Evidence map›Paper›PMID 39576645›Full record

ArticleJAMA network open2024

Data-Driven Cutoff Selection for the Patient Health Questionnaire-9 Depression Screening Tool.

Brooke Levis, Parash Mani Bhandari, Dipika Neupane, Suiqiong Fan, Ying Sun, Chen He, Yin Wu, Ankur Krishnan, Zelalem Negeri, Mahrukh Imran and 118 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing 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.

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

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

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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

128 authors.

Brooke LevisLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Parash Mani BhandariLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Dipika NeupaneLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Suiqiong FanLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Ying SunLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Chen HeLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Yin WuLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Ankur KrishnanLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Zelalem NegeriDepartment of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada.
Mahrukh ImranLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Danielle B RiceDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
Kira E RiehmLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Marleine AzarLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Alexander W LevisLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Jill BoruffSchulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, Québec, Canada.
Pim CuijpersDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Simon GilbodyHull York Medical School and the Department of Health Sciences, University of York, Heslington, York, UK.
John P A IoannidisDepartment of Medicine, Stanford University, Stanford, California.
Lorie A KlodaMcGill University Libraries, Montréal, Québec, Canada.
Scott B PattenDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Roy C ZiegelsteinDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Daphna HarelDepartment of Applied Statistics, Social Science, and Humanities, New York University, New York.
Yemisi TakwoingiDepartment of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Sarah MarkhamDepartment of Biostatistics and Health Informatics, King's College London, London, UK.
Sultan H AlamriFaculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Dagmar AmtmannDepartment of Rehabilitation Medicine, University of Washington, Seattle.
Bruce ArrollDepartment of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
Liat AyalonLouis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel.
Hamid R BaradaranEndocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Anna BeraldiKbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen, Klinik für Psychiatrie, Psychotherapie and Psychosomatik, Lehrkrankenhaus der Technischen Universität München, Munich, Germany.
Charles N BernsteinUniversity of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada.
Arvin BhanaCentre for Rural Health, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Charles H BombardierDepartment of Rehabilitation Medicine, University of Washington, Seattle.
Ryna Imma BujiDepartment of Psychiatry, Hospital Mesra Bukit Padang, Sabah, Malaysia.
Peter ButterworthCentre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
Gregory CarterCentre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia.
Marcos H ChagasDepartment of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Juliana C N ChanDepartment of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity and Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China.
Lai Fong ChanDepartment of Psychiatry, National University of Malaysia, Kuala Lumpur, Malaysia.
Dixon ChibandaDepartment of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
Kerrie CloverSchool of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.
Aaron ConwaySchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Yeates ConwellDepartment of Psychiatry, University of Rochester Medical Center, Rochester, New York.
Federico M DarayInstitute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
Janneke M de Man-van GinkelLeids University Medical Center, Leiden, the Netherlands.
Jesse R FannDepartment of Psychiatry and Behavioral Sciences, University of Washington, Seattle.
Felix H FischerCenter for Patient-Centered Outcomes Research, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Sally FieldPerinatal Mental Health Project, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Jane R W FisherGlobal and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Daniel S S FungDepartment of Developmental Psychiatry, Institute of Mental Health, Singapore.
Bizu GelayeDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Leila GholizadehFaculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
Felicity Goodyear-SmithDepartment of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
Eric P GreenDuke Global Health Institute, Duke University, Durham, North Carolina.
Catherine G GreenoSchool of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania.
Brian J HallCenter for Global Health Equity, New York University Shanghai, Shanghai, China.
Liisa HantsooDepartment of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Martin HärterDepartment of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Leanne HidesSchool of Psychology, The University of Queensland, Brisbane, Queensland, Australia.
Stevan E HobfollSTAR-Stress, Anxiety and Resilience Consultants, Chicago, Illinois.
Simone HonikmanPerinatal Mental Health Project, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Thomas HyphantisDepartment of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Masatoshi InagakiDepartment of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan.
Maria Iglesias-GonzalezDepartment of Psychiatry, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Hong Jin JeonDepartment of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Nathalie JettéDepartment of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Mohammad E KhamsehEndocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Kim M KielySchool of Health and Society and School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, New South Wales, Australia.
Brandon A KohrtCenter for Global Mental Health Equity, The George Washington University, Washington, DC.
Yunxin KwanDepartment of Psychological Medicine, Tan Tock Seng Hospital, Singapore.
Maria Asunción LaraInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, San Lorenzo Huipulco, Tlalpan, Mexico.
Holly F Levin-AspensonDepartment of Psychology, University of North Texas, Denton.
Shen-Ing LiuProgramme in Health Services and Systems Research, Duke-NUS Medical School, Singapore.
Manote LotrakulDepartment of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Sonia R LoureiroDepartment of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Bernd LöweDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Nagendra P LuitelResearch Department, TPO Nepal, Kathmandu, Nepal.
Crick LundCentre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Ruth Ann MarrieDepartments of Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Laura MarshBaylor College of Medicine, Houston and Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.
Brian P MarxNational Center for PTSD at Veterans Affairs Boston Healthcare System, Boston, Massachusetts.
Anthony McGuireCollege of Nursing, University of South Florida, Tampa.
Sherina Mohd SidikDepartment of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
Tiago N MunhozPost-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
Kumiko MuramatsuNiigata Seiryo University Health Service Center, Niigata, Japan.
Juliet E M NakkuButabika National Referral Teaching Hospital, Kampala, Uganda.
Laura NavarreteDepartment of Epidemiology and Psychosocial Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México.
Flávia L OsórioDepartment of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Brian W PenceDepartment of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill.
Philippe PersoonsDepartment of Psycho-Pedagogic Psychiatry, Healthcare Group Sint-Kamillus, Broeders van Liefde, Bierbeek, Belgium.
Inge PetersenCentre for Rural Health, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Angelo PicardiCentre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy.
Stephanie L PughDepartment of Statistics, American College of Radiology, NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania.
Terence J QuinnInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK.
Elmars RancansInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK.
Sujit D RathodDepartment of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Katrin ReuterGroup Practice for Psychotherapy and Psycho-oncology, Freiburg, Germany.
Alasdair G RooneyDivision of Psychiatry, Royal Edinburgh Hospital, The University of Edinburgh, Edinburgh, Scotland, UK.
Iná S SantosPost-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
Miranda T SchramDepartment of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
Juwita ShaabanDepartment of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Eileen H ShinnDepartment of Behavioral Science, The University of Texas M.D. Anderson Cancer Center, Houston.
Abbey SidebottomAllina Health, Minneapolis, Minnesota.
Adam SimningDepartment of Psychiatry, University of Rochester Medical Center, Rochester, New York.
Lena SpangenbergDepartment of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
Lesley StaffordMelbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
Sharon C SungProgramme in Health Services and Systems Research, Duke-NUS Medical School, Singapore.
Keiko SuzukiDepartment of General Medicine, Asahikawa University Hospital, Asahikawa, Hokkaido, Japan.
Pei Lin Lynnette TanDepartment of Psychological Medicine, Tan Tock Seng Hospital, Singapore.
Martin Taylor-RowanInstitute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK.
Thach D TranGlobal and Women's Health, Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Alyna TurnerIMPACT-the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia.
Christina M van der Feltz-CornelisDepartment of Health Sciences, Hull York Medical School, University of York, York, UK.
Thandi van HeyningenJustice and Violence Prevention Programme, Institute for Security Studies, Pretoria, South Africa.
Paul A VöhringerDepartment of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile.
Lynne I WagnerDepartment of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill.
Jian Li WangDepartment of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
David WatsonDepartment of Psychology, University of Notre Dame, Notre Dame, Indiana.
Jennifer WhiteSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, New South Wales, Australia.
Mary A WhooleyDepartment of Medicine, University of California San Francisco, San Francisco.
Kirsty WinkleyFlorence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
Karen WynterSchool of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.
Mitsuhiko YamadaDepartment of Pathophysiology, Tokyo Kasei Gakuin University, Chiyoda-ku, Tokyo, Japan.
Qing Zhi ZengShanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yuying ZhangDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Brett D ThombsLady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
Andrea BenedettiDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
Depression Screening Data (DEPRESSD) PHQ Group

