{"doi":"10.1017/s0033291719001314","title":"Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis","abstract":"<h4>Background</h4>Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.<h4>Methods</h4>We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.<h4>Results</h4>16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (-0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).<h4>Conclusions</h4>PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.","journal":"Psychological Medicine","year":2019,"id":4294,"datarank":0.90095297394026,"base_score":6.0063531596017325,"endowment":6.0063531596017325,"self_citation_contribution":0.90095297394026,"citation_network_contribution":0.0,"self_endowment_contribution":0.90095297394026,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":405,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.0362,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2019-07-12","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":2035,"name":"Brooke Levis","orcid":"0000-0002-4310-3689","position":1,"is_corresponding":false},{"id":2050,"name":"Kira E. 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