Comparison of four brief depression screening instruments in ovarian cancer patients: Diagnostic accuracy using traditional versus alternative cutpoints
| Autor: | Diane C. Bodurka, Alan D. Valentine, Karen Basen-Engquist, Eileen H. Shinn, Cindy L. Carmack, George Baum, Kelly Kilgore |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Diagnostic accuracy Article 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Psychiatry Major depressive episode Ovarian Neoplasms Psychiatric Status Rating Scales Depressive Disorder Depressive Disorder Major business.industry Scoring methods Obstetrics and Gynecology Gold standard (test) Middle Aged medicine.disease Depression screening Oncology 030220 oncology & carcinogenesis Female Active treatment medicine.symptom Ovarian cancer business |
| Zdroj: | Gynecol Oncol |
| ISSN: | 1095-6859 |
| Popis: | OBJECTIVES: We compared the diagnostic accuracy of 4 depression screening scales, using traditional and alternative scoring methods, to the gold standard Structured Clinical Interview-DSM IV major depressive episode (MDE) in ovarian cancer patients on active treatment. METHODS: At the beginning of a new chemotherapy regimen, ovarian cancer patients completed the following surveys on the same day: the Center for Epidemiological Studies Depression Scale (CES-D), the Beck Depression Inventory Fast-Screen for Primary Care (BDI-FastScreen), the Patient Health Questionnaire-9 (PHQ-9), and a 1-item screener (“Are you depressed?”). Each instrument's sensitivity, specificity, positive predictive value (PPV) and negative predictive value were calculated with respect to major depression. To control for antidepressant use, the analyses were re-run for a subsample of patients who were not on antidepressants. RESULTS: One hundred fifty-three ovarian cancer patients were enrolled into the study. Only fourteen participants met SCID criteria for current MDE (9%). When evaluating all patients regardless of whether they were already being treated with antidepressants, the two-phase scoring approach with an alternate cutpoint of 6 on the PHQ-9 had the best positive predictive value (PPV=32%). Using a traditional cutpoint of 16 on the CES-D resulted in the lowest PPV (5%); using a more stringent cutpoint of 22 resulted in a slightly improved but still poor PPV, 7%. CONCLUSIONS: Screening with a two-phase PHQ-9 proved best overall, and its accuracy was improved when used with patients who were not already being treated with antidepressants. |
| Databáze: | OpenAIRE |
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