Melbourne Institute of Applied Economic and Social Research - Research Publications

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Start date: 2020 × End date: 2022 × Author: Butterworth, Peter × Author: Stafford, Lesley ×

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    Probability of Major Depression Classification Based on the SCID, CIDI, and MINI Diagnostic Interviews: A Synthesis of Three Individual Participant Data Meta-Analyses.
    Wu, Y ; Levis, B ; Ioannidis, JPA ; Benedetti, A ; Thombs, BD ; DEPRESsion Screening Data (DEPRESSD) Collaboration, (Karger Publishers, 2021)
    INTRODUCTION: Three previous individual participant data meta-analyses (IPDMAs) reported that, compared to the Structured Clinical Interview for the DSM (SCID), alternative reference standards, primarily the Composite International Diagnostic Interview (CIDI) and the Mini International Neuropsychiatric Interview (MINI), tended to misclassify major depression status, when controlling for depression symptom severity. However, there was an important lack of precision in the results. OBJECTIVE: To compare the odds of the major depression classification based on the SCID, CIDI, and MINI. METHODS: We included and standardized data from 3 IPDMA databases. For each IPDMA, separately, we fitted binomial generalized linear mixed models to compare the adjusted odds ratios (aORs) of major depression classification, controlling for symptom severity and characteristics of participants, and the interaction between interview and symptom severity. Next, we synthesized results using a DerSimonian-Laird random-effects meta-analysis. RESULTS: In total, 69,405 participants (7,574 [11%] with major depression) from 212 studies were included. Controlling for symptom severity and participant characteristics, the MINI (74 studies; 25,749 participants) classified major depression more often than the SCID (108 studies; 21,953 participants; aOR 1.46; 95% confidence interval [CI] 1.11-1.92]). Classification odds for the CIDI (30 studies; 21,703 participants) and the SCID did not differ overall (aOR 1.19; 95% CI 0.79-1.75); however, as screening scores increased, the aOR increased less for the CIDI than the SCID (interaction aOR 0.64; 95% CI 0.52-0.80). CONCLUSIONS: Compared to the SCID, the MINI classified major depression more often. The odds of the depression classification with the CIDI increased less as symptom levels increased. Interpretation of research that uses diagnostic interviews to classify depression should consider the interview characteristics.
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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
    He, C ; Levis, B ; Riehm, KE ; Saadat, N ; Levis, AW ; Azar, M ; Rice, DB ; Krishnan, A ; Wu, Y ; Sun, Y ; Imran, M ; Boruff, J ; Cuijpers, P ; Gilbody, S ; Ioannidis, JPA ; Kloda, LA ; McMillan, D ; Patten, SB ; Shrier, I ; Ziegelstein, RC ; Akena, DH ; Arroll, B ; Ayalon, L ; Baradaran, HR ; Baron, M ; Beraldi, A ; Bombardier, CH ; Butterworth, P ; Carter, G ; Chagas, MHN ; Chan, JCN ; Cholera, R ; Clover, K ; Conwell, Y ; de Man-van Ginkel, JM ; Fann, JR ; Fischer, FH ; Fung, D ; Gelaye, B ; Goodyear-Smith, F ; Greeno, CG ; Hall, BJ ; Harrison, PA ; Harter, M ; Hegerl, U ; Hides, L ; Hobfoll, SE ; Hudson, M ; Hyphantis, TN ; Inagaki, M ; Ismail, K ; Jette, N ; Khamseh, ME ; Kiely, KM ; Kwan, Y ; Lamers, F ; Liu, S-I ; Lotrakul, M ; Loureiro, SR ; Loewe, B ; Marsh, L ; McGuire, A ; Mohd-Sidik, S ; Munhoz, TN ; Muramatsu, K ; Osorio, FL ; Patel, V ; Pence, BW ; Persoons, P ; Picardi, A ; Reuter, K ; Rooney, AG ; da Silva dos Santos, IS ; Shaaban, J ; Sidebottom, A ; Simning, A ; Stafford, L ; Sung, S ; Tan, PLL ; Turner, A ; van Weert, HCPM ; White, J ; Whooley, MA ; Winkley, K ; Yamada, M ; Thombs, BD ; Benedetti, A (KARGER, 2020-01)
    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.
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    Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis.
    Wu, Y ; Levis, B ; Riehm, KE ; Saadat, N ; Levis, AW ; Azar, M ; Rice, DB ; Boruff, J ; Cuijpers, P ; Gilbody, S ; Ioannidis, JPA ; Kloda, LA ; McMillan, D ; Patten, SB ; Shrier, I ; Ziegelstein, RC ; Akena, DH ; Arroll, B ; Ayalon, L ; Baradaran, HR ; Baron, M ; Bombardier, CH ; Butterworth, P ; Carter, G ; Chagas, MH ; Chan, JCN ; Cholera, R ; Conwell, Y ; de Man-van Ginkel, JM ; Fann, JR ; Fischer, FH ; Fung, D ; Gelaye, B ; Goodyear-Smith, F ; Greeno, CG ; Hall, BJ ; Harrison, PA ; Härter, M ; Hegerl, U ; Hides, L ; Hobfoll, SE ; Hudson, M ; Hyphantis, T ; Inagaki, MD ; Jetté, N ; Khamseh, ME ; Kiely, KM ; Kwan, Y ; Lamers, F ; Liu, S-I ; Lotrakul, M ; Loureiro, SR ; Löwe, B ; McGuire, A ; Mohd-Sidik, S ; Munhoz, TN ; Muramatsu, K ; Osório, FL ; Patel, V ; Pence, BW ; Persoons, P ; Picardi, A ; Reuter, K ; Rooney, AG ; Santos, IS ; Shaaban, J ; Sidebottom, A ; Simning, A ; Stafford, MD ; Sung, S ; Tan, PLL ; Turner, A ; van Weert, HC ; White, J ; Whooley, MA ; Winkley, K ; Yamada, M ; Benedetti, A ; Thombs, BD (Cambridge University Press (CUP), 2020)
    BACKGROUND: Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9. METHODS: We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy. RESULTS: 16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (-0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01). CONCLUSIONS: PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.