The diagnostic accuracy of the Patient Health Questionnaire-2 (PHQ-2), Patient Health Questionnaire-8 (PHQ-8), and Patient Health Questionnaire-9 (PHQ-9) for detecting major depression: protocol for a systematic review and individual patient data meta-analyses.

摘要

Background: Major depressive disorder (MDD) may be present in 10%–20% of patients in medical settings. Routinedepression screening is sometimes recommended to improve depression management. However, studies of thediagnostic accuracy of depression screening tools have typically used data-driven, exploratory methods to selectoptimal cutoffs. Often, these studies report results from a small range of cutoff points around whatever cutoff score ismost accurate in that given study. When published data are combined in meta-analyses, estimates of accuracy fordifferent cutoff points may be based on data from different studies, rather than data from all studies for each possiblecutoff point. As a result, traditional meta-analyses may generate exaggerated estimates of accuracy. Individual patientdata (IPD) meta-analyses can address this problem by synthesizing data from all studies for each cutoff score to obtaindiagnostic accuracy estimates. The nine-item Patient Health Questionnaire-9 (PHQ-9) and the shorter PHQ-2 and PHQ-8are commonly recommended for depression screening. Thus, the primary objectives of our IPD meta-analyses are todetermine the diagnostic accuracy of the PHQ-9, PHQ-8, and PHQ-2 to detect MDD among adults across all potentiallyrelevant cutoff scores. Secondary analyses involve assessing accuracy accounting for patient factors that may influenceaccuracy (age, sex, medical comorbidity). [...]