ReviewInternational journal of methods in psychiatric research2023
'Optimal' cutoff selection in studies of depression screening tool accuracy using the PHQ-9, EPDS, or HADS-D: A meta-research study.
Review in International journal of methods in psychiatric research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
What it found
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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.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The prevalence of mental health-related multimorbidity during pregnancy: a systematic review and meta-analysis.BMC public health · 2026Pooled 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
- Article
- Associations of sleep quality and physical activity with anxiety and depressive symptoms among university students: a cross-sectional study.Frontiers in public health · 2026Article
- Evaluating the agreement between ChatGPT-4 and validated questionnaires in screening for anxiety and depression in college students: a cross-sectional study.BMC psychiatry · 2025Article
- Combined symptoms of diabetes distress, depression, and anxiety and their association with glycemic control in primary care patients with type 2 diabetes in Egypt.Diabetology international · 2025Article
- Genetic Variants in Oxytocinergic System Genes and Their Association with Postpartum Depression Susceptibility.International journal of molecular sciences · 2025Article
- Psychometric validation of the WHO-5 and WHO-4 well-being index scales for assessing psychological well-being and detecting depression in Japanese school-aged children: a community-based study.Frontiers in public health · 2025Article
- Data-Driven Cutoff Selection for the Patient Health Questionnaire-9 Depression Screening Tool.JAMA network open · 2024Article
- 'Optimal' cutoff selection in studies of depression screening tool accuracy using the PHQ-9, EPDS, or HADS-D: A meta-research study.International journal of methods in psychiatric research · 2023Review
- Prevalence of and relevant factors for depression and anxiety symptoms among pregnant women on the eastern seaboard of China in the post-COVID-19 era: a cross-sectional study.BMC psychiatry · 2023Article
- Measuring depression in Primary Health Care in Spain: Psychometric properties and diagnostic accuracy of HSCL-5 and HSCL-10.Frontiers in medicine · 2022Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
objectivesOptimal cutoff thresholds are selected to separate 'positive' from 'negative' screening results. We evaluated how depression screening tool studies select optimal cutoffs.
methodsWe included studies from previously conducted meta-analyses of Patient Health Questionnaire-9, Edinburgh Postnatal Depression Scale, or Hospital Anxiety and Depression Scale-Depression accuracy. Outcomes included whether an optimal cutoff was selected, method used, recommendations made, and reporting guideline and protocol citation.
resultsOf 212 included studies, 172 (81%) attempted to identify an optimal cutoff, and 147 of these 172 (85%) reported one or more methods. Methods were heterogeneous with Youden's J (N = 35, 23%) most common. Only 23 of 147 (16%) studies described a rationale for their method. Rationales focused on balancing sensitivity and specificity without describing why desirable. 131 of 172 studies (76%) identified an optimal cutoff other than the standard; most did not make use recommendations (N = 56; 43%) or recommended using a non-standard cutoff (N = 53; 40%). Only 4 studies cited a reporting guideline, and 4 described a protocol with optimal cutoff selection methods, but none used the protocol method in the published study.
conclusionsResearch is needed to guide how selection of cutoffs for depression screening tools can be standardized and reflect clinical considerations.
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