Use of brief depression screening tools in primary care:: consideration of heterogeneity in performance in different patient groups
Use of brief depression screening tools in primary care:: consideration of heterogeneity in performance in different patient groups
复制标题
DOI：
10.1016/j.genhosppsych.2004.02.003
复制
发表时间：
2004-05-01
影响因子：
7
通讯作者：
Hegerl, U
中科院分区：
文献类型：
--
作者：
Henkel, V;Mergl, R;Hegerl, U
在初级保健抑郁症筛查的文献中，很少考虑不同患者群体中筛查工具表现的异质性。本研究的目的是评估和比较三种筛查问卷（简要患者健康问卷，一般健康问卷-12，WHO-5）在不同患者亚群中识别抑郁症的诊断准确性，并评估初级保健医生在相同亚群中独立临床评估的准确性。我们对448名初级保健患者进行了横断面验证研究。采用了二乘二表以及接收机的工作特性。结果表明，三种筛查手段的诊断准确性（敏感性、特异性）以及临床诊断在不同的患者群体中存在差异。一种筛选工具的优越性取决于所考虑的子群体。性别、年龄、形式（亚型）和抑郁症的严重程度影响筛查工具的测试特征。如果常规抑郁症筛查应该被广泛采用，这一点应该被考虑。当然，常规筛查的好处也取决于对诊断为抑郁症的患者进行治疗和监测的努力。(C) 2004爱思唯尔公司版权所有。
Heterogeneity of performance of screening tools in different patient groups has rarely been considered in the literature on depression screening in primary care. The objectives of the present study were to assess and to compare diagnostic accuracy of three screening questionnaires (Brief Patient Health Questionnaire, General Health Questionnaire-12, WHO-5) in identifying depression across various patient subpopulations and to assess the accuracy of the unaided clinical assessment of primary care physicians in the same subgroups. We conducted a cross-sectional validation study in 448 primary care patients. Two-by-two tables as well as receiver operating characteristics were applied. Results indicated that diagnostic accuracy (sensitivity, specificity) of the three screening instruments as well as of the clinical diagnoses differed in the various patient groups. Superiority of one screening tool over the other depends on the subgroup considered. Gender, age, form (subtype), and severity of depression influence the test characteristics of a screening tool. This should be considered if routine depression screening should be widely introduced. Of course, the benefit of routine screening also depends on efforts made for treatment and monitoring of patients in whom depression was diagnosed. (C) 2004 Elsevier Inc. All rights reserved.