Evidence map›Paper›PMID 36095145›Full record

ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2023

Two-step screening for depressive symptoms in patients treated with kidney replacement therapies: a cross-sectional analysis.

Sumaya Dano, Haoyue Helena Lan, Sara Macanovic, Susan Bartlett, Doris Howell, Madeline Li, Janel Hanmer, John Devin Peipert, Marta Novak, Istvan Mucsi

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 37% 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

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Barriers to Immunosuppressant Medication Adherence in Thoracic Transplant Recipients: Initial Findings.International journal of environmental research and public health · 2025
    Article
  3. 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

10 authors at 5 institutions in 2 countries.

Sumaya DanoAjmera Transplant Center, University Health Network, Toronto, ON, Canada.
Haoyue Helena LanAjmera Transplant Center, University Health Network, Toronto, ON, Canada.
Sara MacanovicAjmera Transplant Center, University Health Network, Toronto, ON, Canada.
Susan BartlettCentre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, QC, Canada.ORCID 0000-0001-9755-2490
Doris HowellPrincess Margaret Cancer Centre, Toronto, ON, Canada.ORCID 0000-0002-0683-8715
Madeline LiPrincess Margaret Cancer Centre, Toronto, ON, Canada.ORCID 0000-0002-3977-7437
Janel HanmerDivision of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
John Devin PeipertDepartment of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Marta NovakCentre for Mental Health, University Health Network, Toronto, ON, Canada.
Istvan MucsiAjmera Transplant Center, University Health Network, Toronto, ON, Canada.
University Health Network · CAPrincess Margaret Cancer Centre · CAMcGill University Health Centre · CANorthwestern University · USUniversity of Pittsburgh · US

Funding

CIHR PJT 165915
6 · The paper itself

Abstract

backgroundSystematic screening for depressive symptoms may identify patients who may benefit from clinical assessment and psychosocial support. Here we assess a two-step screening using ultrabrief pre-screeners [Edmonton Symptom Assessment Survey-revised Depression item (ESASr-D) or Patient Health Questionnaire-2 (PHQ-2)] followed by the Patient-Reported Outcomes Measurement Information System Depression questionnaire (PROMIS-D) to identify depressive symptoms in patients on kidney replacement therapies.

methodsWe conducted a cross-sectional study of adults (kidney transplant recipients or treated with dialysis) in Toronto, ON, Canada. We simulated various two-step screening scenarios where only patients above a pre-screening cut-off score on the ESASr-D or PHQ-2 would move to step 2 (PROMIS-D). Screening performance was evaluated by sensitivity, specificity and positive and negative predictive values using the Patient Health Questionnaire-9 (PHQ-9) as the referent. The average number of items completed by patients in different scenarios was reported.

resultsOf 480 participants, 60% were male with a mean age of 55 years. Based on PHQ-9, 19% of patients had moderate or severe depressive symptoms. Pre-screening with a PHQ-2 score ≥1 combined with a PROMIS-D score of ≥53 provided the best two-step results (sensitivity 0.81, specificity 0.84, NPV 0.95). Two-step screening also reduces question burden.

conclusionsA two-step screening using a PHQ-2 score ≥1 followed by a PROMIS-D score ≥53 has good sensitivity and specificity for identifying potentially significant depressive symptoms among patients on kidney replacement therapies. This approach has lower question burden. Screened-in patients will need further clinical assessment to establish a diagnosis.

Indexed as

DepressionRenal DialysisAdultCross-Sectional StudiesFemaleHumansMaleMass ScreeningMiddle AgedRenal Replacement TherapyReproducibility of ResultsSurveys and Questionnaires2-step screeningdepressive symptomskidney failurePHQ-9PROMIS

Identifiers

PMID36095145
PMCPMC10157790
OpenAlexW4295510678

What OpenQuestion holds

Textmetadata
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.