Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

Brooke Levis; Andrea Benedetti; Brett D. Thombs; Kira E. Riehm; Nazanin Saadat; Alexander W. Levis; Marleine Azar; Danielle B. Rice; Matthew J. Chiovitti; Tatiana A. Sanchez; Jill Boruff; Pim  Cuijpers; Simon Gilbody; Dean McMillan; Scott B Patten; Ian Shrier; Roy Ziegelstein; Howard Akena Dickens; Bruce Arroll; Liat Ayalon; Hamid Baradaran; Murray Baron; Charles H. Bombardier; Peter Butterworth; Gregory Carter; Marcos Chagas; Juliana Chan; Kerrie Clover; Yeates Conwell; Janneke de Man-van Ginkel; Jaime Delgadillo; Jesse Fann; Felix Fischer; Daniel Fung; Bizu Gelaye; Felicity Goodyear-Smith; Catherine G. Greeno; Brian J. Hall; John Hambridge; Patricia A. Harrison; Martin Harter; Ulrich Hegerl; Leanne Hides; Stevan E. Hobfoll; Marie Hudson; Masatoshi Inagaki; Khalida Ismail; Nathalie Jette; Mohammadebrahim Khamseh; Kim M. Kiely; Yunxin Kwan; Shen-Ing Liu; Manote Lotrakul; Sonia Loureiro; Bernd Lowe; Laura Marsh; Anthony Mcguire; Sherina Mohd-Sidik; Tiago Munhoz; Kumiko Muramatsu; Flavia Osorio; Vikram Patel; Brian W. Pence; Philippe Persoons; Angelo Picardi; Katrin Reuter; Alasdair G. Rooney; Ina Santos; Juwita Shaaban; Abbey Sidebottom; Adam Simning; Lesley Stafford; Sharon Sung; Pei Tan; Alyna Turner; Christina M van der Feltz-Cornelis; Henk van Weert; Paul A Vöhringer; Jennifer White; Mary A. Whooley; Kirsty Winkley-Bryant; Mitsuhiko Yamada; Yuying Zhang

doi:10.1136/bmj.l1476

Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

Brooke Levis, Andrea Benedetti, Brett D. Thombs, Kira E. Riehm, Nazanin Saadat, Alexander W. Levis, Marleine Azar, Danielle B. Rice, Matthew J. Chiovitti, Tatiana A. Sanchez, Jill Boruff, Pim Cuijpers, Simon Gilbody, Dean McMillan, Scott B Patten, Ian Shrier, Roy Ziegelstein, Howard Akena Dickens, Bruce Arroll, Liat AyalonHamid Baradaran, Murray Baron, Charles H. Bombardier, Peter Butterworth, Gregory Carter, Marcos Chagas, Juliana Chan, Kerrie Clover, Yeates Conwell, Janneke de Man-van Ginkel, Jaime Delgadillo, Jesse Fann, Felix Fischer, Daniel Fung, Bizu Gelaye, Felicity Goodyear-Smith, Catherine G. Greeno, Brian J. Hall, John Hambridge, Patricia A. Harrison, Martin Harter, Ulrich Hegerl, Leanne Hides, Stevan E. Hobfoll, Marie Hudson, Masatoshi Inagaki, Khalida Ismail, Nathalie Jette, Mohammadebrahim Khamseh, Kim M. Kiely, Yunxin Kwan, Shen-Ing Liu, Manote Lotrakul, Sonia Loureiro, Bernd Lowe, Laura Marsh, Anthony Mcguire, Sherina Mohd-Sidik, Tiago Munhoz, Kumiko Muramatsu, Flavia Osorio, Vikram Patel, Brian W. Pence, Philippe Persoons, Angelo Picardi, Katrin Reuter, Alasdair G. Rooney, Ina Santos, Juwita Shaaban, Abbey Sidebottom, Adam Simning, Lesley Stafford, Sharon Sung, Pei Tan, Alyna Turner, Christina M van der Feltz-Cornelis, Henk van Weert, Paul A Vöhringer, Jennifer White, Mary A. Whooley, Kirsty Winkley-Bryant, Mitsuhiko Yamada, Yuying Zhang

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Abstract

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 randomeffects 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.

