Relationship between the Hamilton Depression Rating Scale and the Montgomery-Asberg Depression Rating Scale in depressed elderly: A meta-analysis
Relationship between the Hamilton Depression Rating Scale and the Montgomery-Asberg Depression Rating Scale in depressed elderly: A meta-analysis
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DOI：
10.1097/jgp.0b013e318098614e
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发表时间：
2007-10-01
影响因子：
7.2
通讯作者：
Meyers, Barnett S.
中科院分区：
文献类型：
--
作者：
Heo, Moonseong;Murphy, Christopher F.;Meyers, Barnett S.
目的：通过建立和验证一个关联汉密尔顿抑郁量表（HDRS）和蒙哥马利-安氏抑郁量表（MADRS）的方程，确定两种量表在老年抗抑郁药随机对照试验中对治疗效果的敏感性是否具有可比性。研究方法：本荟萃分析的文献检索基于三个来源：MEDLINE，最近的相关荟萃分析，以及老年抗抑郁药试验的专家。搜索结果显示，有11项相关的老年抗抑郁药试验研究，这些研究使用两种工具进行症状评级。作者使用基线评级作为建模样本，随机化后评级作为验证样本。HDRS评分按比例分配到HDRS 17（17项HDRS）中进行分析。开发和验证基于总计1，874例受试者。结果如下：基线平均HDRS17和MADRS评分之间（r = 0.80; Fisher's z = 1.09，N = 25，p <0.0001）以及随机化后评分之间（r = 0.88，Fisher's z = 1.39，N = 65，p <0.0001）的相关性较高。推导出以下方程：HDRS 17 =-1.58 +0.86 x MADRS。在由随机化后随访平均值组成的验证样本中，观察到的和估计的HDRS17之间的差异不取决于HDRS17的幅度。结论：虽然研究结果在更广泛人群中的可推广性可能有限，并且作者无法评估HDRS和MADRS评分之间特定项目结构变化的一致性，但在评估总体抑郁症状严重程度变化方面，两种评分在汇总组平均水平上对抑郁老年人抗抑郁药的反应具有可比性。
Objective: To determine whether the sensitivity of the Hamilton Depression Rating Scale (HDRS) and Montgomery-angstrom sberg Depression Rating Scale (MADRS) to treatment effects are comparable in geriatric antidepressant randomized controlled trials by developing and validating an equation that links between the two instruments. Methods: Literature search for this meta-analysis was based on three sources: MEDLINE, a recent related meta-analysis, and experts in geriatric antidepressant trials. The search resulted in 11 relevant geriatric antidepressant trial studies that administered both instruments for symptom ratings. The authors used baseline ratings as a model-building sample and postrandomization ratings as a validation sample. HDRS scores were prorated into HDRS17, a 17-item HDRS, for analysis. The development and validation was based on a total number of 1,874 subjects. Results: The correlations were high between baseline mean HDRS17 and MADRS ratings (r = 0.80; Fisher's z = 1.09, N = 25, p < 0.0001) and between postrandomization ratings (r = 0.88, Fisher's z = 1.39, N = 65, p < 0.0001). The following equation was derived: HDRS17 = -1.58 + 0.86 x MADRS. The difference between observed and estimated HDRS17 in a validation sample consisting of postrandomization follow-up means did not depend on magnitudes of HDRS17. Conclusion: Although generalizability of findings into a broader population could be limited, and the authors could not assess concordance of changes of particular item constructs between HDRS and MADRS ratings, both ratings are comparable in assessing changes in overall depressive symptom severity in response to antidepressants in depressed elderly at aggregated group mean levels.