老年抑郁量表 (GDS)-4 和 GDS-5 用于筛查老年人抑郁症的准确性：系统评价和荟萃分析。,PLOS ONE

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老年抑郁量表 (GDS)-4 和 GDS-5 用于筛查老年人抑郁症的准确性：系统评价和荟萃分析。
PLOS ONE ( IF 2.9 ) Pub Date : 2021-07-01 , DOI: 10.1371/journal.pone.0253899
Ana Brañez-Condorena _{1,

2} , David R Soriano-Moreno ₃ , Alba Navarro-Flores ₄ , Blanca Solis-Chimoy _{1,

2} , Mario E Diaz-Barrera _{5,

6} , Alvaro Taype-Rondan ₇

Affiliation

背景老年抑郁量表 (GDS) 是一种广泛使用的工具，用于评估老年人的抑郁症。包含四个 (GDS-4) 和五个项目 (GDS-5) 的简短 GDS 版本代表了在资源有限的环境中进行抑郁症筛查的替代方案。然而，它们的准确性仍然不确定。目的评估 GDS-4 和 GDS-5 版本对老年人抑郁症筛查的准确性。方法截至2020年5月，系统检索PubMed、PsycINFO、Scopus、Google Scholar；用于评估 GDS-4 和 GDS-5 对老年人抑郁症筛查的敏感性和特异性的研究。我们对使用精神疾病诊断和统计手册 (DSM) 或国际疾病分类 10 (ICD-10) 作为参考标准的那些研究的敏感性和特异性进行了荟萃分析。使用 QUADAS-2 工具评估研究质量。我们进行了双变量随机效应荟萃分析，以计算每个报告的共同截止点的汇总敏感性和特异性及其 95% 置信区间 (95% CI)。对于整体荟萃分析，我们按每个临界值分别评估了每个 GDS-4 版本或 GDS-5 版本，为了调查异质性，我们按每个临界值对相似的 GDS 版本进行了整体评估。此外，我们使用 GRADE 方法评估了证据的确定性。结果纳入并荟萃分析了 23 项研究，评估 11 个不同的 GDS 版本。包括的参与者人数为 5048。当将所有版本一起包括在内时，在截止值为 2 时，GDS-4 的汇总敏感性为 0.77（95% CI：0.70-0.82），汇总特异性为 0.75（0.68-0.81） ; 而 GDS-5 的综合敏感性为 0.85 (0.80-0.90)，综合特异性为 0.75 (0.69-0.81)。我们在分界点 1、2 和 3 处找到了多个 GDS-4 版本的结果；对于超过一个 GDS-5 版本在分界点 1、2、3 和 4 处。大多数情况下，在不同版本的不同测试阈值下发现了显着的亚组差异。不同 GDS-4 和 GDS-5 版本的准确性显示出高度的异质性。指标测试领域存在高偏倚风险。此外，对于大多数 GDS 版本，证据的确定性很低或非常低。结论我们发现几个 GDS-4 和 GDS-5 版本在敏感性和特异性估计方面表现出很大的异质性，大多数证据的确定性很低或非常低。总而言之，我们的结果表明需要更多设计良好的研究来比较不同的 GDS 版本。

"点击查看英文标题和摘要"

Accuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis.

BACKGROUND The Geriatric Depression Scale (GDS) is a widely used instrument to assess depression in older adults. The short GDS versions that have four (GDS-4) and five items (GDS-5) represent alternatives for depression screening in limited-resource settings. However, their accuracy remains uncertain. OBJECTIVE To assess the accuracy of the GDS-4 and GDS-5 versions for depression screening in older adults. METHODS Until May 2020, we systematically searched PubMed, PsycINFO, Scopus, and Google Scholar; for studies that have assessed the sensitivity and specificity of GDS-4 and GDS-5 for depression screening in older adults. We conducted meta-analyses of the sensitivity and specificity of those studies that used the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases-10 (ICD-10) as reference standard. Study quality was assessed with the QUADAS-2 tool. We performed bivariate random-effects meta-analyses to calculate the pooled sensitivity and specificity with their 95% confidence intervals (95% CI) at each reported common cut-off. For the overall meta-analyses, we evaluated each GDS-4 version or GDS-5 version separately by each cut-off, and for investigations of heterogeneity, we assessed altogether across similar GDS versions by each cut-off. Also, we assessed the certainty of evidence using the GRADE methodology. RESULTS Twenty-three studies were included and meta-analyzed, assessing eleven different GDS versions. The number of participants included was 5048. When including all versions together, at a cut-off 2, GDS-4 had a pooled sensitivity of 0.77 (95% CI: 0.70-0.82) and a pooled specificity of 0.75 (0.68-0.81); while GDS-5 had a pooled sensitivity of 0.85 (0.80-0.90) and a pooled specificity of 0.75 (0.69-0.81). We found results for more than one GDS-4 version at cut-off points 1, 2, and 3; and for more than one GDS-5 version at cut-off points 1, 2, 3, and 4. Mostly, significant subgroup differences at different test thresholds across versions were found. The accuracy of the different GDS-4 and GDS-5 versions showed a high heterogeneity. There was high risk of bias in the index test domain. Also, the certainty of the evidence was low or very low for most of the GDS versions. CONCLUSIONS We found several GDS-4 and GDS-5 versions that showed great heterogeneity in estimates of sensitivity and specificity, mostly with a low or very low certainty of the evidence. Altogether, our results indicate the need for more well-designed studies that compare different GDS versions.

更新日期：2021-07-01

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