Original language	English
Article number	l1476
Pages (from-to)	1-11
Journal	BMJ (Online)
Volume	365
Issue number	8196
Early online date	9 Apr 2019
DOIs	https://doi.org/10.1136/bmj.l1476
Publication status	Published - 2019

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Accuracy of Patient Health Questionnaire_LEVIS_Accepted 13 March 2019_GOLD VoR(CC BY NC)Final published version, 316 KBLicence: CC BY-NC

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Levis, B., Benedetti, A., Thombs, B. D., Riehm, K. E., Saadat, N., Levis, A. W., Azar, M., Rice, D. B., Chiovitti, M. J., Sanchez, T. A., Boruff, J., Cuijpers, P., Gilbody, S., McMillan, D., Patten, S. B., Shrier, I., Ziegelstein, R., Dickens, H. A., Arroll, B., ... Zhang, Y. (2019). Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. BMJ (Online), 365(8196), 1-11. Article l1476. https://doi.org/10.1136/bmj.l1476

@article{746c110691db4ff19f9349b0d6e11e61,

title = "Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis",

abstract = "OBJECTIVETo determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression.DESIGNIndividual participant data meta-analysis.DATA SOURCESMedline, Medline In-Process and Other Non-IndexedCitations, PsycINFO, and Web of Science (January 2000-February 2015).INCLUSION CRITERIAEligible studies compared PHQ-9 scores with major depression diagnoses from validated diagnostic interviews. Primary study data and study level dataextracted from primary reports were synthesized.For PHQ-9 cut-off scores 5-15, bivariate randomeffects meta-analysis was used to estimate pooledsensitivity 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 allsubgroup variables in a single model.",

author = "Brooke Levis and Andrea Benedetti and Thombs, {Brett D.} and Riehm, {Kira E.} and Nazanin Saadat and Levis, {Alexander W.} and Marleine Azar and Rice, {Danielle B.} and Chiovitti, {Matthew J.} and Sanchez, {Tatiana A.} and Jill Boruff and Pim Cuijpers and Simon Gilbody and Dean McMillan and Patten, {Scott B} and Ian Shrier and Roy Ziegelstein and Dickens, {Howard Akena} and Bruce Arroll and Liat Ayalon and Hamid Baradaran and Murray Baron and Bombardier, {Charles H.} and Peter Butterworth and Gregory Carter and Marcos Chagas and Juliana Chan and Kerrie Clover and Yeates Conwell and {de Man-van Ginkel}, Janneke and Jaime Delgadillo and Jesse Fann and Felix Fischer and Daniel Fung and Bizu Gelaye and Felicity Goodyear-Smith and Greeno, {Catherine G.} and Hall, {Brian J.} and John Hambridge and Harrison, {Patricia A.} and Martin Harter and Ulrich Hegerl and Leanne Hides and Hobfoll, {Stevan E.} and Marie Hudson and Masatoshi Inagaki and Khalida Ismail and Nathalie Jette and Mohammadebrahim Khamseh and Kiely, {Kim M.} and Yunxin Kwan and Shen-Ing Liu and Manote Lotrakul and Sonia Loureiro and Bernd Lowe and Laura Marsh and Anthony Mcguire and Sherina Mohd-Sidik and Tiago Munhoz and Kumiko Muramatsu and Flavia Osorio and Vikram Patel and Pence, {Brian W.} and Philippe Persoons and Angelo Picardi and Katrin Reuter and Rooney, {Alasdair G.} and Ina Santos and Juwita Shaaban and Abbey Sidebottom and Adam Simning and Lesley Stafford and Sharon Sung and Pei Tan and Alyna Turner and {van der Feltz-Cornelis}, {Christina M} and {van Weert}, Henk and V{\"o}hringer, {Paul A} and Jennifer White and Whooley, {Mary A.} and Kirsty Winkley-Bryant and Mitsuhiko Yamada and Yuying Zhang",

year = "2019",

doi = "10.1136/bmj.l1476",

language = "English",

volume = "365",

pages = "1--11",

journal = "BMJ (Online)",

issn = "0959-8146",

number = "8196",

}

Levis, B, Benedetti, A, Thombs, BD, Riehm, KE, Saadat, N, Levis, AW, Azar, M, Rice, DB, Chiovitti, MJ, Sanchez, TA, Boruff, J, Cuijpers, P, Gilbody, S, McMillan, D, Patten, SB, Shrier, I, Ziegelstein, R, Dickens, HA, Arroll, B, Ayalon, L, Baradaran, H, Baron, M, Bombardier, CH, Butterworth, P, Carter, G, Chagas, M, Chan, J, Clover, K, Conwell, Y, de Man-van Ginkel, J, Delgadillo, J, Fann, J, Fischer, F, Fung, D, Gelaye, B, Goodyear-Smith, F, Greeno, CG, Hall, BJ, Hambridge, J, Harrison, PA, Harter, M, Hegerl, U, Hides, L, Hobfoll, SE, Hudson, M, Inagaki, M, Ismail, K, Jette, N, Khamseh, M, Kiely, KM, Kwan, Y, Liu, S-I, Lotrakul, M, Loureiro, S, Lowe, B, Marsh, L, Mcguire, A, Mohd-Sidik, S, Munhoz, T, Muramatsu, K, Osorio, F, Patel, V, Pence, BW, Persoons, P, Picardi, A, Reuter, K, Rooney, AG, Santos, I, Shaaban, J, Sidebottom, A, Simning, A, Stafford, L, Sung, S, Tan, P, Turner, A, van der Feltz-Cornelis, CM, van Weert, H, Vöhringer, PA, White, J, Whooley, MA, Winkley-Bryant, K, Yamada, M & Zhang, Y 2019, 'Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis', BMJ (Online), vol. 365, no. 8196, l1476, pp. 1-11. https://doi.org/10.1136/bmj.l1476

TY - JOUR

T1 - Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression

T2 - individual participant data meta-analysis

AU - Levis, Brooke

AU - Benedetti, Andrea

AU - Thombs, Brett D.

