{"doi":"10.1136/bmjopen-2015-009742","title":"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","abstract":"<h4>Introduction</h4>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 cut-off 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) meta-analyses synthesise data from all studies for each cut-off 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).<h4>Methods and analysis</h4>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 random-effects 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.<h4>Ethics and dissemination</h4>This study does not require ethics approval. Dissemination will include journal articles and presentations to policymakers, healthcare providers and researchers.<h4>Systematic review registration</h4>PROSPERO 2015:CRD42015024785.","journal":"BMJ Open","year":2015,"id":12017,"datarank":2.3466769460769408,"base_score":4.060443010546419,"endowment":4.060443010546419,"self_citation_contribution":0.6090664515819629,"citation_network_contribution":1.737610494494978,"self_endowment_contribution":0.6090664515819629,"citer_contribution":1.737610494494978,"corpus_percentile":null,"corpus_rank":null,"citation_count":57,"citer_count":38,"citers_with_citation_signal":34,"citers_with_endowment":34,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.0426,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2015-10-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":2083,"name":"Andrea Benedetti","orcid":"0000-0002-8314-9497","position":1,"is_corresponding":false},{"id":2054,"name":"Lorie A. 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