Eileen H Shinn1, Alan Valentine2, George Baum3, Cindy Carmack4, Kelly Kilgore5, Diane Bodurka6, Karen Basen-Engquist7. 1. Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center: Cancer Prevention Building - Unit 1330, 1155 Pressler St., Houston, TX 77030, USA. Electronic address: eshinn@mdanderson.org. 2. Department of Psychiatry, The University of Texas MD Anderson Cancer Center: T. Boone Pickens Academic Tower - Unit 1454, 1515 Holcombe Blvd., Houston, TX 77030, USA. Electronic address: avalenti@mdanderson.org. 3. Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center: Cancer Prevention Building - Unit 1330, 1155 Pressler St., Houston, TX 77030, USA. Electronic address: gpbaum@mdanderson.org. 4. Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center: T. Boone Pickens Academic Tower - Unit 1414, 1515 Holcombe Blvd., Houston, TX 77030, USA. Electronic address: ccarmack@mdanderson.org. 5. Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center: T. Boone Pickens Academic Tower - Unit 1414, 1515 Holcombe Blvd., Houston, TX 77030, USA. Electronic address: kkilgore@mdanderson.org. 6. Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas M. D. Anderson Cancer Center: Mid Campus Building 1 - Unit 1727, 1515 Holcombe Blvd., Houston, TX 77030, USA. Electronic address: dcbodurka@mdanderson.org. 7. Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center: Cancer Prevention Building - Unit 1330, 1155 Pressler St., Houston, TX 77030, USA. Electronic address: kbasenen@mdanderson.org.
Abstract
OBJECTIVES: We compared the diagnostic accuracy of 4 depression screening scales, using traditional and alternative scoring methods, to the gold standard Structured Clinical Interview-DSM IV major depressive episode (MDE) in ovarian cancer patients on active treatment. METHODS: At the beginning of a new chemotherapy regimen, ovarian cancer patients completed the following surveys on the same day: the Center for Epidemiological Studies Depression Scale (CES-D), the Beck Depression Inventory Fast-Screen for Primary Care (BDI-FastScreen), the Patient Health Questionnaire-9 (PHQ-9), and a 1-item screener ("Are you depressed?"). Each instrument's sensitivity, specificity, positive predictive value (PPV) and negative predictive value were calculated with respect to major depression. To control for antidepressant use, the analyses were re-run for a subsample of patients who were not on antidepressants. RESULTS:One hundred fifty-three ovarian cancer patients were enrolled into the study. Only fourteen participants met SCID criteria for current MDE (9%). When evaluating all patients regardless of whether they were already being treated with antidepressants, the two-phase scoring approach with an alternate cutpoint of 6 on the PHQ-9 had the best positive predictive value (PPV=32%). Using a traditional cutpoint of 16 on the CES-D resulted in the lowest PPV (5%); using a more stringent cutpoint of 22 resulted in a slightly improved but still poor PPV, 7%. CONCLUSIONS: Screening with a two-phase PHQ-9 proved best overall, and its accuracy was improved when used with patients who were not already being treated with antidepressants.
RCT Entities:
OBJECTIVES: We compared the diagnostic accuracy of 4 depression screening scales, using traditional and alternative scoring methods, to the gold standard Structured Clinical Interview-DSM IV major depressive episode (MDE) in ovarian cancerpatients on active treatment. METHODS: At the beginning of a new chemotherapy regimen, ovarian cancerpatients completed the following surveys on the same day: the Center for Epidemiological Studies Depression Scale (CES-D), the Beck Depression Inventory Fast-Screen for Primary Care (BDI-FastScreen), the Patient Health Questionnaire-9 (PHQ-9), and a 1-item screener ("Are you depressed?"). Each instrument's sensitivity, specificity, positive predictive value (PPV) and negative predictive value were calculated with respect to major depression. To control for antidepressant use, the analyses were re-run for a subsample of patients who were not on antidepressants. RESULTS: One hundred fifty-three ovarian cancerpatients were enrolled into the study. Only fourteen participants met SCID criteria for current MDE (9%). When evaluating all patients regardless of whether they were already being treated with antidepressants, the two-phase scoring approach with an alternate cutpoint of 6 on the PHQ-9 had the best positive predictive value (PPV=32%). Using a traditional cutpoint of 16 on the CES-D resulted in the lowest PPV (5%); using a more stringent cutpoint of 22 resulted in a slightly improved but still poor PPV, 7%. CONCLUSIONS: Screening with a two-phase PHQ-9 proved best overall, and its accuracy was improved when used with patients who were not already being treated with antidepressants.
Authors: Michelle B Riba; Kristine A Donovan; Barbara Andersen; IIana Braun; William S Breitbart; Benjamin W Brewer; Luke O Buchmann; Matthew M Clark; Molly Collins; Cheyenne Corbett; Stewart Fleishman; Sofia Garcia; Donna B Greenberg; Rev George F Handzo; Laura Hoofring; Chao-Hui Huang; Robin Lally; Sara Martin; Lisa McGuffey; William Mitchell; Laura J Morrison; Megan Pailler; Oxana Palesh; Francine Parnes; Janice P Pazar; Laurel Ralston; Jaroslava Salman; Moreen M Shannon-Dudley; Alan D Valentine; Nicole R McMillian; Susan D Darlow Journal: J Natl Compr Canc Netw Date: 2019-10-01 Impact factor: 11.908