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Review: Diagnosing depression in primary care—ultra-short screening instruments may have limited use

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How accurate are ultra-short screening instruments for depression in primary care?

Mitchell AJ, Coyne JC. Do ultra-short screening instruments accurately detect depression in primary care? A pooled analysis and meta-analysis of 22 studies. Br J Gen Pract 2007;57:144–51.


Embedded ImageDesign:

Systematic review of diagnostic studies with meta-analysis.

Embedded ImageData sources:

MEDLINE, PsycINFO, EMBASE, CINAHL, Science Direct, Ingenta Select, Ovid Full text, Wiley Interscience, Web of Knowledge; search date June 2006.

Embedded ImageStudy selection and analysis:

Studies of ultra-short depression screening tests (one, two or three questions) for use in primary care from published and non-peer reviewed sources. Exclusions: studies in medical patients, secondary care or nursing homes; studies of visual analogue scales or short tools (5–14 items); studies not Standards for Reporting of Diagnostic Accuracy (STARD) compliant. The meta-analysis involved using raw data to calculate the ratio of the proportion of true diagnoses to the proportion of false diagnoses. Where the ratio was significantly greater than 1, data were pooled to determine sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).

Embedded ImageOutcomes:

Ratio of true cases to …

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  • Sources of funding: reported as “not applicable”.


  • Competing interests: Professor Kendrick is Chair of the Mental Health Expert Reference Group for the UK GP Contract Quality and Outcomes Framework, whose responsibility it is to review the mental health indicator for screening for depression among diabetes and heart disease patients in UK primary care.