Manea Laura, Boehnke Jan Rasmus, Gilbody Simon, Moriarty Andrew S, McMillan Dean
Deparment of Health Sciences, University of York, York, UK.
Hull York Medical School, University of York, York, United Kingdom.
BMJ Open. 2017 Sep 29;7(9):e015247. doi: 10.1136/bmjopen-2016-015247.
To investigate whether an authorship effect is found that leads to better performance in studies conducted by the original developers of the Patient Health Questionnaire (PHQ-9) (allegiant studies).
Systematic review with random effects bivariate diagnostic meta-analysis. Search strategies included electronic databases, examination of reference lists and forward citation searches.
Included studies provided sufficient data to calculate the diagnostic accuracy of the PHQ-9 against a gold standard diagnosis of major depression using the algorithm or the summed item scoring method at cut-off point 10.
Descriptive information, methodological quality criteria and 2×2 contingency tables.
Seven allegiant and 20 independent studies reported the diagnostic performance of the PHQ-9 using the algorithm scoring method. Pooled diagnostic OR (DOR) for the allegiant group was 64.40, and 15.05 for non-allegiant studies group. The allegiance status was a significant predictor of DOR variation (p<0.0001).Five allegiant studies and 26 non-allegiant studies reported the performance of the PHQ-9 at recommended cut-off point of 10. Pooled DOR for the allegiant group was 49.31, and 24.96 for the non-allegiant studies. The allegiance status was a significant predictor of DOR variation (p=0.015).Some potential alternative explanations for the observed authorship effect including differences in study characteristics and quality were found, although it is not clear how some of them account for the observed differences.
Allegiant studies reported better performance of the PHQ-9. Allegiance status was predictive of variation in the DOR. Based on the observed differences between independent and non-independent studies, we were unable to conclude or exclude that allegiance effects are present in studies examining the diagnostic performance of the PHQ-9. This study highlights the need for future meta-analyses of diagnostic validation studies of psychological measures to evaluate the impact of researcher allegiance in the primary studies.
调查是否存在作者效应，即《患者健康问卷》（PHQ - 9）的原始开发者开展的研究（忠实性研究）表现更优。
采用随机效应双变量诊断性荟萃分析的系统评价。检索策略包括电子数据库、参考文献列表检查及向前引文检索。
纳入的研究提供了足够的数据，以使用算法或在截断点为10时的分项得分总和法，计算PHQ - 9相对于重度抑郁症金标准诊断的诊断准确性。
描述性信息、方法学质量标准及2×2列联表。
7项忠实性研究和20项独立研究报告了使用算法评分法时PHQ - 9的诊断性能。忠实性研究组的合并诊断比值比（DOR）为64.40，非忠实性研究组为15.05。忠实性状态是DOR变异的显著预测因素（p<0.0001）。5项忠实性研究和26项非忠实性研究报告了PHQ - 9在推荐截断点10时的性能。忠实性研究组的合并DOR为49.31，非忠实性研究为24.96。忠实性状态是DOR变异的显著预测因素（p = 0.015）。发现了一些对观察到的作者效应可能的替代解释，包括研究特征和质量的差异，尽管尚不清楚其中一些如何解释观察到的差异。
忠实性研究报告的PHQ - 9性能更佳。忠实性状态可预测DOR的变异。基于独立研究与非独立研究之间观察到的差异，我们无法得出结论或排除在检验PHQ - 9诊断性能的研究中存在忠实性效应。本研究强调未来对心理测量诊断验证研究进行荟萃分析时，需要评估研究者忠实性在原始研究中的影响。
