Diagnostic accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for detecting major depression in pregnant and postnatal women: protocol for a systematic review and individual patient data meta-analyses.
BACKGROUND
Studies of the diagnostic accuracy of depression screening tools often used data-driven methods to select optimal cut-offs. Typically, these studies report results from a small range of cut-off points around whatever cut-off score is identified as most accurate. When published data are combined in meta-analyses, estimates of accuracy for different cut-off points may be based on data from different studies, rather than data from all studies for each cut-off point. Thus, traditional meta-analyses may exaggerate accuracy estimates. Individual patient data (IPD) meta-analyses synthesise data from all studies for each cut-off score to obtain accuracy estimates. The 10-item Edinburgh Postnatal Depression Scale (EPDS) is commonly recommended for depression screening in the perinatal period. The primary objective of this IPD meta-analysis is to determine the diagnostic accuracy of the EPDS to detect major depression among women during pregnancy and in the postpartum period across all potentially relevant cut-off scores, accounting for patient factors that may influence accuracy (age, pregnancy vs postpartum).


METHODS
Data sources will include Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO, and Web of Science. Studies that include a diagnosis of major depression based on a validated structured or semistructured clinical interview administered within 2 weeks of (before or after) the administration of the EPDS will be included. Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Bivariate random-effects meta-analysis will be conducted for the full range of plausible cut-off values. Analyses will evaluate data from pregnancy and the postpartum period separately, as well as combining data from all women in a single model.


BACKGROUND
This study does not require ethics approval. Dissemination will include journal articles and presentations to policymakers, healthcare providers and researchers.


BACKGROUND
PROSPERO 2015:CRD42015024785.
Departments of Psychiatry, McGill University, Montreal, Quebec, Canada Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada Department of Medicine, McGill University, Montreal, Quebec, Canada Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada Department of Psychology, McGill University, Montreal, Quebec, Canada School of Nursing, McGill University, Montreal, Quebec, Canada Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
Brett D
BD
Thombs
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada Department of Medicine, McGill University, Montreal, Quebec, Canada Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada.
Andrea
A
Benedetti
Library, McGill University, Montreal, Quebec, Canada.
Lorie A
LA
Kloda
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
Brooke
B
Levis
Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
Kira E
KE
Riehm
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
Marleine
M
Azar
Department of Clinical, Neuro, Developmental Psychology, VU-University, Amsterdam, The Netherlands.
Pim
P
Cuijpers
Psychological Medicine and Health Services Research, Department of Health Sciences, Hull York Medical School University of York, York, UK.
Simon
S
Gilbody
Department of Medicine, Department of Health Research and Policy, Department of Statistics, Stanford Prevention Research Center, Stanford School of Medicine, Stanford University School of Humanities and Sciences, Stanford, California, USA.
John P A
JP
Ioannidis
Psychological Medicine and Health Services Research, Department of Health Sciences, Hull York Medical School University of York, York, UK.
Dean
D
McMillan
Departments of Psychiatry and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Scott B
SB
Patten
Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
Ian
I
Shrier
Department of Mathematics and Statistics, McGill University, Montreal, Quebec, Canada Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
Russell J
RJ
Steele
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Roy C
RC
Ziegelstein
Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Marcello
M
Tonelli
Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.
Nicholas
N
Mitchell
Institut national de santé publique du Québec and Université de Montréal, Montreal, Quebec, Canada.
Liane
L
Comeau
Public Health Department, Laval, Quebec, Canada.
Joy
J
Schinazi
Department of Psychiatry, Women's College Hospital and Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada.
Simone
S
Vigod
D019052:Depression, Postpartum / Q000175:diagnosis*; D003865:Major Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000592:standards*; D008603:Mental Health; D015201:Meta-Analysis as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011569:Psychiatric Status Rating Scales; D012107:Research Design; D057566:Self Report; D000078202:Systematic Reviews as Topic
MENTAL HEALTH; PSYCHIATRY