Evidence map›Paper›PMID 33177069›Full record

SynthesisBMJ (Clinical research ed.)2020

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.

Brooke Levis, Zelalem Negeri, Ying Sun, Andrea Benedetti, Brett D Thombs, DEPRESsion Screening Data (DEPRESSD) EPDS Group

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 510 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
510citing papers in PubMed, 6 pooled it
62.5field-weighted citation impact, top 1% 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

510 citing papers in PubMed, 6 syntheses or guidelines pooled it, 808 citations in OpenAlex.

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  12. Exercise in Pregnancy and Risk of Postpartum Depression: A Randomised Controlled Trial.BJOG : an international journal of obstetrics and gynaecology · 2026
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450 more citing papers are in PubMed but not listed here.

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

6 authors at 2 institutions in 2 countries.

Brooke LevisLady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
Zelalem NegeriLady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
Ying SunLady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
Andrea BenedettiDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
Brett D ThombsLady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada brett.thombs@mcgill.ca.ORCID 0000-0002-5644-8432
DEPRESsion Screening Data (DEPRESSD) EPDS Group
Jewish General Hospital · CAMcGill University Health Centre · CA

Funding

Medical Research Council MR/S035818/1
6 · The paper itself

Abstract

objectiveTo evaluate the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression in pregnant and postpartum women.

designIndividual participant data meta-analysis. DATA SOURCES: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (from inception to 3 October 2018). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Eligible datasets included EPDS scores and major depression classification based on validated diagnostic interviews. Bivariate random effects meta-analysis was used to estimate EPDS sensitivity and specificity compared with semi-structured, fully structured (Mini International Neuropsychiatric Interview (MINI) excluded), and MINI diagnostic interviews separately using individual participant data. One stage meta-regression was used to examine accuracy by reference standard categories and participant characteristics.

resultsIndividual participant data were obtained from 58 of 83 eligible studies (70%; 15 557 of 22 788 eligible participants (68%), 2069 with major depression). Combined sensitivity and specificity was maximised at a cut-off value of 11 or higher across reference standards. Among studies with a semi-structured interview (36 studies, 9066 participants, 1330 with major depression), sensitivity and specificity were 0.85 (95% confidence interval 0.79 to 0.90) and 0.84 (0.79 to 0.88) for a cut-off value of 10 or higher, 0.81 (0.75 to 0.87) and 0.88 (0.85 to 0.91) for a cut-off value of 11 or higher, and 0.66 (0.58 to 0.74) and 0.95 (0.92 to 0.96) for a cut-off value of 13 or higher, respectively. Accuracy was similar across reference standards and subgroups, including for pregnant and postpartum women.

conclusionsAn EPDS cut-off value of 11 or higher maximised combined sensitivity and specificity; a cut-off value of 13 or higher was less sensitive but more specific. To identify pregnant and postpartum women with higher symptom levels, a cut-off of 13 or higher could be used. Lower cut-off values could be used if the intention is to avoid false negatives and identify most patients who meet diagnostic criteria. REGISTRATION: PROSPERO (CRD42015024785).

Indexed as

PsychometricsDepression, PostpartumFemaleHumansMajor Depressive DisorderPregnancyPregnancy ComplicationsPrenatal CareSensitivity and Specificity

Identifiers

PMID33177069
PMCPMC7656313
OpenAlexW3093810429

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.