Evidence map›Paper›PMID 39467616›Full record

Trial reportBMJ mental health2024

Development and validation of a prognostic model to predict relapse in adults with remitted depression in primary care: secondary analysis of pooled individual participant data from multiple studies.

Andrew S Moriarty, Lewis W Paton, Kym I E Snell, Lucinda Archer, Richard D Riley, Joshua E J Buckman, Carolyn A Chew Graham, Simon Gilbody, Shehzad Ali, Stephen Pilling and 7 more

Registry-linked trialAbstract readRandomized Controlled TrialValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ mental health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04666662 (Development and Validation of a Prognostic Model to PREDICT Relapse of Depression in Adult Patients in Primary Care), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT04666662 completednot on this map

Development and Validation of a Prognostic Model to PREDICT Relapse of Depression in Adult Patients in Primary Care

TypeobservationalSponsorUniversity of YorkRan2021 to 2024Enrolled1,244ConditionsDepression
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

17 authors.

Andrew S MoriartyHull York Medical School and Department of Health Sciences, University of York, York, Yorkshire, UK andrew.moriarty@york.ac.uk.ORCID http://orcid.org/0000-0003-0770-3262
Lewis W PatonHull York Medical School and Department of Health Sciences, University of York, York, Yorkshire, UK.ORCID http://orcid.org/0000-0002-3328-5634
Kym I E SnellInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Lucinda ArcherInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Richard D RileyInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Joshua E J BuckmanResearch Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Carolyn A Chew GrahamSchool of Medicine, Keele University, Keele, Staffordshire, UK.
Simon GilbodyHull York Medical School and Department of Health Sciences, University of York, York, UK.ORCID http://orcid.org/0000-0002-8236-6983
Shehzad AliSchulich School of Medicine & Dentistry, Western University, London, Great Britain, Canada.
Stephen PillingResearch Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Nick MeaderPopulation Health Sciences Institute, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
Bob PhillipsHull York Medical School, University of York, York, Yorkshire, UK.
Peter A CoventryDepartment of Health Sciences, University of York, York, Yorkshire, UK.
Jaime DelgadilloDepartment of Psychology, The University of Sheffield, Sheffield, UK.
David A RichardsFaculty of Health and Life Sciences, University of Exeter, Exeter, UK.
Chris SalisburyCentre for Academic Primary Care, University of Bristol, Bristol, UK.
Dean McMillanHull York Medical School and Department of Health Sciences, University of York, York, Yorkshire, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRelapse of depression is common and contributes to the overall associated morbidity and burden. We lack evidence-based tools to estimate an individual's risk of relapse after treatment in primary care, which may help us more effectively target relapse prevention.

objectiveThe objective was to develop and validate a prognostic model to predict risk of relapse of depression in primary care.

methodsMultilevel logistic regression models were developed, using individual participant data from seven primary care-based studies (n=1244), to predict relapse of depression. The model was internally validated using bootstrapping, and generalisability was explored using internal-external cross-validation.

findingsResidual depressive symptoms (OR: 1.13 (95% CI: 1.07 to 1.20), p<0.001) and baseline depression severity (OR: 1.07 (1.04 to 1.11), p<0.001) were associated with relapse. The validated model had low discrimination (C-statistic 0.60 (0.55-0.65)) and miscalibration concerns (calibration slope 0.81 (0.31-1.31)). On secondary analysis, being in a relationship was associated with reduced risk of relapse (OR: 0.43 (0.28-0.67), p<0.001); this remained statistically significant after correction for multiple significance testing.

conclusionsWe could not predict risk of depression relapse with sufficient accuracy in primary care data, using routinely recorded measures. Relationship status warrants further research to explore its role as a prognostic factor for relapse. CLINICAL IMPLICATIONS: Until we can accurately stratify patients according to risk of relapse, a universal approach to relapse prevention may be most beneficial, either during acute-phase treatment or post remission. Where possible, this could be guided by the presence or absence of known prognostic factors (eg, residual depressive symptoms) and targeted towards these. TRIAL REGISTRATION NUMBER: NCT04666662.

Indexed as

Primary Health CareRecurrenceAdultAgedDepressionDepressive DisorderFemaleHumansMaleMiddle AgedPrognosisSecondary PreventionAdult psychiatryData Interpretation, StatisticalDepression

Identifiers

PMID39467616
PMCPMC11529744

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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.