Kelvin K. F. Tsoi, PhD, Jockey Club School of Public Health and Primary Care and Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong; Joyce Y. C. Chan, MPH, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Hoyee W. Hirai, MSc, Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong; Samuel Y. S. Wong, MPH, MD, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
Kelvin K. F. Tsoi, PhD, Jockey Club School of Public Health and Primary Care and Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong; Joyce Y. C. Chan, MPH, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Hoyee W. Hirai, MSc, Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong; Samuel Y. S. Wong, MPH, MD, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
Br J Psychiatry. 2017 Apr;210(4):255-260. doi: 10.1192/bjp.bp.116.186932. Epub 2017 Feb 16.
Screening for depression in older adults is recommended.To evaluate the diagnostic accuracy of the Two-Question Screen for older adults and compare it with other screening instruments for depression.We undertook a literature search for studies assessing the diagnostic performance of depression screening instruments in older adults. Combined diagnostic accuracy including sensitivity and specificity were the primary outcomes. Potential risks of bias and the quality of studies were also assessed.A total of 46 506 participants from 132 studies were identified evaluating 16 screening instruments. The majority of studies (63/132) used various versions of the Geriatric Depression Scale (GDS) and 6 used the Two-Question Screen. The combined sensitivity and specificity for the Two-Question Screen were 91.8% (95% CI 85.2-95.6) and 67.7% (95% CI 58.1-76.0), respectively; the diagnostic performance area under the curve (AUC) was 90%. The Two-Question Screen showed comparable performance with other instruments, including clinician-rated scales. The One-Question Screen showed the lowest diagnostic performance with an AUC of 78%. In subgroup analysis, the Two-Question Screen also had good diagnostic performance in screening for major depressive disorder.The Two-Question Screen is a simple and short instrument for depression screening. Its diagnostic performance is comparable with other instruments and, therefore, it would be favourable to use it for older adult screening programmes.
对老年人进行抑郁症筛查是被推荐的。为了评估 Two-Question Screen 筛查老年人抑郁症的诊断准确性，并将其与其他抑郁症筛查工具进行比较，我们进行了文献检索，以评估评估老年人抑郁症筛查工具的诊断性能的研究。综合诊断准确性包括敏感性和特异性是主要结果。还评估了潜在的偏倚风险和研究质量。从 132 项研究中确定了 46506 名参与者，评估了 16 种筛查工具。大多数研究（63/132）使用了各种版本的老年抑郁量表（GDS），6 项研究使用了 Two-Question Screen。Two-Question Screen 的合并敏感性和特异性分别为 91.8%（95%CI 85.2-95.6）和 67.7%（95%CI 58.1-76.0）；诊断性能曲线下面积（AUC）为 90%。Two-Question Screen 的性能与其他工具相当，包括临床医生评定量表。One-Question Screen 的诊断性能最低，AUC 为 78%。在亚组分析中，Two-Question Screen 在筛查重度抑郁症方面也具有良好的诊断性能。Two-Question Screen 是一种用于抑郁症筛查的简单而简短的工具。其诊断性能与其他工具相当，因此，它有利于用于老年人筛查计划。
