Journal
BMJ-BRITISH MEDICAL JOURNAL
Volume 365, Issue -, Pages -Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/bmj.l1476
Keywords
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Categories
Funding
- Canadian Institutes of Health Research (CIHR) [KRS-134297]
- CIHR Frederick Banting and Charles Best Canada Graduate Scholarship doctoral award
- Fonds de recherche du Quebec - Sante (FRQS)
- CIHR Frederick Banting and Charles Best Canada Graduate Scholarship master's awards
- FRQS Masters Training Awards
- Vanier Canada Graduate Scholarship
- Health Research Council of New Zealand
- Lundbeck International
- Tehran University of Medical Sciences [M-288]
- Department of Education, National Institute on Disability and Rehabilitation Research, Spinal Cord Injury Model Systems: University of Washington [H133N060033]
- Department of Education, National Institute on Disability and Rehabilitation Research, Spinal Cord Injury Model Systems: Baylor College of Medicine [H133N060003]
- Department of Education, National Institute on Disability and Rehabilitation Research, Spinal Cord Injury Model Systems: University of Michigan [H133N060032]
- Australian Research Council Future Fellowship [FT130101444]
- European Foundation for Study of Diabetes
- Chinese Diabetes Society
- Lilly Foundation
- Liao Wun Yuk Diabetes Memorial Fund
- NIMH [RO1-MH069666, R24MH071604, R34 MH072925, K02 MH65919, P30 DK50456, R24 MH56858, R01 MH073687, R34 MH084673]
- Centers for Disease Control and Prevention [R49 CE002093]
- St Anne's Community Services, Leeds, UK
- US National Center for Medical Rehabilitation Research [RO1 HD39415]
- University of Calgary Faculty of Medicine
- German Federal Ministry of Education and Research [01GY1150]
- NIH [T32 GM07356, T37 MD001449]
- Ohio Board of Regents
- Research and Development Administration Office, University of Macau [MYRG2015-00109-FSS]
- Federal Ministry of Education and Research [01 GD 9802/4, 01 GD 0101]
- Federation of German Pension Insurance Institute
- Jack Brockhoff Foundation
- Grosvenor Settlement
- Danks Trust
- CIHR [FRN 83518]
- Scleroderma Society of Canada
- Cure Scleroderma Foundation
- FRQS
- Canadian Arthritis Network
- Lady Davis Institute of Medical Research of the Jewish General Hospital, Montreal, QC
- FRQS Senior Investigator Award
- European Union
- Greek Ministry of Education, Lifelong Learning and Religious Affairs (ARISTEIA-ABREVIATE) [1259]
- Ministry of Health, Labour and Welfare, Japan
- Canada Research Chair in Neurological Health Services Research
- National Health and Medical Research Council [1002160]
- Safe Work Australia
- Australian National Health and Medical Research Council fellowship [1088313]
- Netherlands Organisation for Health Research and Development [945-03-047]
- National Health Research Institute, Republic of China [NHRI-EX97-9706PI]
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand [49086]
- Pfizer, Germany
- medical faculty of the University of Heidelberg, Germany [121/2000]
- Research University Grant Scheme from Universiti Putra Malaysia, Malaysia
- Postgraduate Research Student Support Accounts of the University of Auckland, New Zealand
- Pfizer US Pharmaceutical Inc.
- Reitoria de Pesquisa da Universidade de Sao Paulo [09.1.01689.17.7]
- Banco Santander [10.1.01232.17.9]
- Italian Ministry of Health
- Belgian Ministry of Public Health and Social Affairs
- Pfizer Belgium
- Universiti Sains Malaysia
- United States Department of Health and Human Services, Health Resources and Services Administration [R40MC07840]
- Agency for Healthcare Research and Quality [R36 HS018246]
- National Center for Research Resources [TL1 RR024135]
- University of Melbourne
- Innovatiefonds Zorgverzekeraars
- Fund for Innovation and Competitiveness of the Chilean Ministry of Economy, Development and Tourism, through the Millennium Scientific Initiative [IS130005]
- Department of Veterans Epidemiology Merit Review Program
- Department of Veterans Affairs Health Services Research and Development service
- National Heart Lung and Blood Institute [R01 HL079235]
- American Federation for Ageing Research
- Robert Wood Johnson Foundation
- UK National Institute for Health Research under its Programme Grants for Applied Research Programme [RP-PG-0606-1142]
- Netherlands Organization for Health Research and Development (ZonMw) Mental Health Program [100.003.005, 100.002.021]
- Academic Medical Center/University of Amsterdam
- Asia Diabetes Foundation
- Alberta Health Services
- Hotchkiss Brain Institute
- Perpetual Trustees
- Flora and Frank Leith Charitable Trust
- Sunshine Foundation
- German Ministry of Research and Education
- Scleroderma Society of Ontario
- Scleroderma Society of Saskatchewan
- Sclerodermie Quebec
- Inova Diagnostics Inc
- Euroimmun
- National Strategic Reference Framework
- National Program for Centers of Excellence (PRONEX/FAPERGS/CNPq, Brazil)
- PQ-CNPq-2 [301321/2016-7]
- UK National Health Service Lothian Neuro-Oncology Endowment Fund
- Hunter Medical Research Institute
- Ischemia Research and Education Foundation
- Australian Research Council [FT130101444] Funding Source: Australian Research Council
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OBJECTIVE To determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression. DESIGN Individual participant data meta-analysis. DATA SOURCES Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (January 2000-February 2015). INCLUSION CRITERIA Eligible studies compared PHQ-9 scores with major depression diagnoses from validated diagnostic interviews. Primary study data and study level data extracted from primary reports were synthesized. For PHQ-9 cut-off scores 5-15, bivariate random effects meta-analysis was used to estimate pooled sensitivity and specificity, separately, among studies that used semistructured diagnostic interviews, which are designed for administration by clinicians; fully structured interviews, which are designed for lay administration; and the Mini International Neuropsychiatric (MINI) diagnostic interviews, a brief fully structured interview. Sensitivity and specificity were examined among participant subgroups and, separately, using meta-regression, considering all subgroup variables in a single model. RESULTS Data were obtained for 58 of 72 eligible studies (total n=17 357; major depression cases n=2312). Combined sensitivity and specificity was maximized at a cut-off score of 10 or above among studies using a semistructured interview (29 studies, 6725 participants; sensitivity 0.88, 95% confidence interval 0.83 to 0.92; specificity 0.85, 0.82 to 0.88). Across cut-off scores 5-15, sensitivity with semistructured interviews was 5-22% higher than for fully structured interviews (MINI excluded; 14 studies, 7680 participants) and 2-15% higher than for the MINI (15 studies, 2952 participants). Specificity was similar across diagnostic interviews. The PHQ-9 seems to be similarly sensitive but may be less specific for younger patients than for older patients; a cut-off score of 10 or above can be used regardless of age.. CONCLUSIONS PHQ-9 sensitivity compared with semistructured diagnostic interviews was greater than in previous conventional meta-analyses that combined reference standards. A cut-off score of 10 or above maximized combined sensitivity and specificity overall and for subgroups.
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