Kim S, Lee K. Screening for Depression in Mobile Devices Using Patient Health Questionnaire-9 (PHQ-9) Data: A Diagnostic Meta-Analysis via Machine Learning Methods.
Neuropsychiatr Dis Treat 2021;
17:3415-3430. [PMID:
34848962 PMCID:
PMC8612669 DOI:
10.2147/ndt.s339412]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/02/2021] [Indexed: 12/25/2022] Open
Abstract
PURPOSE
Depression is a symptom commonly encountered in primary care; however, it is often not detected by doctors. Recently, disease diagnosis and treatment approaches have been attempted using smart devices. In this study, instrumental effectiveness was confirmed with the diagnostic meta-analysis of studies that demonstrated the diagnostic effectiveness of PHQ-9 for depression using mobile devices.
PATIENTS AND METHODS
We found all published and unpublished studies through EMBASE, MEDLINE, MEDLINE In-Process, and PsychINFO up to March 26, 2021. We performed a meta-analysis by including 1099 subjects in four studies. We performed a diagnostic meta-analysis according to the PHQ-9 cut-off score and machine learning algorithm techniques. Quality assessment was conducted using the QUADAS-2 tool. Data on the sensitivity and specificity of the studies included in the meta-analysis were extracted in a standardized format. Bivariate and summary receiver operating characteristic (SROC) curve were constructed using the metandi, midas, metabias, and metareg functions of the Stata algorithm meta-analysis words.
RESULTS
Using four studies out of the 5476 papers searched, a diagnostic meta-analysis of the PHQ-9 scores of 1099 people diagnosed with depression was performed. The pooled sensitivity and specificity were 0.797 (95% CI = 0.642-0.895) and 0.85 (95% CI = 0.780-0.900), respectively. The diagnostic odds ratio was 22.16 (95% CI = 7.273-67.499). Overall, a good balance was maintained, and no heterogeneity or publication bias was presented.
CONCLUSION
Through various machine learning algorithm techniques, it was possible to confirm that PHQ-9 depression screening in mobiles is an effective diagnostic tool when integrated into a diagnostic meta-analysis.
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