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Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis – ERRATUM
- Yin Wu, Brooke Levis, Kira E. Riehm, Nazanin Saadat, Alexander W. Levis, Marleine Azar, Danielle B. Rice, Jill Boruff, Pim Cuijpers, Simon Gilbody, John P.A. Ioannidis, Lorie A. Kloda, Dean McMillan, Scott B. Patten, Ian Shrier, Roy C. Ziegelstein, Dickens H. Akena, Bruce Arroll, Liat Ayalon, Hamid R. Baradaran, Murray Baron, Charles H. Bombardier, Peter Butterworth, Gregory Carter, Marcos H. Chagas, Juliana C. N. Chan, Rushina Cholera, Yeates Conwell, Janneke M. de Manvan Ginkel, Jesse R. Fann, Felix H. Fischer, Daniel Fung, Bizu Gelaye, Felicity Goodyear-Smith, Catherine G. Greeno, Brian J. Hall, Patricia A. Harrison, Martin Härter, Ulrich Hegerl, Leanne Hides, Stevan E. Hobfoll, Marie Hudson, Thomas Hyphantis, Masatoshi Inagaki, Nathalie Jetté, Mohammad E. Khamseh, Kim M. Kiely, Yunxin Kwan, Femke Lamers, Shen-Ing Liu, Manote Lotrakul, Sonia R. Loureiro, Bernd Löwe, Anthony McGuire, Sherina Mohd-Sidik, Tiago N. Munhoz, Kumiko Muramatsu, Flávia L. Osório, Vikram Patel, Brian W. Pence, Philippe Persoons, Angelo Picardi, Katrin Reuter, Alasdair G. Rooney, Iná S. Santos, Juwita Shaaban, Abbey Sidebottom, Adam Simning, Lesley Stafford, Sharon Sung, Pei Lin Lynnette Tan, Alyna Turner, Henk C. van Weert, Jennifer White, Mary A. Whooley, Kirsty Winkley, Mitsuhiko Yamada, Andrea Benedetti, Brett D. Thombs
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- Journal:
- Psychological Medicine / Volume 50 / Issue 16 / December 2020
- Published online by Cambridge University Press:
- 19 August 2019, p. 2816
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Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis
- Yin Wu, Brooke Levis, Kira E. Riehm, Nazanin Saadat, Alexander W. Levis, Marleine Azar, Danielle B. Rice, Jill Boruff, Pim Cuijpers, Simon Gilbody, John P.A. Ioannidis, Lorie A. Kloda, Dean McMillan, Scott B. Patten, Ian Shrier, Roy C. Ziegelstein, Dickens H. Akena, Bruce Arroll, Liat Ayalon, Hamid R. Baradaran, Murray Baron, Charles H. Bombardier, Peter Butterworth, Gregory Carter, Marcos H. Chagas, Juliana C. N. Chan, Rushina Cholera, Yeates Conwell, Janneke M. de Man-van Ginkel, Jesse R. Fann, Felix H. Fischer, Daniel Fung, Bizu Gelaye, Felicity Goodyear-Smith, Catherine G. Greeno, Brian J. Hall, Patricia A. Harrison, Martin Härter, Ulrich Hegerl, Leanne Hides, Stevan E. Hobfoll, Marie Hudson, Thomas Hyphantis, Masatoshi Inagaki, Nathalie Jetté, Mohammad E. Khamseh, Kim M. Kiely, Yunxin Kwan, Femke Lamers, Shen-Ing Liu, Manote Lotrakul, Sonia R. Loureiro, Bernd Löwe, Anthony McGuire, Sherina Mohd-Sidik, Tiago N. Munhoz, Kumiko Muramatsu, Flávia L. Osório, Vikram Patel, Brian W. Pence, Philippe Persoons, Angelo Picardi, Katrin Reuter, Alasdair G. Rooney, Iná S. Santos, Juwita Shaaban, Abbey Sidebottom, Adam Simning, Lesley Stafford, Sharon Sung, Pei Lin Lynnette Tan, Alyna Turner, Henk C. van Weert, Jennifer White, Mary A. Whooley, Kirsty Winkley, Mitsuhiko Yamada, Andrea Benedetti, Brett D. Thombs
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- Journal:
- Psychological Medicine / Volume 50 / Issue 8 / June 2020
- Published online by Cambridge University Press:
- 12 July 2019, pp. 1368-1380
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Background
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
MethodsWe conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
Results16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
ConclusionsPHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Chapter 21 - Austral amphibians – Gondwanan relicts in peril
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- By Jean-Marc Hero, Griffith University,, J. Dale Roberts, University of Western Australia, Conrad J. Hoskin, James Cook University, Katrin Lowe, Griffith University, Edward J. Narayan, Griffith University, Phillip J. Bishop, University of Otago
- Edited by Adam Stow, Macquarie University, Sydney, Norman Maclean, University of Southampton, Gregory I. Holwell, University of Auckland
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- Book:
- Austral Ark
- Published online:
- 05 November 2014
- Print publication:
- 22 December 2014, pp 440-466
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Summary
Summary
Over 30% of Australasian amphibians are currently threatened with extinction. While habitat loss, introduced species and disease have been identified as major threats, the impacts of climate change are understudied. Threatened frogs fall into distinct biogeographical and ecological groupings that can be linked to specific threats (e.g. mountain- top endemics and climate change; stream-dwelling wet forest frogs and disease; and small island endemics and feral pests). The impacts of gradual climate change over millions of years has isolated specific species into climatic refugia (resulting in restricted geographic ranges), which combined with the ecological traits of these species (e.g. small clutch-size) dramatically increases extinction risk. Australasian frogs demonstrate intrinsic links between biogeographic history, species ecology and conservation status. The solutions to most threats are clear at a broad level, stop land clearing, reduce CO2 emissions and control feral animals; however, declines linked to the disease chytridiomycosis are not easily resolved. Chytridiomycosis is not a universal threat and understanding the causes of variation in impact is critically important. While the threats of land clearing, disease and introduced species are regional and/or species specific, the impacts of climate change must be examined carefully as all species are likely to affected. Here we cover these issues for Australasian frogs, presenting regional examples that highlight threats and avenues for future research and management.
Phylogenetic and biogeographic history
Over 30% of amphibian species are threatened with extinction globally making them the most threatened of the vertebrate groups (Wake and Vredenburg 2008). There are multiple threats to Austral frogs: e.g. disease – critically chytrid fungus for species with more aquatic lifestyles; small clutch size and limited range associated with higher decline or extinction risk; introduced species (Gambusia and trout in Australia, Gillespie and Hero, 1999; Murray et al., 2011; Rattus in New Zealand, Thurley and Bell, 1994; and mongoose in the Pacific Islands, Pernetta and Watling, 1979) and less specific threats, identified in both Austral and global analyses of amphibian declines: e.g. climate change (Hero et al., 2006, 2008; Hof et al., 2011) and habitat loss and fragmentation (Hero et al., 2008). These factors pose serious threats in many other regions of the world (Stuart, 2008) and their impacts vary among species and genera, depending on their current distribution and habitat use (Table 21.1).