Miyabi Ishihara1,2,3, Daphna Harel2,3, Brooke Levis4,5, Alexander W Levis4,5, Kira E Riehm4, Nazanin Saadat4, Marleine Azar4,5, Danielle B Rice4,6, Tatiana A Sanchez4, Matthew J Chiovitti4, Pim Cuijpers7, Simon Gilbody8, John P A Ioannidis9,10,11,12, Lorie A Kloda13, Dean McMillan8, Scott B Patten14,15,16, Ian Shrier4,5, Bruce Arroll17, Charles H Bombardier18, Peter Butterworth19,20,21, Gregory Carter22, Kerrie Clover22,23, Yeates Conwell24, Felicity Goodyear-Smith17, Catherine G Greeno25, John Hambridge26, Patricia A Harrison27, Marie Hudson4,28, Nathalie Jetté14,15,16,29, Kim M Kiely19, Anthony McGuire30, Brian W Pence31, Alasdair G Rooney32, Abbey Sidebottom33, Adam Simning25, Alyna Turner34,35, Jennifer White36, Mary A Whooley37,38,39, Kirsty Winkley29, Andrea Benedetti5,28,40, Brett D Thombs4,5,6,28,41,42. 1. Department of Statistics, University of California, Berkeley, California. 2. PRIISM Applied Statistics Center, New York University, New York, New York. 3. Department of Applied Statistics, Social Science, and Humanities, New York University, New York, New York. 4. Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada. 5. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada. 6. Department of Psychology, McGill University, Montréal, Québec, Canada. 7. Department of Clinical, Neuro and Developmental Psychology, EMGO Institute, VU University, Amsterdam, The Netherlands. 8. Department of Health Sciences, Hull York Medical School, University of York, Heslington, York, UK. 9. Department of Medicine, Stanford University, Stanford, California. 10. Department of Health Research and Policy, Stanford University, Stanford, California. 11. Department of Biomedical Data Science, Stanford University, Stanford, California. 12. Department of Statistics, Stanford University, Stanford, California. 13. Library, Concordia University, Montréal, Québec, Canada. 14. Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. 15. Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. 16. O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada. 17. Department of General Practice and Primary Health Care, University of Auckland, New Zealand. 18. Department of Rehabilitation Medicine, University of Washington, Seattle, Washington. 19. Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australia. 20. Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia. 21. Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Melbourne, Australia. 22. Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia. 23. Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia. 24. Department of Psychiatry, University of Rochester Medical Center, Rochester, New York. 25. School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania. 26. Liaison Psychiatry Department, John Hunter Hospital, Newcastle, Australia. 27. Minneapolis Health Department, Minneapolis, Minnesota. 28. Department of Medicine, McGill University, Montréal, Québec, Canada. 29. Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada. 30. Department of Nursing, St. Joseph's College, Standish, Maine. 31. Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 32. Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, Scotland, UK. 33. Allina Health, Minneapolis, Minnesota. 34. School of Medicine and Public Health, University of Newcastle, New South Wales, Newcastle, Australia. 35. IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia. 36. Monash University, Melbourne, Australia. 37. Department of Epidemiology and Biostatistics, University of California, San Francisco, California. 38. Department of Medicine, Veterans Affairs Medical Center, San Francisco, California. 39. Department of Medicine, University of California, San Francisco, California. 40. Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada. 41. Department of Psychiatry, McGill University, Montréal, Québec, Canada. 42. Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada.
Abstract
BACKGROUND: The objective of this study was to develop and validate a short form of the Patient Health Questionnaire-9 (PHQ-9), a self-report questionnaire for assessing depressive symptomatology, using objective criteria. METHODS: Responses on the PHQ-9 were obtained from 7,850 English-speaking participants enrolled in 20 primary diagnostic test accuracy studies. PHQ unidimensionality was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally precise short form for each possible length between one and eight items, including and excluding the ninth item. The final short form was selected based on prespecified validity, reliability, and diagnostic accuracy criteria. RESULTS: A four-item short form of the PHQ (PHQ-Dep-4) was selected. The PHQ-Dep-4 had a Cronbach's alpha of 0.805. Sensitivity and specificity of the PHQ-Dep-4 were 0.788 and 0.837, respectively, and were statistically equivalent to the PHQ-9 (sensitivity = 0.761, specificity = 0.866). The correlation of total scores with the full PHQ-9 was high (r = 0.919). CONCLUSION: The PHQ-Dep-4 is a valid short form with minimal loss of information of scores when compared to the full-length PHQ-9. Although OTA methods have been used to shorten patient-reported outcome measures based on objective, prespecified criteria, further studies are required to validate this general procedure for broader use in health research. Furthermore, due to unexamined heterogeneity, there is a need to replicate the results of this study in different patient populations.
