic Instruments Committees, as well as several other European and international organisations. MPR aims to publish rapidly articles of highest methodological quality in such areas as epidemiology, biostatistics, generics, psychopharmacology, psychology and the neurosciences. Articles informing about innovative and critical methodological, statistical and clinical issues, including nosology, can be submitted as regular papers and brief reports. Reviews are only occasionally accepted. MPR seeks to monitor, discuss, influence and improve the standards of mental health and behavioral neuroscience research by providing a platform for rapid publication of outstanding contributions. As a quarterly journal MPR is a major source of information and ideas and is an important medium for students, clinicians and researchers in psychiatry, clinical psychology, epidemiology and the allied disciplines in the mental health field.