Evidence map›Paper›PMID 26706625›Full record

Trial reportJournal of pain and symptom management2016

Measuring Depression-Severity in Critically Ill Patients' Families with the Patient Health Questionnaire (PHQ): Tests for Unidimensionality and Longitudinal Measurement Invariance, with Implications for CONSORT.

Lois Downey, Leslie A Hayduk, J Randall Curtis, Ruth A Engelberg

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of pain and symptom management, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Article
  6. Post-Intensive Care Syndrome Family.Critical care clinics · 2025
    Review
  7. Article
  8. Article
  9. Article
  10. The severity of psychiatric disorders.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2018
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Lois DowneyDivision of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle, Washington, USA. Electronic address: ldowney@uw.edu.
Leslie A HaydukDepartment of Sociology, University of Alberta, Edmonton, Alberta, Canada.
J Randall CurtisDivision of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle, Washington, USA.
Ruth A EngelbergDivision of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle, Washington, USA.
University of Washington · USHarborview Medical Center · USUniversity of Alberta · CA

Funding

Randomized trial of an interdisciplinary communication intervention to improve paR01NR005226 · NINR · UNIVERSITY OF WASHINGTON · PI CURTIS, J RANDALL, ENGELBERG, RUTH ANN · 1999 to 2012
$6.7M
NINR NIH HHS R01 NR005226
6 · The paper itself

Abstract

contextFamilies of intensive care unit patients are at risk for depression and are important targets for depression-reducing interventions. Multi-item scores for evaluating such interventions should meet criteria for unidimensionality and longitudinal measurement invariance. The Patient Health Questionnaire (PHQ), widely used for measuring depression severity, provides standard nine-, eight-, and two-item scores. However, published studies often report no (or weak) evidence of these scores' unidimensionality/invariance, and no tests have evaluated them as measures of depression severity in intensive care unit patients' families.

objectivesTo identify multi-item PHQ constructs with promise for evaluating change in depression severity among family members of critically ill patients.

methodsStructural equation models with rigorous fit criterion (χ(2), P ≥ 0.05) tested the standard nine-, eight-, and two-item PHQ, and other item subsets, for unidimensionality and longitudinal invariance, using data from a trial evaluating an intervention to reduce depressive symptoms in family members.

resultsNeither the standard nine-item nor the eight-item PHQ construct showed longitudinal invariance, although the standard two-item construct and other item subsets did.

conclusionThe longer eight- and nine-item PHQ scores appear inappropriate for assessing depression severity in this population, with constructs based on smaller subsets of items being more promising targets for future trials. The Consolidated Standards of Reporting Trials requirement for prespecified trial outcomes is problematic because unidimensionality/invariance testing must occur after trial completion. Consolidated Standards of Reporting Trials could be strengthened by endorsing rigorous assessment of composite scores and encouraging use of the most appropriate substitute, should trial-based evidence challenge the legitimacy of prespecified multi-item scores.

Indexed as

Patient Health QuestionnaireCritical CareDepressionFamilyFemaleFollow-Up StudiesHumansLongitudinal StudiesMaleMiddle AgedModels, StatisticalCONSORTdepression severityICU patients' familieslongitudinal measurement invariancePatient Health Questionnaire (PHQ)unidimensionality

Identifiers

PMID26706625
PMCPMC4875822
OpenAlexW2220723747

What OpenQuestion holds

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Registered trials

None linked

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.