Contributors: Wu, Yin; Levis, Brooke; Daray, Federico M; Ioannidis, John P A; Patten, Scott B; Cuijpers, Pim; Ziegelstein, Roy C; Gilbody, Simon; Fischer, Felix H; Fan, Suiqiong; Sun, Ying; He, Chen; Krishnan, Ankur; Neupane, Dipika; Bhandari, Parash Mani; Negeri, Zelalem; Riehm, Kira E; Rice, Danielle B; Azar, Marleine; Yan, Xin Wei; Imran, Mahrukh; Chiovitti, Matthew J; Boruff, Jill T; Mcmillan, Dean; Kloda, Lorie A; Markham, Sarah; Henry, Melissa; Ismail, Zahinoor; Loiselle, Carmen G; Mitchell, Nicholas D; Al-Adawi, Samir; Beck, Kevin R; Beraldi, Anna; Bernstein, Charles N; Boye, Birgitte; Büel-Drabe, Natalie; Bunevicius, Adoma; Can, Ceyhun; Carter, Gregory; Chen, Chih-Ken; Cheung, Gary; Clover, Kerrie; Conroy, Ronán M; Costa-Requena, Gema; Cukor, Daniel; Dabscheck, Eli; De Souza, Jennifer; Downing, Marina; Feinstein, Anthony; Ferentinos, Panagiotis P; Flint, Alastair J; Gallagher, Pamela; Gandy, Milena; Grassi, Luigi; Härter, Martin; Hernando, Asuncion; Jackson, Melinda L; Jenewein, Josef; Jetté, Nathalie; Julião, Miguel; Kjærgaard, Marie; Köhler, Sebastian; König, Hans-Helmut; Krishna, Lalit K R; Lee, Yu; Löbner, Margrit; Loosman, Wim L; Love, Anthony W; Löwe, Bernd; Malt, Ulrik F; Marrie, Ruth Ann; Massardo, Loreto; Matsuoka, Yutaka; Mehnert, Anja; Michopoulos, Ioanni; Misery, Laurent; Nelson, Christian J; Ng, Chong Guan; O'Donnell, Meaghan L; O'Rourke, Suzanne J; Öztürk, Ahmet; Pabst, Alexander; Pasco, Julie A; Peceliuniene, Jurate; Pintor, Lui; Ponsford, Jennie L; Pulido, Federico; Quinn, Terence J; Reme, Silje E; Reuter, Katrin; Riedel-Heller, Steffi G; Rooney, Alasdair G; Sánchez-González, Roberto; Saracino, Rebecca M; Schellekens, Melanie P J; Scherer, Martin; Schwarzbold, Marcelo; Senturk Cankorur, Vesile; Sharpe, Louise; Sharpe, Michael
نبذة مختصرة : The seven-item Hospital Anxiety and Depression Scale Depression subscale (HADS-D) and the total score of the 14-item HADS (HADS-T) are both used for major depression screening. Compared to the HADS-D, the HADS-T includes anxiety items and requires more time to complete. We compared the screening accuracy of the HADS-D and HADS-T for major depression detection. We conducted an individual participant data meta-analysis and fit bivariate random effects models to assess diagnostic accuracy among participants with both HADS-D and HADS-T scores. We identified optimal cutoffs, estimated sensitivity and specificity with 95% confidence intervals, and compared screening accuracy across paired cutoffs via two-stage and individual-level models. We used a 0.05 equivalence margin to assess equivalency in sensitivity and specificity. 20,700 participants (2,285 major depression cases) from 98 studies were included. Cutoffs of ≥7 for the HADS-D (sensitivity 0.79 [0.75, 0.83], specificity 0.78 [0.75, 0.80]) and ≥15 for the HADS-T (sensitivity 0.79 [0.76, 0.82], specificity 0.81 [0.78, 0.83]) minimized the distance to the top-left corner of the receiver operating characteristic curve. Across all sets of paired cutoffs evaluated, differences of sensitivity between HADS-T and HADS-D ranged from −0.05 to 0.01 (0.00 at paired optimal cutoffs), and differences of specificity were within 0.03 for all cutoffs (0.02–0.03). The pattern was similar among outpatients, although the HADS-T was slightly (not nonequivalently) more specific among inpatients. The accuracy of HADS-T was equivalent to the HADS-D for detecting major depression. In most settings, the shorter HADS-D would be preferred.
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