Diagnostic accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for detecting major depression in pregnant and postnatal women:protocol for a systematic review and individual patient data meta-analyses

摘要

Studies of the diagnostic accuracy ofdepression screening tools often used data-drivenmethods to select optimal cut-offs. Typically, thesestudies report results from a small range of cut-offpoints around whatever cut-off score is identified asmost accurate. When published data are combined inmeta-analyses, estimates of accuracy for different cutoffpoints may be based on data from different studies,rather than data from all studies for each cut-off point.Thus, traditional meta-analyses may exaggerateaccuracy estimates. Individual patient data (IPD) metaanalysessynthesise data from all studies for each cutoffscore to obtain accuracy estimates. The 10-itemEdinburgh Postnatal Depression Scale (EPDS) iscommonly recommended for depression screening inthe perinatal period. The primary objective of this IPDmeta-analysis is to determine the diagnostic accuracyof the EPDS to detect major depression among womenduring pregnancy and in the postpartum period acrossall potentially relevant cut-off scores, accounting forpatient factors that may influence accuracy (age,pregnancy vs postpartum).