Data-Driven Cutoff Selection for the Patient Health Questionnaire-9 Depression Screening Tool

作者：Brooke Levis, Parash Mani Bhandari, Dipika Neupane, Suiqiong Fan, Ying Sun, Chen He, Yin Wu, Ankur Krishnan, Zelalem Negeri, Mahrukh Imran, Danielle B. Rice, Kira E. Riehm, Marleine Azar, A.H. Levis, Jill Boruff, Pim Cuijpers, Simon Gilbody, John P. A. Ioannidis, Lorie A. Kloda, Scott B. Patten, Roy C. Ziegelstein, Daphna Harel, Yemisi Takwoingi, Sarah Markham, Sultan H. Alamri, Dagmar Amtmann, Bruce Arroll, Liat Ayalon, Hamid Reza Baradaran, Anna Beraldi, Charles N. Bernstein, Arvin Bhana, Charles H. Bombardier, Ryna Imma Buji, Peter Butterworth, Gregory Carter, Marcos Hortes Nisihara Chagas, Juliana C.N. Chan, Lai Fong Chan, Dixon Chibanda, Kerrie Clover, Aaron Conway, Yeates Conwell, Federico M. Daray, Janneke M. de Man‐van Ginkel, Jesse R. Fann, Felix Fischer, Sally Field, Jane Fisher, Daniel Fung, Bizu Gelaye, Leila Gholizadeh, Felicity Goodyear‐Smith, Eric Green, Catherine G. Greeno, Brian J. Hall, Liisa Hantsoo, Martin Härter, Leanne Hides, Stevan E. Hobfoll, Simone Honikman, Thomas Hyphantis, Masatoshi Inagaki, María Iglesias-González, Hong Jin Jeon, Nathalie Jetté, Mohammad E. Khamseh, Kim M. Kiely, Brandon A. Kohrt, Yunxin Kwan, Ma. Asunción Lara, Holly Frances Levin-Aspenson, Shen‐Ing Liu, Manote Lotrakul, Sônia Regina Loureiro, Bernd Löwe, Nagendra P. Luitel, Crick Lund, Ruth Ann Marrie, Laura Marsh, Brian P. Marx, Anthony McGuire, Sherina Mohd Sidik, Tiago N. Munhoz, Kumiko Muramatsu, Juliet Nakku, Laura Navarrete, Flávia L. Osório, Brian W. Pence, Philippe Persoons, Inge Petersen, Angelo Picardi, Stephanie L. Pugh, Terence J. Quinn, Elmārs Rancāns, Sujit D. Rathod, Katrin Reuter, Alasdair G Rooney, Iná S. Santos, Miranda T. Schram, Juwita Shaaban, Eileen H. Shinn, Abbey Sidebottom, Adam Simning, Lena Spangenberg, Lesley Stafford, Sharon C. Sung, Keiko Suzuki, Pei Lin Lynnette Tan, Martin Taylor‐Rowan, Thach Tran, Alyna Turner, Christina M. van der Feltz‐Cornelis, Thandi van Heyningen, Paul A. Vöhringer, Lynne I. Wagner, JianLi Wang, David Watson, Jennifer White, Mary A. Whooley, Kirsty Winkley, Karen Wynter, Mitsuhiko Yamada, Qing Zhi Zeng, Yuying Zhang, Brett D. Thombs, Andrea Benedetti, Depression Screening Data (DEPRESSD) PHQ Group · 发表于：JAMA Network Open · 年份：2024 · DOI：10.1001/jamanetworkopen.2024.29630 · 被引用次数：26 · 研究领域：Meta-analysis and systematic reviews、Treatment of Major Depression、Mental Health Treatment and Access

Importance: Test accuracy studies often use small datasets to simultaneously select an optimal cutoff score that maximizes test accuracy and generate accuracy estimates. Objective: To evaluate the degree to which using data-driven methods to simultaneously select an optimal Patient Health Questionnaire-9 (PHQ-9) cutoff score and estimate accuracy yields (1) optimal cutoff scores that differ from the population-level optimal cutoff score and (2) biased accuracy estimates. Design, Setting, and Participants: This study used cross-sectional data from an existing individual participant data meta-analysis (IPDMA) database on PHQ-9 screening accuracy to represent a hypothetical population. Studies in the IPDMA database compared participant PHQ-9 scores with a major depression classification. From the IPDMA population, 1000 studies of 100, 200, 500, and 1000 participants each were resampled. Main Outcomes and Measures: For the full IPDMA population and each simulated study, an optimal cutoff score was selected by maximizing the Youden index. Accuracy estimates for optimal cutoff scores in simulated studies were compared with accuracy in the full population. Results: The IPDMA database included 100 primary studies with 44 503 participants (4541 [10%] cases of major depression). The population-level optimal cutoff score was 8 or higher. Optimal cutoff scores in simulated studies ranged from 2 or higher to 21 or higher in samples of 100 participants and 5 or higher to 11 or higher in sa...