- Title
- Comparison of the Accuracy of the 7-Item HADS Depression Subscale and 14-Item Total HADS for Screening for Major Depression: A Systematic Review and Individual Participant Data Meta-Analysis
- Creator
- Wu, Yin; Levis, Brooke; Sun, Ying; He, Chen; Krishnan, Ankur; Neupane, Dipika; Bhandari, Parash Mani; Negeri, Zelalem; Riehm, Kira E.; Rice, Danielle B.; Azar, Marleine; Yan, Xin Wei; Daray, Federico M.; Imran, Mahrukh; Chiovitti, MJ; Boruff, JT; McMillan, D; Kloda, LA; Markham, S; Henry, M; Ismail, Z; Loiselle, CG; Mitchell, ND; Ioannidis, John P. A.; Al-Adawi, S; Beck, KR; Beraldi, A; Bernstein, CN; Boye, B; Büel-Drabe, N; Bunevicius, A; Can, C; Carter, Gregory; Chen, C-K; Patten, Scott B.; Cheung, G; Clover, Kerrie; Conroy, RM; Costa-Requena, G; Cukor, D; Dabscheck, E; De Souza, J; Downing, M; Feinstein, A; Ferentinos, PP; Cuijpers, Pim; Flint, AJ; Gallagher, P; Gandy, M; Grassi, L; Härter, M; Hernando, A; Jackson, ML; Jenewein, J; Jetté, N; Julião, M; Ziegelstein, Roy C.; Kjærgaard, M; Köhler, S; König, H-H; Krishna, LKR; Lee, Y; Löbner, M; Loosman, WL; Love, AW; Löwe, B; Malt, UF; Gilbody, Simon; Marrie, RA; Massardo, L; Matsuoka, Y; Mehnert, A; Michopoulos, I; Misery, L; Nelson, CJ; Ng, CG; O'Donnell, ML; O'Rourke, SJ; Fischer, Felix H.; Öztürk, A; Pabst, A; Pasco, JA; Peceliuniene, J; Pintor, L; Ponsford, JL; Pulido, F; Quinn, TJ; Reme, SE; Reuter, K; Fan, Suiqiong; Riedel-Heller, SG; Rooney, AG; Sánchez-González, R; Saracino, RM; Schellekens, MPJ; Scherer, M; Benedetti, A; Thombs, BD; Et Al,; Turner, Alyna
- Relation
- Psychological Assessessment Vol. 35, Issue 2, p. 95-114
- Publisher Link
- http://dx.doi.org/10.1037/pas0001181
- Publisher
- American Psychological Association
- Resource Type
- journal article
- Date
- 2023
- Description
- The seven-item Hospital Anxiety and Depression Scale Depression subscale (HADS-D) and the total score of the 14-item HADS (HADS-T) are both used for major depression screening. Compared to the HADS-D, the HADS-T includes anxiety items and requires more time to complete. We compared the screening accuracy of the HADS-D and HADS-T for major depression detection. We conducted an individual participant data meta-analysis and fit bivariate random effects models to assess diagnostic accuracy among participants with both HADS-D and HADS-T scores. We identified optimal cutoffs, estimated sensitivity and specificity with 95% confidence intervals, and compared screening accuracy across paired cutoffs via two-stage and individual-level models. We used a 0.05 equivalence margin to assess equivalency in sensitivity and specificity. 20,700 participants (2,285 major depression cases) from 98 studies were included. Cutoffs of ≥7 for the HADS-D (sensitivity 0.79 [0.75, 0.83], specificity 0.78 [0.75, 0.80]) and ≥15 for the HADS-T (sensitivity 0.79 [0.76, 0.82], specificity 0.81 [0.78, 0.83]) minimized the distance to the top-left corner of the receiver operating characteristic curve. Across all sets of paired cutoffs evaluated, differences of sensitivity between HADS-T and HADS-D ranged from -0.05 to 0.01 (0.00 at paired optimal cutoffs), and differences of specificity were within 0.03 for all cutoffs (0.02-0.03). The pattern was similar among outpatients, although the HADS-T was slightly (not nonequivalently) more specific among inpatients. The accuracy of HADS-T was equivalent to the HADS-D for detecting major depression. In most settings, the shorter HADS-D would be preferred.
- Subject
- Hospital Anxiety and Depression Scale (HADS-D); HADS-T; individual participant data meta-analysis; depression screening; diagnostic accuracy
- Identifier
- http://hdl.handle.net/1959.13/1482794
- Identifier
- uon:51028
- Identifier
- ISSN:1040-3590
- Language
- eng
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