What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cancer (n=2811). Intervention: Single-item measure of anxiety and depression vs. Hospital Anxiety and Depression Scale (HADS). Primary outcome: Sensitivity and specificity of single-item measures compared to HADS subscales (score ≥8) (Anxiety sensitivity 0.78, specificity 0.75; Depression sensitivity 0.63, specificity 0.84).

January 4, 2019PLoS ONEOpen Access

Agreement between a single-item measure of anxiety and depression and the Hospital Anxiety and Depression Scale: A cross-sectional study

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Key result

Single-item measures of anxiety and depression demonstrated moderate sensitivity (0.78 and 0.63) and specificity (0.75 and 0.84) compared to the Hospital Anxiety and Depression Scale in patients with cancer.

Why the study?

Traditional tools to identify anxiety and depression in chronic disease are not always feasible, so evaluating the diagnostic performance of single-item questions compared with the Hospital Anxiety and Depression Scale is needed.

Does a single-item measure of anxiety and depression accurately identify symptoms compared to the Hospital Anxiety and Depression Scale in cancer patients?

Population

2,811 people with cancer attending 19 treatment centres in Australia

Comparison

Single-item anxiety and depression questions vs Hospital Anxiety and Depression Scale (HADS)

Design

Cross-sectional survey

Authors

HTHeidi TuronHunter Medical Research Institute MCMariko CareyBrigham and Women's Hospital ABAllison BoyesWashburn University

Discussion

Member takes

Implication

May support rapid ruling-out of symptoms in cancer; hypothesis-generating pending prospective validation.

Study Design

Type

Cross-Sectional (n=2,811)

Multicenter

Yes

Structured PICO

Does a single-item measure of anxiety and depression accurately identify symptoms compared to the Hospital Anxiety and Depression Scale in cancer patients?

Population

2,811 adults with cancer attending outpatient clinics in Australia completed a cross-sectional survey to evaluate the accuracy of single-item measures for anxiety and depression.

Exposure

Single-item self-report questions asking if the patient has felt anxious or depressed in the past week (Yes/No).

Comparator

Hospital Anxiety and Depression Scale (HADS) with a cut-off score of ≥8 for possible anxiety or depression.

Outcome

Agreement, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the single-item questions compared to HADS.patient reported

Main Result

Effect estimate: Anxiety sensitivity 0.78, specificity 0.75; Depression sensitivity 0.63, specificity 0.84

Single-item measures for anxiety and depression have high negative predictive value, making them potentially useful as a rapid initial screening tool to rule out patients who do not require further psychological assessment.

Limitations

Not administered to inpatients or acutely unwell people on the day of recruitment
Potential response bias from self-report
Some participants completed the survey post-consultation due to variations in waiting times
Individual variance in interpreting the single-item question
Simplicity of the yes/no response scale does not capture the severity of an individual's symptoms
Debate remains about appropriate HADS cut points
Potential response bias
Some participants completed the survey post-consultation rather than pre-consultation

Cite This Study

Turon et al. (2019) conducted a cross-sectional in Cancer (n=2,811). Single-item measure of anxiety and depression vs. Hospital Anxiety and Depression Scale (HADS) was evaluated on Sensitivity and specificity of single-item measures compared to HADS subscales (score ≥8) (Anxiety sensitivity 0.78, specificity 0.75; Depression sensitivity 0.63, specificity 0.84). Single-item measures of anxiety and depression demonstrated moderate sensitivity (0.78 and 0.63) and specificity (0.75 and 0.84) compared to the Hospital Anxiety and Depression Scale in patients with cancer.

synapsesocial.com/papers/6a809230c48c717e4deebcc1 https://doi.org/10.1371/journal.pone.0210111

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Agreement between a single-item measure of anxiety and depression and the Hospital Anxiety and Depression Scale: A cross-sectional study

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Agreement between a single-item measure of anxiety and depression and the Hospital Anxiety and Depression Scale: A cross-sectional study

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider