title: Using the Short Form-36 mental summary score as an indicator of depressive symptoms in patients with coronary heart disease.
abstract: BACKGROUND
  Depression is common in patients with cardiac disease; however, the use of depression-specific health instruments is limited by their increased responder and analyst burden. The study aimed to define a threshold value on the Short Form-36 (SF-36) mental component summary score (MCS) that identified depressed cardiac patients as measured by the Centre for Epidemiologic Studies Depression Scale (CES-D).
  
  
  METHODS
  An optimal threshold was determined using receiver-operating characteristic (ROC) curves on SF-36 and CES-D data from a large cardiac cohort (N = 1,221). The performance of this threshold was evaluated in a further two cardiac populations.
  
  
  RESULTS
  In the index cohort, an SF-36 MCS score of ≤45 was revealed as an optimal threshold according to maximal Youden Index, with high sensitivity (77%, 95% CI = 74-80%) and specificity (73%, 95% CI = 69-77%). At this threshold, in a second sample of hospital cardiac patients, sensitivity was 93% (95% CI = 76-99%) and specificity was 64% (95% CI = 49-77%). In a final sample generated from a community population, specificity was 100% (95% CI = 85-100%) and sensitivity was 68% (95% CI = 61-74%) at the cut-off of 45.
  
  
  CONCLUSIONS
  The SF-36 MCS may be a useful research tool to aid in the classification of cardiac patients according to the presence or absence of depressive symptoms.
authors.affiliation: Cardiology Research Unit, The Queen Elizabeth Hospital, University of Adelaide, 28 Woodville Rd, Woodville South, 5011 Adelaide, SA, Australia. rosanna.tavella@adelaide.edu.au
authors.forename: Rosanna
authors.initials: R
authors.lastname: Tavella
authors.forename: Tracy
authors.initials: T
authors.lastname: Air
authors.forename: Graeme
authors.initials: G
authors.lastname: Tucker
authors.forename: Robert
authors.initials: R
authors.lastname: Adams
authors.forename: John F
authors.initials: JF
authors.lastname: Beltrame
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Schrader
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003327:Coronary Disease / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012016:Reference Values; D012680:Sensitivity and Specificity
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