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
Standard
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. / Wu, Yin; Levis, Brooke; Daray, Federico M; Ioannidis, John P A; Patten, Scott B; Cuijpers, Pim; Ziegelstein, Roy C; Gilbody, Simon; Fischer, Felix H; Fan, Suiqiong; Sun, Ying; He, Chen; Krishnan, Ankur; Neupane, Dipika; Bhandari, Parash Mani; Negeri, Zelalem; Riehm, Kira E; Rice, Danielle B; Azar, Marleine; Yan, Xin Wei; Imran, Mahrukh; Chiovitti, Matthew J; Boruff, Jill T; McMillan, Dean; Kloda, Lorie A; Markham, Sarah; Henry, Melissa; Ismail, Zahinoor; Loiselle, Carmen G; Mitchell, Nicholas D; Al-Adawi, Samir; Beck, Kevin R; Beraldi, Anna; Bernstein, Charles N; Boye, Birgitte; Büel-Drabe, Natalie; Bunevicius, Adomas; Can, Ceyhun; Carter, Gregory; Chen, Chih-Ken; Cheung, Gary; Clover, Kerrie; Conroy, Ronán M; Costa-Requena, Gema; Cukor, Daniel; Dabscheck, Eli; De Souza, Jennifer; Downing, Marina; Feinstein, Anthony; Ferentinos, Panagiotis P; Flint, Alastair J; Gallagher, Pamela; Gandy, Milena; Grassi, Luigi; Härter, Martin; Hernando, Asuncion; Jackson, Melinda L; Jenewein, Josef; Jetté, Nathalie; Julião, Miguel; Kjærgaard, Marie; Köhler, Sebastian; König, Hans-Helmut; Krishna, Lalit K R; Lee, Yu; Löbner, Margrit; Loosman, Wim L; Love, Anthony W; Löwe, Bernd; Malt, Ulrik F; Marrie, Ruth Ann; Massardo, Loreto; Matsuoka, Yutaka; Mehnert, Anja; Michopoulos, Ioannis; Misery, Laurent; Nelson, Christian J; Ng, Chong Guan; O'Donnell, Meaghan L; O'Rourke, Suzanne J; Öztürk, Ahmet; Pabst, Alexander; Pasco, Julie A; Peceliuniene, Jurate; Pintor, Luis; Ponsford, Jennie L; Pulido, Federico; Quinn, Terence J; Reme, Silje E; Reuter, Katrin; Riedel-Heller, Steffi G; Rooney, Alasdair G; Sánchez-González, Roberto; Saracino, Rebecca M; Schellekens, Melanie P J; Scherer, Martin; Benedetti, Andrea; Thombs, Brett D.
In: PSYCHOL ASSESSMENT, Vol. 35, No. 2, 02.2023, p. 95-114.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - 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
AU - Wu, Yin
AU - Levis, Brooke
AU - Daray, Federico M
AU - Ioannidis, John P A
AU - Patten, Scott B
AU - Cuijpers, Pim
AU - Ziegelstein, Roy C
AU - Gilbody, Simon
AU - Fischer, Felix H
AU - Fan, Suiqiong
AU - Sun, Ying
AU - He, Chen
AU - Krishnan, Ankur
AU - Neupane, Dipika
AU - Bhandari, Parash Mani
AU - Negeri, Zelalem
AU - Riehm, Kira E
AU - Rice, Danielle B
AU - Azar, Marleine
AU - Yan, Xin Wei
AU - Imran, Mahrukh
AU - Chiovitti, Matthew J
AU - Boruff, Jill T
AU - McMillan, Dean
AU - Kloda, Lorie A
AU - Markham, Sarah
AU - Henry, Melissa
AU - Ismail, Zahinoor
AU - Loiselle, Carmen G
AU - Mitchell, Nicholas D
AU - Al-Adawi, Samir
AU - Beck, Kevin R
AU - Beraldi, Anna
AU - Bernstein, Charles N
AU - Boye, Birgitte
AU - Büel-Drabe, Natalie
AU - Bunevicius, Adomas
AU - Can, Ceyhun
AU - Carter, Gregory
AU - Chen, Chih-Ken
AU - Cheung, Gary
AU - Clover, Kerrie
AU - Conroy, Ronán M
AU - Costa-Requena, Gema
AU - Cukor, Daniel
AU - Dabscheck, Eli
AU - De Souza, Jennifer
AU - Downing, Marina
AU - Feinstein, Anthony
AU - Ferentinos, Panagiotis P
AU - Flint, Alastair J
AU - Gallagher, Pamela
AU - Gandy, Milena
AU - Grassi, Luigi
AU - Härter, Martin
AU - Hernando, Asuncion
AU - Jackson, Melinda L
AU - Jenewein, Josef
AU - Jetté, Nathalie
AU - Julião, Miguel
AU - Kjærgaard, Marie
AU - Köhler, Sebastian
AU - König, Hans-Helmut
AU - Krishna, Lalit K R
AU - Lee, Yu
AU - Löbner, Margrit
AU - Loosman, Wim L
AU - Love, Anthony W
AU - Löwe, Bernd
AU - Malt, Ulrik F
AU - Marrie, Ruth Ann
AU - Massardo, Loreto
AU - Matsuoka, Yutaka
AU - Mehnert, Anja
AU - Michopoulos, Ioannis
AU - Misery, Laurent
AU - Nelson, Christian J
AU - Ng, Chong Guan
AU - O'Donnell, Meaghan L
AU - O'Rourke, Suzanne J
AU - Öztürk, Ahmet
AU - Pabst, Alexander
AU - Pasco, Julie A
AU - Peceliuniene, Jurate
AU - Pintor, Luis
AU - Ponsford, Jennie L
AU - Pulido, Federico
AU - Quinn, Terence J
AU - Reme, Silje E
AU - Reuter, Katrin
AU - Riedel-Heller, Steffi G
AU - Rooney, Alasdair G
AU - Sánchez-González, Roberto
AU - Saracino, Rebecca M
AU - Schellekens, Melanie P J
AU - Scherer, Martin
AU - Benedetti, Andrea
AU - Thombs, Brett D
PY - 2023/2
Y1 - 2023/2
N2 - 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. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
AB - 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. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
U2 - 10.1037/pas0001181
DO - 10.1037/pas0001181
M3 - SCORING: Journal article
C2 - 36689386
VL - 35
SP - 95
EP - 114
JO - PSYCHOL ASSESSMENT
JF - PSYCHOL ASSESSMENT
SN - 1040-3590
IS - 2
ER -