SynthesisBMJ (Clinical research ed.)2011
Risk of bias from inclusion of patients who already have diagnosis of or are undergoing treatment for depression in diagnostic accuracy studies of screening tools for depression: systematic review.
Synthesis in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 18 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 18 syntheses or guidelines pooled it.
- Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A) for detecting anxiety disorders in adults.The Cochrane database of systematic reviews · 2025Pooled it
- Generalized Anxiety Disorder 7-item (GAD-7) and 2-item (GAD-2) scales for detecting anxiety disorders in adults.The Cochrane database of systematic reviews · 2025Pooled it
- Arthroscopic procedures for degenerative rotator cuff disease: a systematic review and network meta-analysis.Journal of orthopaedic surgery and research · 2024Pooled it
- Optimal cut-offs of depression screening tools during the COVID-19 pandemic: a systematic review.BMC psychiatry · 2023Pooled it
- Accuracy of the Patient Health Questionnaire-9 for screening to detect major depression: updated systematic review and individual participant data meta-analysis.BMJ (Clinical research ed.) · 2021Pooled it
- Accuracy of the Hospital Anxiety and Depression Scale Depression subscale (HADS-D) to screen for major depression: systematic review and individual participant data meta-analysis.BMJ (Clinical research ed.) · 2021Pooled it
- 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.BMJ (Clinical research ed.) · 2020Pooled it
- Pooled it
- The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis.Psychotherapy and psychosomatics · 2020Pooled it
- Diagnostic accuracy and feasibility of depression screening in spinal cord injury: A systematic review.The journal of spinal cord medicine · 2019Pooled it
- Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis.BMJ (Clinical research ed.) · 2019Pooled it
- Accuracy of Depression Screening Tools to Detect Major Depression in Children and Adolescents: A Systematic Review.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2016Pooled it
- Sample sizes and precision of estimates of sensitivity and specificity from primary studies on the diagnostic accuracy of depression screening tools: a survey of recently published studies.International journal of methods in psychiatric research · 2016Pooled it
- Diagnostic accuracy of the Whooley questions for the identification of depression: a diagnostic meta-analysis.BMJ open · 2015Pooled it
- Pooled it
- Recommendations on screening for depression in adults.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2013Guideline
- Pooled it
- Pooled it
- Comparison of four brief depression screening instruments in ovarian cancer patients: Diagnostic accuracy using traditional versus alternative cutpoints.Gynecologic oncology · 2017Trial
- Prevalence and correlates of prolonged grief disorder symptom severity in a large sample of Italian adults.BJPsych open · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectivesTo investigate the proportion of original studies included in systematic reviews and meta-analyses on the diagnostic accuracy of screening tools for depression that appropriately exclude patients who already have a diagnosis of or are receiving treatment for depression and to determine whether these systematic reviews and meta-analyses evaluate possible bias from the inclusion of such patients.
designSystematic review. DATA SOURCES: Medline, PsycINFO, CINAHL, Embase, ISI, SCOPUS, and Cochrane databases were searched from 1 January 2005 to 29 October 2009. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Systematic reviews and meta-analyses in any language that reported on the diagnostic accuracy of screening tools for depression.
resultsOnly eight of 197 (4%) unique publications from 17 systematic reviews and meta-analyses specifically excluded patients who already had a diagnosis of or were receiving treatment for depression. No systematic reviews or meta-analyses commented on possible bias from the inclusion of such patients, even though 10 reviews used quality assessment tools with items to rate risk of bias from composition of the sample of patients.
conclusionsStudies of the accuracy of screening tools for depression rarely exclude patients who already have a diagnosis of or are receiving treatment for depression, a potential bias that is not evaluated in systematic reviews and meta-analyses. This could result in inflated estimates of accuracy on which clinical practice and preventive care guidelines are often based, a problem that takes on greater importance as the rate of diagnosed and treated depression in the population increases.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.