title: Depression screening using the Patient Health Questionnaire-9 administered on a touch screen computer.
abstract: OBJECTIVE
  To (1) evaluate the feasibility of touch screen depression screening in cancer patients using the Patient Health Questionnaire-9 (PHQ-9), (2) evaluate the construct validity of the PHQ-9 using the touch screen modality, and (3) examine the prevalence and severity of depression using this screening modality.
  
  
  METHODS
  The PHQ-9 was placed in a web-based survey within a study of the clinical impact of computerized symptom and quality of life screening. Patients in medical oncology, radiation oncology, and hematopoietic stem cell transplantation (HSCT) clinics used the program on a touch screen computer in waiting rooms prior to therapy (T1) and during therapy (T2). Responses of depressed mood or anhedonia (PHQ-2 cardinal depression symptoms) triggered additional items. PHQ-9 scores were provided to the oncology team in real time.
  
  
  RESULTS
  Among 342 patients enrolled, 33 (9.6%) at T1 and 69 (20.2%) at T2 triggered the full PHQ-9 by endorsing at least one cardinal symptom. Feasibility was high, with at least 97% completing the PHQ-2 and at least 96% completing the PHQ-9 when triggered and a mean completion time of about 2 min. The PHQ-9 had good construct validity. Medical oncology patients had the highest percent of positive screens (12.9%) at T1, while HSCT patients had the highest percent (30.5%) at T2. Using this method, 21 (6.1%) at T1 and 54 (15.8%) at T2 of the total sample had moderate to severe depression.
  
  
  CONCLUSIONS
  The PHQ-9 administered on a touch screen computer is feasible and provides valid depression data in a diverse cancer population.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA 98195-6560, USA. fann@u.washington.edu
authors.forename: Jesse R
authors.initials: JR
authors.lastname: Fann
authors.forename: Donna L
authors.initials: DL
authors.lastname: Berry
authors.forename: Seth
authors.initials: S
authors.lastname: Wolpin
authors.forename: Mary
authors.initials: M
authors.lastname: Austin-Seymour
authors.forename: Nigel
authors.initials: N
authors.lastname: Bush
authors.forename: Barbara
authors.initials: B
authors.lastname: Halpenny
authors.forename: William B
authors.initials: WB
authors.lastname: Lober
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003201:Computers; D003863:Depression / Q000453:epidemiology / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D015995:Prevalence; D011581:Psychological Tests; D015203:Reproducibility of Results; D014861:Washington / Q000453:epidemiology