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  • 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

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Mental health
Protocol
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
  1. Brett D Thombs1,2,3,4,5,6,7,
  2. Andrea Benedetti2,3,8,
  3. Lorie A Kloda9,
  4. Brooke Levis2,7,
  5. Kira E Riehm7,
  6. Marleine Azar2,7,
  7. Pim Cuijpers10,
  8. Simon Gilbody11,
  9. John P A Ioannidis12,
  10. Dean McMillan11,
  11. Scott B Patten13,
  12. Ian Shrier2,7,
  13. Russell J Steele14,7,
  14. Roy C Ziegelstein15,
  15. Marcello Tonelli16,
  16. Nicholas Mitchell17,
  17. Liane Comeau18,
  18. Joy Schinazi19,
  19. Simone Vigod20
  1. 1Departments of Psychiatry, McGill University, Montreal, Quebec, Canada
  2. 2Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
  3. 3Department of Medicine, McGill University, Montreal, Quebec, Canada
  4. 4Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
  5. 5Department of Psychology, McGill University, Montreal, Quebec, Canada
  6. 6School of Nursing, McGill University, Montreal, Quebec, Canada
  7. 7Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
  8. 8Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
  9. 9Library, McGill University, Montreal, Quebec, Canada
  10. 10Department of Clinical, Neuro, Developmental Psychology, VU-University, Amsterdam, The Netherlands
  11. 11Psychological Medicine and Health Services Research, Department of Health Sciences, Hull York Medical School University of York, York, UK
  12. 12Department 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
  13. 13Departments of Psychiatry and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
  14. 14Department of Mathematics and Statistics, McGill University, Montreal, Quebec, Canada
  15. 15Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  16. 16Department of Medicine, University of Calgary, Calgary, Alberta, Canada
  17. 17Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
  18. 18Institut national de santé publique du Québec and Université de Montréal, Montreal, Quebec, Canada
  19. 19Public Health Department, Laval, Quebec, Canada
  20. 20Department of Psychiatry, Women's College Hospital and Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Brett D Thombs; brett.thombs{at}mcgill.ca

Abstract

Introduction 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 and analysis 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.

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

Systematic review registration PROSPERO 2015:CRD42015024785.

  • MENTAL HEALTH
  • PSYCHIATRY

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2015-009742

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