AU - Riehm, Kira E.

AU - Saadat, Nazanin

AU - Levis, Alexander W.

AU - Azar, Marleine

AU - Rice, Danielle B.

AU - Chiovitti, Matthew J.

AU - Sanchez, Tatiana A.

AU - Boruff, Jill

AU - Cuijpers, Pim

AU - Gilbody, Simon

AU - McMillan, Dean

AU - Patten, Scott B

AU - Shrier, Ian

AU - Ziegelstein, Roy

AU - Dickens, Howard Akena

AU - Arroll, Bruce

AU - Ayalon, Liat

AU - Baradaran, Hamid

AU - Baron, Murray

AU - Bombardier, Charles H.

AU - Butterworth, Peter

AU - Carter, Gregory

AU - Chagas, Marcos

AU - Chan, Juliana

AU - Clover, Kerrie

AU - Conwell, Yeates

AU - de Man-van Ginkel, Janneke

AU - Delgadillo, Jaime

AU - Fann, Jesse

AU - Fischer, Felix

AU - Fung, Daniel

AU - Gelaye, Bizu

AU - Goodyear-Smith, Felicity

AU - Greeno, Catherine G.

AU - Hall, Brian J.

AU - Hambridge, John

AU - Harrison, Patricia A.

AU - Harter, Martin

AU - Hegerl, Ulrich

AU - Hides, Leanne

AU - Hobfoll, Stevan E.

AU - Hudson, Marie

AU - Inagaki, Masatoshi

AU - Ismail, Khalida

AU - Jette, Nathalie

AU - Khamseh, Mohammadebrahim

AU - Kiely, Kim M.

AU - Kwan, Yunxin

AU - Liu, Shen-Ing

AU - Lotrakul, Manote

AU - Loureiro, Sonia

AU - Lowe, Bernd

AU - Marsh, Laura

AU - Mcguire, Anthony

AU - Mohd-Sidik, Sherina

AU - Munhoz, Tiago

AU - Muramatsu, Kumiko

AU - Osorio, Flavia

AU - Patel, Vikram

AU - Pence, Brian W.

AU - Persoons, Philippe

AU - Picardi, Angelo

AU - Reuter, Katrin

AU - Rooney, Alasdair G.

AU - Santos, Ina

AU - Shaaban, Juwita

AU - Sidebottom, Abbey

AU - Simning, Adam

AU - Stafford, Lesley

AU - Sung, Sharon

AU - Tan, Pei

AU - Turner, Alyna

AU - van der Feltz-Cornelis, Christina M

AU - van Weert, Henk

AU - Vöhringer, Paul A

AU - White, Jennifer

AU - Whooley, Mary A.

AU - Winkley-Bryant, Kirsty

AU - Yamada, Mitsuhiko

AU - Zhang, Yuying

PY - 2019

Y1 - 2019

N2 - OBJECTIVETo determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression.DESIGNIndividual participant data meta-analysis.DATA SOURCESMedline, Medline In-Process and Other Non-IndexedCitations, PsycINFO, and Web of Science (January 2000-February 2015).INCLUSION CRITERIAEligible studies compared PHQ-9 scores with major depression diagnoses from validated diagnostic interviews. Primary study data and study level dataextracted from primary reports were synthesized.For PHQ-9 cut-off scores 5-15, bivariate randomeffects meta-analysis was used to estimate pooledsensitivity 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 allsubgroup variables in a single model.

AB - OBJECTIVETo determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression.DESIGNIndividual participant data meta-analysis.DATA SOURCESMedline, Medline In-Process and Other Non-IndexedCitations, PsycINFO, and Web of Science (January 2000-February 2015).INCLUSION CRITERIAEligible studies compared PHQ-9 scores with major depression diagnoses from validated diagnostic interviews. Primary study data and study level dataextracted from primary reports were synthesized.For PHQ-9 cut-off scores 5-15, bivariate randomeffects meta-analysis was used to estimate pooledsensitivity 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 allsubgroup variables in a single model.

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U2 - 10.1136/bmj.l1476

DO - 10.1136/bmj.l1476

M3 - Article

SN - 0959-8146

VL - 365

SP - 1

EP - 11

JO - BMJ (Online)

JF - BMJ (Online)

IS - 8196

M1 - l1476

ER -

Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

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