An Assessment of the Screening Performance of a Single-Item Measure of Depression From the Edmonton Symptom Assessment Scale Among Chronically Ill Hospitalized Patients

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• 作者：Steven Z. Pantilat ; MD^a ; ^{stevep@medicine.ucsf.edu} ; David L. O&rsquo ; Riordan ; PhD^a ; Suzanne L. Dibble ; DNSc ; RN^b ; C. Seth Landefeld ; MD^c
• 关键词：Depression ; validity ; Geriatric Depression Scale ; Edmonton Symptom Assessment System ; chronically ill hospitalized elderly patients
• 刊名：Journal of Pain and Symptom Management
• 出版年：2012
• 期刊代码：166_08853924
• 类别：med
• 出版时间：May, 2012
• 卷：43
• 期：5
• 页码：866-873
• 文件大小：122 K

摘要

Context

Few studies have examined the validity of using a single item from the Edmonton Symptom Assessment Scale (ESAS) for screening for depression.

Objectives

To examine the screening performance of the single-item depression question from the ESAS in chronically ill hospitalized patients.

Methods

A total of 162 chronically ill inpatients aged 65 and older completed a survey after admission that included the well-validated, 15-item Geriatric Depression Scale (GDS-15) and four single-item screening questions for depression based on the ESAS question, using two different time frames (鈥渘ow鈥?and 鈥渋n the past 24 hours鈥? and two response categories (a 0-10 numeric rating scale [NRS] and a categorical scale: none, mild, moderate, and severe).

Results

The GDS-15 categorized 20%(n = 33) of participants as possibly being depressed with a score 鈮?. The NRS for depression 鈥渘ow鈥?achieved the highest level of sensitivity at a cutoff 鈮?#xA0;1 (68.8%), and an acceptable level of specificity was obtained at a cutoff of 鈮? (82.2%). For depression 鈥渋n the past 24 hours,鈥?a cutoff of 鈮? achieved a sensitivity of 68.8%and a cutoff of 鈮? a specificity of 80.3%. For the categorical scale, a cutoff of 鈥渘one鈥?provided the best level of sensitivity for depression 鈥渘ow鈥?(65.6%) and 鈥渋n the past 24 hours鈥?(81.3%), with an acceptable level of specificity being obtained at 鈮モ€渕ild鈥?(68.8%) and 鈮モ€渕oderate鈥?(68.8%), respectively.

Conclusion

These single-item measures were not effective in screening for聽probable depression in chronically ill patients regardless of the time frame or聽the response format used, but a cutoff of 鈮? or 鈥渕ild鈥?or greater did achieve聽sufficient specificity to raise clinical suspicion.