Bosanquet Katharine, Mitchell Natasha, Gabe Rhian, Lewis Helen, McMillan Dean, Ekers David, Bailey Della, Gilbody Simon
Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK.
Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK.
J Affect Disord. 2015 Aug 15;182:39-43. doi: 10.1016/j.jad.2015.04.020. Epub 2015 Apr 20.
To validate the Whooley questions as a screening tool for depression amongst a population of older adults in UK primary care.
To assess the diagnostic performance of the Whooley questions as a screening tool for depression amongst older adults in UK primary care.
A cross-sectional validation study was conducted with 766 patients aged ≥75 from UK primary care, recruited via 17 general practices based in the North of England during the pilot phase of a randomized controlled trial.
Sensitivity, specificity and likelihood ratios comparing the index test (two Whooley questions) with a diagnosis of major depressive disorder (MDD) ascertained by the reference standard Mini International Neuropsychiatric Interview (MINI).
The two screening questions had a sensitivity of 94.3% (95% confidence interval, 80.8-99.3%) and specificity of 62.7% (95% confidence interval, 59.0-66.2%). The likelihood ratio for a positive test was 2.5 (95% confidence interval, 2.2-2.9) and the likelihood ratio for a negative test was 0.09 (95% confidence interval, 0.02-0.35).
The two Whooley questions missed few cases of depression. However, they were responsible for a high rate of false positives. This creates additional burden on general practitioners, to conduct more detailed investigation on patients who screen positive, but many of whom turn out not to have MDD.
验证Whooley问题作为英国初级保健中老年人群抑郁症筛查工具的有效性。
评估Whooley问题作为英国初级保健中老年人群抑郁症筛查工具的诊断性能。
在一项随机对照试验的试点阶段，通过英格兰北部的17家全科诊所招募了766名年龄≥75岁的英国初级保健患者，进行了一项横断面验证研究。
将指标测试（两个Whooley问题）与通过参考标准迷你国际神经精神访谈（MINI）确定的重度抑郁症（MDD）诊断进行比较，得出敏感性、特异性和似然比。
这两个筛查问题的敏感性为94.3%（95%置信区间，80.8 - 99.3%），特异性为62.7%（95%置信区间，59.0 - 66.2%）。阳性测试的似然比为2.5（95%置信区间，2.2 - 2.9），阴性测试的似然比为0.09（95%置信区间，0.02 - 0.35）。
这两个Whooley问题漏诊的抑郁症病例很少。然而，它们导致了较高的假阳性率。这给全科医生带来了额外负担，需要对筛查呈阳性的患者进行更详细的调查，但其中许多患者最终被证明没有患MDD。
