Diagnostic accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for detecting major depression in pregnant and postnatal women: Protocol for a systematic review and individual patient data meta-analyses

Brett D. Thombs, Andrea Benedetti, Lorie A. Kloda, Brooke Levis, Kira E. Riehm, Marleine Azar, Pim Cuijpers, Simon Gilbody, John P.A. Ioannidis, Dean McMillan, Scott B. Patten, Ian Shrier, Russell J. Steele, Roy C. Ziegelstein, Marcello Tonelli, Nicholas Mitchell, Liane Comeau, Joy Schinazi, Simone Vigod

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Studies of the diagnostic accuracy of depression screening tools often used data-driven methods to select optimal cut-offs. Typically, these studies report results from a small range of cut-off points around whatever cut-off score is identified as most accurate. When published data are combined in meta-analyses, estimates of accuracy for different cutoff points may be based on data from different studies, rather than data from all studies for each cut-off point. Thus, traditional meta-analyses may exaggerate accuracy estimates. Individual patient data (IPD) metaanalyses synthesise data from all studies for each cutoff score to obtain accuracy estimates. The 10-item Edinburgh Postnatal Depression Scale (EPDS) is commonly recommended for depression screening in the perinatal period. The primary objective of this IPD meta-analysis is to determine the diagnostic accuracy of the EPDS to detect major depression among women during pregnancy and in the postpartum period across all potentially relevant cut-off scores, accounting for patient factors that may influence accuracy (age, pregnancy vs postpartum). Methods and analysis: Data sources will include Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO, and Web of Science. Studies that include a diagnosis of major depression based on a validated structured or semistructured clinical interview administered within 2 weeks of (before or after) the administration of the EPDS will be included. Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Bivariate randomeffects meta-analysis will be conducted for the full range of plausible cut-off values. Analyses will evaluate data from pregnancy and the postpartum period separately, as well as combining data from all women in a single model.

Original languageEnglish (US)
Article number009742
JournalBMJ open
Volume5
Issue number10
DOIs
StatePublished - 2015

ASJC Scopus subject areas

  • Medicine(all)

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