BACKGROUND: The objective of this study was to develop and validate a short form of the Patient Health Questionnaire-9 (PHQ-9), a self-report questionnaire for assessing depressive symptomatology, using objective criteria. METHODS: Responses on the PHQ-9 were obtained from 7,850 English-speaking participants enrolled in 20 primary diagnostic test accuracy studies. PHQ unidimensionality was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally precise short form for each possible length between one and eight items, including and excluding the ninth item. The final short form was selected based on prespecified validity, reliability, and diagnostic accuracy criteria. RESULTS: A four-item short form of the PHQ (PHQ-Dep-4) was selected. The PHQ-Dep-4 had a Cronbach's alpha of 0.805. Sensitivity and specificity of the PHQ-Dep-4 were 0.788 and 0.837, respectively, and were statistically equivalent to the PHQ-9 (sensitivity = 0.761, specificity = 0.866). The correlation of total scores with the full PHQ-9 was high (r = 0.919). CONCLUSION: The PHQ-Dep-4 is a valid short form with minimal loss of information of scores when compared to the full-length PHQ-9. Although OTA methods have been used to shorten patient-reported outcome measures based on objective, prespecified criteria, further studies are required to validate this general procedure for broader use in health research. Furthermore, due to unexamined heterogeneity, there is a need to replicate the results of this study in different patient populations.
Authors: Allison Leavens; Scott B Patten; Marie Hudson; Murray Baron; Brett D Thombs Journal: Arthritis Care Res (Hoboken) Date: 2012-08 Impact factor: 4.794
Authors: Kim D Baas; Angélique O J Cramer; Maarten W J Koeter; Eloy H van de Lisdonk; Henk C van Weert; Aart H Schene Journal: J Affect Disord Date: 2011-03 Impact factor: 4.839
Authors: Brooke Levis; Andrea Benedetti; Kira E Riehm; Nazanin Saadat; Alexander W Levis; Marleine Azar; Danielle B Rice; Matthew J Chiovitti; Tatiana A Sanchez; Pim Cuijpers; Simon Gilbody; John P A Ioannidis; Lorie A Kloda; Dean McMillan; Scott B Patten; Ian Shrier; Russell J Steele; Roy C Ziegelstein; Dickens H Akena; Bruce Arroll; Liat Ayalon; Hamid R Baradaran; Murray Baron; Anna Beraldi; Charles H Bombardier; Peter Butterworth; Gregory Carter; Marcos H Chagas; Juliana C N Chan; Rushina Cholera; Neerja Chowdhary; Kerrie Clover; Yeates Conwell; Janneke M de Man-van Ginkel; Jaime Delgadillo; Jesse R Fann; Felix H Fischer; Benjamin Fischler; Daniel Fung; Bizu Gelaye; Felicity Goodyear-Smith; Catherine G Greeno; Brian J Hall; John Hambridge; Patricia A Harrison; Ulrich Hegerl; Leanne Hides; Stevan E Hobfoll; Marie Hudson; Thomas Hyphantis; Masatoshi Inagaki; Khalida Ismail; Nathalie Jetté; Mohammad E Khamseh; Kim M Kiely; Femke Lamers; Shen-Ing Liu; Manote Lotrakul; Sonia R Loureiro; Bernd Löwe; Laura Marsh; Anthony McGuire; Sherina Mohd Sidik; Tiago N Munhoz; Kumiko Muramatsu; Flávia L Osório; Vikram Patel; Brian W Pence; Philippe Persoons; Angelo Picardi; Alasdair G Rooney; Iná S Santos; Juwita Shaaban; Abbey Sidebottom; Adam Simning; Lesley Stafford; Sharon Sung; Pei Lin Lynnette Tan; Alyna Turner; Christina M van der Feltz-Cornelis; Henk C van Weert; Paul A Vöhringer; Jennifer White; Mary A Whooley; Kirsty Winkley; Mitsuhiko Yamada; Yuying Zhang; Brett D Thombs Journal: Br J Psychiatry Date: 2018-05-02 Impact factor: 10.671
Authors: Yin Wu; Brooke Levis; Kira E Riehm; Nazanin Saadat; Alexander W Levis; Marleine Azar; Danielle B Rice; Jill Boruff; Pim Cuijpers; Simon Gilbody; John P A Ioannidis; Lorie A Kloda; Dean McMillan; Scott B Patten; Ian Shrier; Roy C Ziegelstein; Dickens H Akena; Bruce Arroll; Liat Ayalon; Hamid R Baradaran; Murray Baron; Charles H Bombardier; Peter Butterworth; Gregory Carter; Marcos H Chagas; Juliana C N Chan; Rushina Cholera; Yeates Conwell; Janneke M de Man-van Ginkel; Jesse R Fann; Felix H Fischer; Daniel Fung; Bizu Gelaye; Felicity Goodyear-Smith; Catherine G Greeno; Brian J Hall; Patricia A Harrison; Martin Härter; Ulrich Hegerl; Leanne Hides; Stevan E Hobfoll; Marie Hudson; Thomas Hyphantis; Masatoshi Inagaki; Nathalie Jetté; Mohammad E Khamseh; Kim M Kiely; Yunxin Kwan; Femke Lamers; Shen-Ing Liu; Manote Lotrakul; Sonia R Loureiro; Bernd Löwe; Anthony McGuire; Sherina Mohd-Sidik; Tiago N Munhoz; Kumiko Muramatsu; Flávia L Osório; Vikram Patel; Brian W Pence; Philippe Persoons; Angelo Picardi; Katrin Reuter; Alasdair G Rooney; Iná S Santos; Juwita Shaaban; Abbey Sidebottom; Adam Simning; Lesley Stafford; Sharon Sung; Pei Lin Lynnette Tan; Alyna Turner; Henk C van Weert; Jennifer White; Mary A Whooley; Kirsty Winkley; Mitsuhiko Yamada; Andrea Benedetti; Brett D Thombs Journal: Psychol Med Date: 2019-07-12 Impact factor: 10.592
Authors: Daphna Harel; Sarah D Mills; Linda Kwakkenbos; Marie-Eve Carrier; Karen Nielsen; Alexandra Portales; Susan J Bartlett; Vanessa L Malcarne; Brett D Thombs Journal: BMJ Open Date: 2019-02-22 Impact factor: 2.692
Authors: Doris Y P Leung; Yim Wah Mak; Sau Fong Leung; Vico C L Chiang; Alice Yuen Loke Journal: Asia Pac Psychiatry Date: 2020-02-03 Impact factor: 2.538
Authors: Eva Heim; Jinane Abi Ramia; Racha Abi Hana; Sebastian Burchert; Kenneth Carswell; Ilja Cornelisz; Pim Cuijpers; Rabih El Chammay; Philip Noun; Chris van Klaveren; Mark van Ommeren; Edwina Zoghbi; Edith Van't Hof Journal: Internet Interv Date: 2021-03-04
Authors: Rayanne C Ferreira; Thiago S Torres; Maria Das Graças B Ceccato; Daniel Rb Bezerra; Brett D Thombs; Paula M Luz; Daphna Harel Journal: JMIR Public Health Surveill Date: 2022-03-29
Authors: Felix Fischer; Brooke Levis; Carl Falk; Ying Sun; John P A Ioannidis; Pim Cuijpers; Ian Shrier; Andrea Benedetti; Brett D Thombs Journal: Psychol Med Date: 2021-02-22 Impact factor: 10.592
Authors: S Li; D Y T Fong; J Y H Wong; K Wilkinson; C Shapiro; E P H Choi; B McPherson; E Y Y Lau; C L K Lam; L X Huang; M S M Ip Journal: Qual Life Res Date: 2020-05-16 Impact factor: 4.147
Authors: Ahmed Waqas; Abid Malik; Najia Atif; Anum Nisar; Huma Nazir; Siham Sikander; Atif Rahman Journal: Int J Environ Res Public Health Date: 2021-06-22 Impact factor: 3.390