Screening for major depression in cancer outpatients: the diagnostic accuracy of the 9-item patient health questionnaire.
BACKGROUND: Systematic screening for depression has been recommended for patients who have medical conditions like cancer. The 9-item Patient Health Questionnaire (PHQ-9) is becoming widely used, but its diagnostic accuracy has not yet been tested in a cancer patient population. In this article, the...
| প্রধান লেখক: | , , , , , , , , , |
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| বিন্যাস: | Journal article |
| ভাষা: | English |
| প্রকাশিত: |
2011
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| _version_ | 1826262980217536512 |
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| author | Thekkumpurath, P Walker, J Butcher, I Hodges, L Kleiboer, A O'Connor, M Wall, L Murray, G Kroenke, K Sharpe, M |
| author_facet | Thekkumpurath, P Walker, J Butcher, I Hodges, L Kleiboer, A O'Connor, M Wall, L Murray, G Kroenke, K Sharpe, M |
| author_sort | Thekkumpurath, P |
| collection | OXFORD |
| description | BACKGROUND: Systematic screening for depression has been recommended for patients who have medical conditions like cancer. The 9-item Patient Health Questionnaire (PHQ-9) is becoming widely used, but its diagnostic accuracy has not yet been tested in a cancer patient population. In this article, the authors report on the performance of the PHQ-9 as a screening instrument for major depressive disorder (MDD) in patients with cancer. METHODS: Data obtained from a depression screening service for patients who were attending clinics of a Regional Cancer Centre in Edinburgh, United Kingdom were used. Patients had completed both the PHQ-9 and a 2-stage procedure to identify cases of MDD. Performance of the PHQ-9 in identifying cases of MDD was determined using receiver operating characteristic (ROC) analysis. RESULTS: Data were available on 4264 patients. When scored as a continuous measure, the PHQ-9 performed well with an area under the ROC curve of 0.94 (95% confidence interval [CI], 0.93-0.95). A cutoff score of ≥ 8 provided a sensitivity of 93% (95% CI, 89%-95%), a specificity of 81% (95% CI, 80%-82%), a positive predictive value (PPV) of 25%, and a negative predictive value (NPV) of 99% and could be considered optimum in a screening context. The PHQ-9 did not perform as well when it was scored using an algorithm with a sensitivity of 56% (95% CI, 55%-57%), a specificity of 96% (95% CI, 95%-97%), a PPV of 52%, and an NPV of 97%. CONCLUSIONS: The PHQ-9 scored as a continuous measure with a cutoff score of ≥ 8 performed well in identifying MDD in cancer patients and should be considered as a screening instrument in this population. |
| first_indexed | 2024-03-06T19:44:25Z |
| format | Journal article |
| id | oxford-uuid:21c6900d-f92b-47a3-8b51-83bb6ff2bb75 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:44:25Z |
| publishDate | 2011 |
| record_format | dspace |
| spelling | oxford-uuid:21c6900d-f92b-47a3-8b51-83bb6ff2bb752022-03-26T11:35:12ZScreening for major depression in cancer outpatients: the diagnostic accuracy of the 9-item patient health questionnaire.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:21c6900d-f92b-47a3-8b51-83bb6ff2bb75EnglishSymplectic Elements at Oxford2011Thekkumpurath, PWalker, JButcher, IHodges, LKleiboer, AO'Connor, MWall, LMurray, GKroenke, KSharpe, MBACKGROUND: Systematic screening for depression has been recommended for patients who have medical conditions like cancer. The 9-item Patient Health Questionnaire (PHQ-9) is becoming widely used, but its diagnostic accuracy has not yet been tested in a cancer patient population. In this article, the authors report on the performance of the PHQ-9 as a screening instrument for major depressive disorder (MDD) in patients with cancer. METHODS: Data obtained from a depression screening service for patients who were attending clinics of a Regional Cancer Centre in Edinburgh, United Kingdom were used. Patients had completed both the PHQ-9 and a 2-stage procedure to identify cases of MDD. Performance of the PHQ-9 in identifying cases of MDD was determined using receiver operating characteristic (ROC) analysis. RESULTS: Data were available on 4264 patients. When scored as a continuous measure, the PHQ-9 performed well with an area under the ROC curve of 0.94 (95% confidence interval [CI], 0.93-0.95). A cutoff score of ≥ 8 provided a sensitivity of 93% (95% CI, 89%-95%), a specificity of 81% (95% CI, 80%-82%), a positive predictive value (PPV) of 25%, and a negative predictive value (NPV) of 99% and could be considered optimum in a screening context. The PHQ-9 did not perform as well when it was scored using an algorithm with a sensitivity of 56% (95% CI, 55%-57%), a specificity of 96% (95% CI, 95%-97%), a PPV of 52%, and an NPV of 97%. CONCLUSIONS: The PHQ-9 scored as a continuous measure with a cutoff score of ≥ 8 performed well in identifying MDD in cancer patients and should be considered as a screening instrument in this population. |
| spellingShingle | Thekkumpurath, P Walker, J Butcher, I Hodges, L Kleiboer, A O'Connor, M Wall, L Murray, G Kroenke, K Sharpe, M Screening for major depression in cancer outpatients: the diagnostic accuracy of the 9-item patient health questionnaire. |
| title | Screening for major depression in cancer outpatients: the diagnostic accuracy of the 9-item patient health questionnaire. |
| title_full | Screening for major depression in cancer outpatients: the diagnostic accuracy of the 9-item patient health questionnaire. |
| title_fullStr | Screening for major depression in cancer outpatients: the diagnostic accuracy of the 9-item patient health questionnaire. |
| title_full_unstemmed | Screening for major depression in cancer outpatients: the diagnostic accuracy of the 9-item patient health questionnaire. |
| title_short | Screening for major depression in cancer outpatients: the diagnostic accuracy of the 9-item patient health questionnaire. |
| title_sort | screening for major depression in cancer outpatients the diagnostic accuracy of the 9 item patient health questionnaire |
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