The pooled AUC value of PHQ-9 was 0.885 (95% CI: 0.805 to 0.965), which was greater than 0.7, the value for an instrument to be considered as a sensitive screening tool. In this current systematic review and meta-analysis, statistical details of sensitivity and specificity were not available for the included studies, but data on the area under the ROC curve were obtained for meta-analysis. However, data about its screening ability in Chinese populations are lacking. The screening instrument has been translated into Chinese and validated in Chinese primary-care patients, suggesting that it may be an appropriate tool to identify patients with depressive symptoms in local primary-care settings in view of its high sensitivity of 0.81 (95% CI: 0.68 to 0.89) and specificity of 0.88 (95% CI: 0.84 to 0.91) as shown in a previous systematic review. In a local study that estimated the 12-month cumulative incidence and predictors of a positive screen for depressive symptoms using PHQ-9 among primary-care patients, the cumulative incidence of PHQ-9-screened depressive symptoms were found to be higher than the incidence of depressive disorders reported in systematic reviews.
It is therefore essential to identify an appropriate screening tool to help tackle the under detection of the problem from the point of entry to the healthcare system for most people requiring health services. The non-communicable disease has a significant impact in primary-care settings where subthreshold depressive symptoms are prevalent. Discussionĭepression is a chronic illness commonly affecting the quality of life of patients and posing a burden on the society globally. Meta-analysis of the Area under the Receiver Operator Characteristic Curves for PHQ-9 Instruments.įigure 2. Figure 2 shows the pooled AUC estimates for PHQ-9 for depression screening. Considering the heterogeneity between studies with I 2 statistics of 96.83% (P < 0.0001), a random effect model was adopted. Pooled estimates of AUC were calculated to illustrate the overall estimates. Since most of the studies presented an estimate with 95% CI, calculation of the SE was performed for all studies to standardize the measurement of outcome deviations. Preliminary appraisal of study quality indicated that all investigators of the selected studies were blinded to the screening score results and therefore all four studies were determined to be of good quality for inclusion in the meta-analysis. Results: The pooled estimate of area under the receiver operator characteristic curves for PHQ-9 reported from four studies was 0.885 (95% CI: 0.805 to 0.965 SE: 0.0408 P 60 yrs: 16% Meta-analyses were conducted using a random effects model. Quality of studies were assessed according to the accepted guidelines. Four screening studies (n = 8,403) met the inclusion criteria. MEDLINE, PubMed and PsycINFO databases, and the Cochrane Library were searched between 20 for any report of studies that evaluated performance of PHQ-9. Methods: A systematic review and meta-analysis was undertaken to evaluate PHQ-9 amongst Chinese primary care patients.
There is a need to evaluate the effectiveness of the PHQ-9 in Chinese primary care settings.
The 9-item Patient Health Questionnare-9 (PHQ-9) is a commonly used screening instrument in primary care settings to help enhance the detection of depression. Background: Depression is a chronic illness with mounting burden to the society.
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