Work

Improving the Efficiency of Screening for Major Depression in People With Spinal Cord Injury

Year: 2008

Type: article

Abstract: BACKGROUND/OBJECTIVE: To investigate the metric properties, relative efficiency, sensitivity and specificity, and positive predictive value of a short form of the Patient Health Questionnaire-9 (PHQ-9) that may be used as a screening test for depression. METHODS: Data from the National Spinal Cord Injury Statistical Center Database containing 3,652 records with complete data for the PHQ-9 were analyzed using Confirmatory Factor Analysis, Item Response Theory Graded Response Model analysis, and sensitivity and specificity analysis of classification. RESULTS: A scale comprised of items 1, 2, and 6 from the PHQ-9 has a relative efficiency of 0.66 compared to the 9-item scale. Using this 3-item scale and a cutoff score of 3 or more provides specificity of 0.93 and sensitivity of 0.87; a cutoff of 4 provides specificity of 0.95 and sensitivity of 0.82. The shorter version of the scale reduces the effect of response bias caused by gender. The relative efficiency of the 9-item scale is 0.88 for women compared to men; the 3-item scale increases the relative efficiency to 0.93. CONCLUSION: A 3-item scale provides adequate information for clinical screening purposes. Cutoff scores of either 3 or 4 are acceptable and present options for decision making within a particular clinical setting. Additionally, the 3-item scale reduces the effect of gender of the respondent on the score obtained.

Source: Journal of Spinal Cord Medicine

DOI: 10.1080/10790268.2008.11760709

Authors: Daniel E. Graves, Charles H. Bombardier

Institutions: Baylor College of Medicine, University of Washington

Language: English

Topic: Psychometric Methodologies and Testing

Subfield: Management Science and Operations Research

Field: Decision Sciences

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: bronze

Funder: National Institute on Disability and Rehabilitation Research