Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data
<p><strong>Objective:</strong> To evaluate the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression in pregnancy and postpartum.</p> <p><strong>Design:</strong> Individual participant data meta-analysis.</p> <p>&...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
BMJ Publishing Group
2020
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| _version_ | 1826282006222209024 |
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| author | Levis, B Negeri, Z Ying, S Andrea, B Thombs, BD Stein, A DEPRESsion Screening Data (DEPRESSD) EPDS Group |
| author_facet | Levis, B Negeri, Z Ying, S Andrea, B Thombs, BD Stein, A DEPRESsion Screening Data (DEPRESSD) EPDS Group |
| author_sort | Levis, B |
| collection | OXFORD |
| description | <p><strong>Objective:</strong> To evaluate the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression in pregnancy and postpartum.</p>
<p><strong>Design:</strong> Individual participant data meta-analysis.</p>
<p><strong>Data Sources:</strong> Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO, and Web of Science were searched (inception – October 3, 2018).</p>
<p><strong>Eligibility criteria for selecting studies:</strong> Eligible datasets included EPDS scores and major depression classification via validated diagnostic interviews. Bivariate random-effects meta-analysis was used to estimate EPDS sensitivity and specificity compared to semi-structured, fully structured (Mini International Neuropsychiatric Interview [MINI] excluded), and MINI diagnostic interviews, separately, using individual participant data. One-stage meta-regression was used to examine accuracy by reference standard categories and participant characteristics.</p>
<p><strong>Results:</strong> Individual participant data were obtained from 58 of 83 eligible studies (70%; 15,557 of 22,788 eligible participants [68%], 2,069 cases). Combined sensitivity and specificity was maximized at cutoff 11 across reference standards. Among studies with a semi-structured interview (36 studies, 9,066 participants, 1,330 cases), sensitivity and specificity (95% CI) were 0.85 (0.79 to 0.90) and 0.84 (0.79 to 0.88) for cutoff 10, 0.81 (0.75 to 0.87) and 0.88 (0.85 to 0.91) for cutoff 11, and 0.66 (0.58 to 0.74) and 0.95 (0.92 to 0.96) for cutoff 13. Accuracy was similar across reference standards and subgroups, including for women in pregnancy and postpartum.</p>
<p><strong>Conclusions:</strong> An EPDS cutoff of 11 maximized combined sensitivity and specificity; a cutoff of ≥ 13 was less sensitive but more specific. To identify women in pregnancy and postpartum with higher symptom levels, a cutoff of 13 or greater could be used. Lower cutoffs could be used if the intention is to avoid false negatives and identify most patients who meet diagnostic criteria.</p> |
| first_indexed | 2024-03-07T00:37:21Z |
| format | Journal article |
| id | oxford-uuid:81e19359-719b-4051-bc8d-b7d56b850e3e |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:37:21Z |
| publishDate | 2020 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:81e19359-719b-4051-bc8d-b7d56b850e3e2022-03-26T21:33:18ZAccuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant dataJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:81e19359-719b-4051-bc8d-b7d56b850e3eEnglishSymplectic ElementsBMJ Publishing Group2020Levis, BNegeri, ZYing, SAndrea, BThombs, BDStein, ADEPRESsion Screening Data (DEPRESSD) EPDS Group<p><strong>Objective:</strong> To evaluate the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression in pregnancy and postpartum.</p> <p><strong>Design:</strong> Individual participant data meta-analysis.</p> <p><strong>Data Sources:</strong> Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO, and Web of Science were searched (inception – October 3, 2018).</p> <p><strong>Eligibility criteria for selecting studies:</strong> Eligible datasets included EPDS scores and major depression classification via validated diagnostic interviews. Bivariate random-effects meta-analysis was used to estimate EPDS sensitivity and specificity compared to semi-structured, fully structured (Mini International Neuropsychiatric Interview [MINI] excluded), and MINI diagnostic interviews, separately, using individual participant data. One-stage meta-regression was used to examine accuracy by reference standard categories and participant characteristics.</p> <p><strong>Results:</strong> Individual participant data were obtained from 58 of 83 eligible studies (70%; 15,557 of 22,788 eligible participants [68%], 2,069 cases). Combined sensitivity and specificity was maximized at cutoff 11 across reference standards. Among studies with a semi-structured interview (36 studies, 9,066 participants, 1,330 cases), sensitivity and specificity (95% CI) were 0.85 (0.79 to 0.90) and 0.84 (0.79 to 0.88) for cutoff 10, 0.81 (0.75 to 0.87) and 0.88 (0.85 to 0.91) for cutoff 11, and 0.66 (0.58 to 0.74) and 0.95 (0.92 to 0.96) for cutoff 13. Accuracy was similar across reference standards and subgroups, including for women in pregnancy and postpartum.</p> <p><strong>Conclusions:</strong> An EPDS cutoff of 11 maximized combined sensitivity and specificity; a cutoff of ≥ 13 was less sensitive but more specific. To identify women in pregnancy and postpartum with higher symptom levels, a cutoff of 13 or greater could be used. Lower cutoffs could be used if the intention is to avoid false negatives and identify most patients who meet diagnostic criteria.</p> |
| spellingShingle | Levis, B Negeri, Z Ying, S Andrea, B Thombs, BD Stein, A DEPRESsion Screening Data (DEPRESSD) EPDS Group Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data |
| title | Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data |
| title_full | Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data |
| title_fullStr | Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data |
| title_full_unstemmed | Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data |
| title_short | Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data |
| title_sort | accuracy of the edinburgh postnatal depression scale epds for screening to detect major depression among pregnant and postpartum women systematic review and meta analysis of individual participant data |
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