PROMIS depression measures perform similarly to legacy measures relative to a structured diagnostic interview for depression in cancer patients

Clover, Kerrie; Lambert, Sylvie; Oldmeadow, Christopher; Britton, Ben; King, Madeleine; Mitchell, Alex J.; Carter, Gregory

doi:10.1007/s11136-018-1803-x

Cited by 53 publications

(56 citation statements)

References 25 publications

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“…By examining concordance of the PROMIS‐D‐SF with a structured diagnostic interview, the results of the current study have provided novel information to guide its application in this population at risk of depression. Consistent with previous studies, we found overall good concordance between the PROMIS‐D‐SF and the SCID, but when we evaluated the PROMIS‐D‐SF as a screening instrument for individual YACS, the results were not robust. All PROMIS‐D‐SF cutoff t‐scores fell short of our minimum criteria for both high sensitivity (≥85%) and moderate specificity (≥75%), and the results indicated that screening YACS using the PROMIS‐D‐SF would lead both to a significant percentage of symptomatic survivors being missed and a significant percentage of clinical referrals being deemed unnecessary according to SCID criteria.…”

Section: Discussionsupporting

confidence: 85%

“…Although studies previously have evaluated the PROMIS‐D‐SF as a screening instrument in cancer and other medical populations, we are not aware of any such study conducted with YACS. By examining concordance of the PROMIS‐D‐SF with a structured diagnostic interview, the results of the current study have provided novel information to guide its application in this population at risk of depression.…”

Section: Discussionmentioning

confidence: 99%

“…The PROMIS Depression scale was developed to measure depressive symptoms along a continuum in populations with a broad array of health conditions, rather than to capture the depressive symptoms observed specifically in individuals with psychiatric disorders . Moreover, prior reports have found that the PROMIS‐D‐SF has only moderate agreement with structured diagnostic interviews in patients with medical conditions, including cancer …”

Section: Discussionmentioning

confidence: 99%

“…Clinical screening programs generally select criteria that prioritize high sensitivity to ensure that most, if not all, patients with the condition are identified by the screening instrument. We determined a priori that a PROMIS‐D‐SF cutoff score with a sensitivity of ≥85% and a specificity of ≥75% would be adequate to be recommended for screening purposes using criteria based on clinical considerations and studies demonstrating that depression screening instruments can demonstrate high sensitivity and maintain robust specificity …”

Section: Methodsmentioning

confidence: 99%

“…Although studies support reliability and sensitivity to change in the PROMIS‐D‐SF, we have found research regarding its accuracy as a screening measure has been limited. The PROMIS‐D‐SF was introduced without a recommended case rule, and to date specific clinical cutoff scores have not been supported consistently . Consequently, studies comparing the PROMIS‐D‐SF with gold‐standard psychiatric diagnostic measures are critical to supporting its clinical use .…”

Section: Introductionmentioning

confidence: 99%

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Screening young adult cancer survivors with the PROMIS Depression Short Form (PROMIS‐D‐SF): Comparison with a structured clinical diagnostic interview

Recklitis

Blackmon

Chang

2020

Cancer

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Background The current study was conducted to evaluate the Patient‐Reported Outcomes Measurement Information System Depression Short Form (PROMIS‐D‐SF) as a screening measure for young adult cancer survivors (YACS) compared with a structured diagnostic interview. Methods A total of 249 YACS (aged 18‐40 years) completed the PROMIS‐D‐SF and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (SCID). Based on the SCID, participants were classified as having: 1) an SCID depression diagnosis; 2) depression symptoms without an SCID diagnosis; or 3) no depression symptoms. Receiver operating characteristic analyses evaluated PROMIS‐D‐SF and SCID concordance and the sensitivity and specificity of PROMIS‐D‐SF cutoff t ‐scores. Results The PROMIS‐D‐SF had overall good agreement with the SCID for both depression diagnosis (area under the curve, 0.89) and the presence of depressive symptoms (area under the curve, 0.83). A PROMIS‐D‐SF cutoff t‐score of ≥53.2 came closest to meeting study criteria for detecting a SCID depression diagnosis (sensitivity ≥0.85 and specificity ≥0.75), with a sensitivity of 0.81 and a specificity of 0.74. For identifying survivors with depression symptoms, a t‐score cutoff value of 49.4 was found to have slightly superior sensitivity (0.84) and inferior specificity (0.64). In hypothetical screening examples, these cutoff scores led to moderate levels of missed cases (15%‐19%) and a high percentage of clinical referrals that were unnecessary by SCID criteria (56%‐70%). Conclusions The PROMIS‐D‐SF demonstrated moderately strong concordance with depressive diagnoses and symptoms measured by the SCID, but cutoff t‐scores did not meet study criteria for clinical screening. The PROMIS‐D‐SF may be useful for assessing depression in YACS, but the limitations in its sensitivity and specificity identified in the current study are likely to limit its usefulness as a stand‐alone screening instrument in this population.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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