title: Diagnostic accuracy of the Whooley depression tool in older adults in UK primary care.
abstract: OBJECTIVE
  To validate the Whooley questions as a screening tool for depression amongst a population of older adults in UK primary care.
  
  
  OBJECTIVE
  To assess the diagnostic performance of the Whooley questions as a screening tool for depression amongst older adults in UK primary care.
  
  
  METHODS
  A cross-sectional validation study was conducted with 766 patients aged ≥75 from UK primary care, recruited via 17 general practices based in the North of England during the pilot phase of a randomized controlled trial.
  
  
  METHODS
  Sensitivity, specificity and likelihood ratios comparing the index test (two Whooley questions) with a diagnosis of major depressive disorder (MDD) ascertained by the reference standard Mini International Neuropsychiatric Interview (MINI).
  
  
  RESULTS
  The two screening questions had a sensitivity of 94.3% (95% confidence interval, 80.8-99.3%) and specificity of 62.7% (95% confidence interval, 59.0-66.2%). The likelihood ratio for a positive test was 2.5 (95% confidence interval, 2.2-2.9) and the likelihood ratio for a negative test was 0.09 (95% confidence interval, 0.02-0.35).
  
  
  CONCLUSIONS
  The two Whooley questions missed few cases of depression. However, they were responsible for a high rate of false positives. This creates additional burden on general practitioners, to conduct more detailed investigation on patients who screen positive, but many of whom turn out not to have MDD.
authors.affiliation: Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK. Electronic address: kate.bosanquet@york.ac.uk.
authors.forename: Katharine
authors.initials: K
authors.lastname: Bosanquet
authors.affiliation: Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK.
authors.forename: Natasha
authors.initials: N
authors.lastname: Mitchell
authors.affiliation: Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK.
authors.forename: Rhian
authors.initials: R
authors.lastname: Gabe
authors.affiliation: Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Lewis
authors.affiliation: Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK; Hull York Medical School, University of York, Heslington, York YO10 5DD, UK.
authors.forename: Dean
authors.initials: D
authors.lastname: McMillan
authors.affiliation: Mental Health Research Group, University of Durham, Durham TS17 6BH, UK.
authors.forename: David
authors.initials: D
authors.lastname: Ekers
authors.affiliation: Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK.
authors.forename: Della
authors.initials: D
authors.lastname: Bailey
authors.affiliation: Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK; Hull York Medical School, University of York, Heslington, York YO10 5DD, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Gilbody
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis*; D004739:England; D005260:Female; D058006:General Practice; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Depression; Diagnostic accuracy; Older adults; Primary health care; Screening