Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Carlo, Arao, Vredevoogd, Fortney, Powers, Russo, Unützer); Department of Biostatistics, and Department of Health Services, University of Washington School of Public Health, Seattle (Chan); U.S. Department of Veterans Affairs, Health Services Research and Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle (Fortney).
Psychiatr Serv. 2021 Jul 1;72(7):830-834. doi: 10.1176/appi.ps.202000364. Epub 2021 Apr 15.
The Patient Health Questionnaire-9 (PHQ-9) is commonly used to assess depression symptoms, but its associated treatment success criteria (i.e., metrics) are inconsistently defined. The authors aimed to analyze the impact of metric choice on outcomes and discuss implications for clinical practice and research. Analyses included three overlapping and nonexclusive time cohorts of adult patients with depression treated in 33 organizations between 2008 and 2018. Average depression improvement rates were calculated according to eight metrics. Organization-level rank orders defined by these metrics were calculated and correlated. The 12-month cohort had higher rates of metrics indicating treatment success than did the 3- and 6-month cohorts; the degree of improvement varied by metric, although all organization-level rank orders were highly correlated. Different PHQ-9 treatment metrics are associated with disparate improvement rates. Organization-level rankings defined by different metrics are highly correlated. Consistency of metric use may be more important than specific metric choice.
患者健康问卷-9（PHQ-9）常用于评估抑郁症状，但相关的治疗成功标准（即指标）的定义不一致。作者旨在分析指标选择对结果的影响，并讨论对临床实践和研究的影响。分析包括 2008 年至 2018 年间在 33 个组织中接受治疗的 33 个组织中成年抑郁症患者的三个重叠且不排他的时间队列。根据八个指标计算平均抑郁改善率。根据这些指标计算并关联了组织级别的排名顺序。12 个月队列的指标表明治疗成功的比例高于 3 个月和 6 个月队列；虽然所有组织级别的排名顺序都高度相关，但指标的改善程度有所不同。不同的 PHQ-9 治疗指标与不同的改善率相关。由不同指标定义的组织级别排名高度相关。指标使用的一致性可能比特定指标选择更为重要。
