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首页> 外文期刊>Systematic Reviews >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
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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

机译：患者健康问卷2（PHQ-2），患者健康问卷8（PHQ-8）和患者健康问卷9（PHQ-9）在检测重度抑郁中的诊断准确性：系统评价和个体化的方案患者数据荟萃分析

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Background Major depressive disorder (MDD) may be present in 10%–20% of patients in medical settings. Routine depression screening is sometimes recommended to improve depression management. However, studies of the diagnostic accuracy of depression screening tools have typically used data-driven, exploratory methods to select optimal cutoffs. Often, these studies report results from a small range of cutoff points around whatever cutoff score is most accurate in that given study. When published data are combined in meta-analyses, estimates of accuracy for different cutoff points may be based on data from different studies, rather than data from all studies for each possible cutoff point. As a result, traditional meta-analyses may generate exaggerated estimates of accuracy. Individual patient data (IPD) meta-analyses can address this problem by synthesizing data from all studies for each cutoff score to obtain diagnostic accuracy estimates. The nine-item Patient Health Questionnaire-9 (PHQ-9) and the shorter PHQ-2 and PHQ-8 are commonly recommended for depression screening. Thus, the primary objectives of our IPD meta-analyses are to determine the diagnostic accuracy of the PHQ-9, PHQ-8, and PHQ-2 to detect MDD among adults across all potentially relevant cutoff scores. Secondary analyses involve assessing accuracy accounting for patient factors that may influence accuracy (age, sex, medical comorbidity). Methods/design Data sources will include MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO, and Web of Science. We will include studies that included a Diagnostic and Statistical Manual or International Classification of Diseases diagnosis of MDD based on a validated structured or semi-structured clinical interview administered within 2?weeks of the administration of the PHQ. Two reviewers will independently screen titles and abstracts, perform full article review, and extract study data. Disagreements will be resolved by consensus. Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Bivariate random-effects meta-analysis will be conducted for the full range of plausible cutoff values. Discussion The proposed IPD meta-analyses will allow us to obtain estimates of the diagnostic accuracy of the PHQ-9, PHQ-8, and PHQ-2. Systematic review registration PROSPERO CRD42014010673
机译：背景在医疗机构中，重度抑郁症（MDD）可能占10％–20％的患者。有时建议进行常规的抑郁症筛查以改善抑郁症的管理。但是，对抑郁症筛查工具的诊断准确性的研究通常使用数据驱动的探索性方法来选择最佳临界值。通常，这些研究报告的结果是在给定研究中，最准确的分界点周围只有一小部分分界点。当将发表的数据合并到荟萃分析中时，不同临界点的准确性估计值可能基于来自不同研究的数据，而不是来自所有研究的每个可能临界点的数据。结果，传统的荟萃分析可能会产生准确性的夸大估计。个别患者数据（IPD）荟萃分析可以通过综合所有研究的每个临界值的数据以获得诊断准确性评估来解决此问题。通常建议使用九项患者健康问卷9（PHQ-9）以及较短的PHQ-2和PHQ-8进行抑郁症筛查。因此，我们的IPD荟萃分析的主要目标是确定PHQ-9，PHQ-8和PHQ-2的诊断准确性，以在所有可能相关的截止评分中检测成年人中的MDD。次要分析涉及评估可能影响准确性（年龄，性别，医疗合并症）的患者因素的准确性。方法/设计数据源将包括MEDLINE，MEDLINE进行中和其他非索引引文，PsycINFO和Web of Science。我们将纳入包括诊断和统计手册或国际疾病分类诊断MDD在内的研究，这些研究基于在PHQ给药后2周内进行的经过验证的结构化或半结构化临床访谈。两名审稿人将独立筛选标题和摘要，进行全文审阅，并提取研究数据。分歧将通过协商解决。偏倚风险将通过“诊断准确性研究2的质量评估”工具进行评估。将对所有可能的临界值进行双变量随机效应荟萃分析。讨论提议的IPD荟萃分析将使我们能够获得对PHQ-9，PHQ-8和PHQ-2诊断准确性的估计。系统审核注册PROSPERO CRD42014010673

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