Funding

NRG Oncology Network Group Operations Center - GY9 BIQSFP Reports/BudgetsU10CA180868 · NCI · NRG ONCOLOGY FOUNDATION, INC. · PI NORMAN WOLMARK · 2014 to 2026
$206.8M
Statistics CoreU10CA180822 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Mei-Yin C Polley · 2014 to 2026
$146.4M
Depression Screening &Treatment in Ovarian CancerK07CA093512 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI SHINN, EILEEN H · 2003 to 2007
$599k
NCI NIH HHS K07 CA093512NCI NIH HHS U10 CA180822NCI NIH HHS U10 CA180868
6 · The paper itself

Abstract

Importance: Test accuracy studies often use small datasets to simultaneously select an optimal cutoff score that maximizes test accuracy and generate accuracy estimates. Objective: To evaluate the degree to which using data-driven methods to simultaneously select an optimal Patient Health Questionnaire-9 (PHQ-9) cutoff score and estimate accuracy yields (1) optimal cutoff scores that differ from the population-level optimal cutoff score and (2) biased accuracy estimates. Design, Setting, and Participants: This study used cross-sectional data from an existing individual participant data meta-analysis (IPDMA) database on PHQ-9 screening accuracy to represent a hypothetical population. Studies in the IPDMA database compared participant PHQ-9 scores with a major depression classification. From the IPDMA population, 1000 studies of 100, 200, 500, and 1000 participants each were resampled. Main Outcomes and Measures: For the full IPDMA population and each simulated study, an optimal cutoff score was selected by maximizing the Youden index. Accuracy estimates for optimal cutoff scores in simulated studies were compared with accuracy in the full population. Results: The IPDMA database included 100 primary studies with 44 503 participants (4541 [10%] cases of major depression). The population-level optimal cutoff score was 8 or higher. Optimal cutoff scores in simulated studies ranged from 2 or higher to 21 or higher in samples of 100 participants and 5 or higher to 11 or higher in samples of 1000 participants. The percentage of simulated studies that identified the true optimal cutoff score of 8 or higher was 17% for samples of 100 participants and 33% for samples of 1000 participants. Compared with estimates for a cutoff score of 8 or higher in the population, sensitivity was overestimated by 6.4 (95% CI, 5.7-7.1) percentage points in samples of 100 participants, 4.9 (95% CI, 4.3-5.5) percentage points in samples of 200 participants, 2.2 (95% CI, 1.8-2.6) percentage points in samples of 500 participants, and 1.8 (95% CI, 1.5-2.1) percentage points in samples of 1000 participants. Specificity was within 1 percentage point across sample sizes. Conclusions and Relevance: This study of cross-sectional data found that optimal cutoff scores and accuracy estimates differed substantially from population values when data-driven methods were used to simultaneously identify an optimal cutoff score and estimate accuracy. Users of diagnostic accuracy evidence should evaluate studies of accuracy with caution and ensure that cutoff score recommendations are based on adequately powered research or well-conducted meta-analyses.

Indexed as

Patient Health QuestionnaireCross-Sectional StudiesDepressionFemaleHumansMajor Depressive DisorderMaleMass ScreeningSensitivity and Specificity

Identifiers

PMID39576645
PMCPMC11584932

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