ArticleFrontiers in psychology2026
Psychometric evaluation of a four-item scale derived from the PHQ-9 and GAD-7 among community adults based on multivariate generalizability theory and item response theory.
Article in Frontiers in psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The Patient Health Questionnaire-4 (PHQ-4) consists of the first two items of the Patient Health Questionnaire-9 (PHQ-9) and the first two items of the Generalized Anxiety Disorder-7 (GAD-7). To date, no studies have examined the psychometric properties of this PHQ-4 in a Chinese community sample using modern measurement theory. This study aims to conduct a preliminary psychometric evaluation of the PHQ-4 among community adults based on modern measurement theory. Methods: The Chinese version of the combined PHQ-9 and GAD-7 scale (termed the PHQ-16) was used to assess depression and anxiety symptoms among community-dwelling adults residing in rural areas of Yunnan Province, based on the follow up survey of the China Multi-Ethnic Cohort. We selected the items from the PHQ-16 based on the original structure of the PHQ-4 to form a 4-item scale and refer to it as a "PHQ-4-like" scale. The reliability of the PHQ-16 and the PHQ-4-like scale was evaluated using multivariate generalizability theory (MGT). The validity of the PHQ-4-like scale was evaluated using item response theory (IRT). Results: Based on MGT, reducing the number of items in the PHQ-16 from 16 to 4 decreased the composite generalizability coefficient from 0.906 to 0.719 and the composite reliability index from 0.894 to 0.693. However, when the first two items of the PHQ-9 and the first two items of the GAD-7 were combined to form a four-item scale (the PHQ-4-like scale), the composite generalizability coefficient and composite reliability index were 0.818 and 0.815, respectively. Both the PHQ-9 and the GAD-7 exhibited monotonically increasing threshold parameters. Items 1, 2, 4, and 6 of the PHQ-9 and items 2 and 3 of the GAD-7 showed high discrimination parameters. High average information values were observed for items 1, 2, and 4 of the PHQ-9 and items 2, 3, and 4 of the GAD-7. Conclusion: The PHQ-4-like scale demonstrated satisfactory reliability and validity in this rural Chinese community sample. However, the PHQ-4 screening performance requires criterion validation. Regarding the anxiety dimension of this scale, it may also be worthwhile to consider combining items 2 and 3 from the GAD-7.
Indexed as
Identifiers
What OpenQuestion holds
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.