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Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis

Yin Wu,Brooke Levis,Kira E. Riehm,Nazanin Saadat,Alexander W. Levis,Marleine Azar,Danielle B. Rice,Jill Boruff,Pim Cuijpers,Simon Gilbody,John P. A. Ioannidis,. .,Dean McMillan,Scott B. Patten,Ian Shrier,Roy C. Ziegelstein,Dickens Akena,Bruce Arroll,Liat Ayalon,Hamid Reza Baradaran,Murray Baron,Charles H. Bombardier,Peter Butterworth,Gregory Carter,Marcos Hortes Nisihara Chagas,Juliana C.N. Chan,Rushina Cholera,Yeates Conwell,Janneke M. de Man‐van Ginkel,Jesse R. Fann,Felix Fischer,Daniel Fung,Bizu Gelaye,Felicity Goodyear‐Smith,Catherine G. Greeno,Brian J. Hall,Patricia A. Harrison,Martin Härter,Ulrich Hegerl,Leanne Hides,Stevan E. Hobfoll,Marie Hudson,Thomas Hyphantis,Masumi Inagaki,Nathalie Jetté,Mohammad E. Khamseh,Kim M. Kiely,Yunxin Kwan,Femke Lamers,Shen Ing Liu,Manote Lotrakul,Sônia Regina Loureiro,Bernd Löwe,Anthony McGuire,Sherina Mohd Sidik,Tiago N. Munhoz,Kumiko Muramatsu,Flávia L. Osório,Vikram Patel,Brian W. Pence,Philippe Persoons,Angelo Picardi,Katrin Reuter,Alasdair G Rooney,Iná S. Santos,Juwita Shaaban,Abbey Sidebottom,Adam Simning,Lesley Stafford,So-Young Sung,Pei Lin Lynnette Tan,Alyna Turner,Henk van Weert,Jennifer White,Mary A. Whooley,Kirsty Winkley,Mitsuhiko Yamada,Andrea Benedetti,Brett D. Thombs

Patient Health Questionnaire

Medicine

Cutoff

2019

Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (-0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.

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“Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis” is a paper by Yin Wu Brooke Levis Kira E. Riehm Nazanin Saadat Alexander W. Levis Marleine Azar Danielle B. Rice Jill Boruff Pim Cuijpers Simon Gilbody John P. A. Ioannidis . . Dean McMillan Scott B. Patten Ian Shrier Roy C. Ziegelstein Dickens Akena Bruce Arroll Liat Ayalon Hamid Reza Baradaran Murray Baron Charles H. Bombardier Peter Butterworth Gregory Carter Marcos Hortes Nisihara Chagas Juliana C.N. Chan Rushina Cholera Yeates Conwell Janneke M. de Man‐van Ginkel Jesse R. Fann Felix Fischer Daniel Fung Bizu Gelaye Felicity Goodyear‐Smith Catherine G. Greeno Brian J. Hall Patricia A. Harrison Martin Härter Ulrich Hegerl Leanne Hides Stevan E. Hobfoll Marie Hudson Thomas Hyphantis Masumi Inagaki Nathalie Jetté Mohammad E. Khamseh Kim M. Kiely Yunxin Kwan Femke Lamers Shen Ing Liu Manote Lotrakul Sônia Regina Loureiro Bernd Löwe Anthony McGuire Sherina Mohd Sidik Tiago N. Munhoz Kumiko Muramatsu Flávia L. Osório Vikram Patel Brian W. Pence Philippe Persoons Angelo Picardi Katrin Reuter Alasdair G Rooney Iná S. Santos Juwita Shaaban Abbey Sidebottom Adam Simning Lesley Stafford So-Young Sung Pei Lin Lynnette Tan Alyna Turner Henk van Weert Jennifer White Mary A. Whooley Kirsty Winkley Mitsuhiko Yamada Andrea Benedetti Brett D. Thombs published in 2019. It has an Open Access status of “green”. You can read and download a PDF Full Text of this paper here.