Psychometric Properties of an Automated Telephone-Based PHQ-9
Psychometric Properties of an Automated Telephone-Based PHQ-9
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DOI：
10.1089/tmj.2013.0158
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发表时间：
2014-02-01
影响因子：
4.7
通讯作者：
Friedman, Robert
中科院分区：
文献类型：
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作者：
Farzanfar, Ramesh;Hereen, Timothy;Friedman, Robert
目的：本研究旨在评估患者健康问卷 9 (PHQ-9) 自动版本的心理测量特性，以进一步促进其在初级保健中的使用。我们使用称为电话联通通信 (TLC) 的计算机电话方式（交互式语音应答系统）使 PHQ-9 自动化。 受试者和方法：80 名受试者被分为四个抑郁类别：无、轻度、中度和重度。自动问卷 TLC-PHQ-9 在 3 个月内向所有受试者进行五次，间隔分别为 0 (T1)、1、3、4 和 4 (T5) 周。在 T1 和 T5 进行抑郁症状量表 (IDS)（纸笔）。我们检查了 (1) 可靠性、(2) 有效性、(3) 敏感性和特异性以及 (4) 对变化的敏感性。结果：(1) 重测可靠性显示 T1 和 T2 之间基本一致，加权 kappa 为 0.76（95% 置信区间 [CI] 0.67-0.85）。每次 TLC-PHQ-9 评估的 Cronbach 系数 α 值范围为 0.913 至 0.918。 (2) T1 的加权 kappa 为 0.78 (95% CI 0.70-0.87)，T5 的加权 kappa 为 0.73 (95% CI 0.63-0.83)，表明 TLC-PHQ-9 和 IDS 在所有抑郁症类别中都具有很强的一致性。 (3) TLC-PHQ-9 对于中度以上抑郁症表现出良好的敏感性 (82.4%) 和非常好的特异性 (90.7%)，而对于重度以上抑郁症表现出较差的敏感性 (54.2%) 但非常好的特异性 (97.8%)。 (4) 0.53 的加权 kappa (95% CI 0.35-0.70) 表明 TLC-PHQ-9 和 IDS 之间具有中等一致性。结论：PHQ-9 的自动电话管理似乎是监测抑郁症状的有效且可靠的工具，并且对患者具有很强的保真度。
Objective:This study aims to evaluate the psychometric properties of an automated version of the Patient Health Questionnaire-9 (PHQ-9) to further facilitate its use in primary care. We automated the PHQ-9 using a computer telephony modality (interactive voice response system) called telephone-linked communication (TLC).Subjects and Methods:Eighty subjects were divided into four depression categories: none, mild, moderate, and severe. The automated questionnaire, TLC-PHQ-9, was administered to all subjects five times over a 3-month period, at intervals of 0 (T1), 1, 3, 4, and 4 (T5) weeks, respectively. The Inventory of Depressive Symptomatology (IDS) was administered (paper-and-pencil) at T1 and T5. We examined (1) reliability, (2) validity, (3) sensitivity and specificity, and (4) sensitivity to change.Results:(1) Test-retest reliability showed substantial agreement between T1 and T2, with a weighted kappa of 0.76 (95% confidence interval [CI] 0.67-0.85). Cronbach's coefficient alpha values ranged from 0.913 to 0.918 for each TLC-PHQ-9 assessment. (2) The weighted kappa of 0.78 (95% CI 0.70-0.87) for T1 and 0.73 (95% CI 0.63-0.83) for T5 showed strong agreement between TLC-PHQ-9 and IDS in all depression categories. (3) TLC-PHQ-9 demonstrated good sensitivity (82.4%) and very good specificity (90.7%) for moderate-plus depression and poorer sensitivity (54.2%) but very good specificity (97.8%) for severe-plus depression. (4) The weighted kappa of 0.53 (95% CI 0.35-0.70) indicated moderate agreement between TLC-PHQ-9 and IDS.Conclusions:An automated telephony administration of the PHQ-9 appears to be a valid and reliable tool for monitoring depression symptoms and has strong fidelity across patients.