Dataset Information

The criterion validity of the web-based Major Depression Inventory when used on clinical suspicion of depression in primary care.

ABSTRACT:

Background

The Major Depression Inventory (MDI) is widely used in Danish general practice as a screening tool to assess depression in symptomatic patients. Nevertheless, no validation studies of the MDI have been performed. The aim of this study was to validate the web-based version of the MDI against a fully structured telephone interview in a population selected on clinical suspicion of depression (ie, presence of two or three core symptoms of depression) in general practice.

Materials and methods

General practitioners (GPs) invited consecutive persons suspected of depression to complete the web-based MDI in a primary care setting. The validation was based on the Munich-Composite International Diagnostic Interview (M-CIDI) by phone. GPs in the 22 practices in our study included 132 persons suspected of depression. Depression was rated as yes/no according to the MDI and M-CIDI. Sensitivity, specificity, and positive predictive value of the International Classification of Diseases, Tenth Revision (ICD-10) algorithms of the MDI were examined.

Results

According to the M-CIDI interview, 87.9% of the included population was depressed and 64.4% was severely depressed. According to the MDI scale, 59.1% of the population was depressed and 31.8% was severely depressed. The sensitivity of the MDI for depression was 62.1% (95% confidence interval [95% CI]: 52.6-70.9) and the specificity was 62.5% (95% CI: 35.4-84.8). The sensitivity for severe depression was 42.2% (95% CI: 30.6-52.4) and the specificity was 85.1% (95% CI: 71.7-93.8). The receiver operating curve showed an area under the curve of 0.66 (95% CI: 0.52-0.81) for any depression and of 0.72 (95% CI: 0.63-0.81) for severe depression.

Conclusion

The MDI is a conservative instrument for diagnosing ICD-10 depression in a clinical setting compared to the M-CIDI interview. Only a few false-positive diagnoses were identified when the MDI was used on clinical suspicion of depression.

SUBMITTER: Nielsen MG

PROVIDER: S-EPMC5505538 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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The criterion validity of the web-based Major Depression Inventory when used on clinical suspicion of depression in primary care.

Nielsen Marie Germund MG Ørnbøl Eva E Bech Per P Vestergaard Mogens M Christensen Kaj Sparle KS

Clinical epidemiology 20170706

<h4>Background</h4>The Major Depression Inventory (MDI) is widely used in Danish general practice as a screening tool to assess depression in symptomatic patients. Nevertheless, no validation studies of the MDI have been performed. The aim of this study was to validate the web-based version of the MDI against a fully structured telephone interview in a population selected on clinical suspicion of depression (ie, presence of two or three core symptoms of depression) in general practice.<h4>Materi ...[more]

PMID: 28740432

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Project description:Objective: This study aimed to assess the measurement properties of the Major Depression Inventory (MDI) in a clinical sample of primary care patients. Design: General practitioners (GPs) handed out the MDI to patients aged 18-65 years on clinical suspicion of depression. Setting: Thirty-seven general practices in the Central Denmark Region participated in the study. Patients: Data for 363 patients (65% females, mean age: 49.8 years, SD: 17.7) consulting their GP were included in the analysis. Main outcome measures: The overall fit to the Rasch model, individual item and person fit, and adequacy of response categories were tested. Statistical tests for local dependency, unidimensionality, differential item functioning, and correct targeting of the scale were performed. The person separation reliability index was calculated. All analyses were performed using RUMM2030 software. Results: Items 9 and 10 demonstrated misfit to the Rasch model, and all items demonstrated disordered response categories. After modifying the original six-point to a five-point scoring system, ordered response categories were achieved for all 10 items. The MDI items seemed well targeted to the population approached. Model fit was also achieved for core symptoms of depression (items 1-3) and after dichotomization of items according to diagnostic procedure. Conclusion: Despite some minor problems with its measurement structure, the MDI seems to be a valid instrument for identification of depression among adults in primary care. The results support screening for depression based on core symptoms and dichotomization of items according to diagnostic procedure. Key points The Major Depression Inventory (MDI) is widely used for screening, diagnosis and monitoring of depression in general practice. This study demonstrates misfit of items 9 and 10 to the Rasch model and a need to modify the scoring system The findings support screening for depression based on core symptoms and dichotomization of items according to diagnostic procedure. Minor problems with measurement structure should be addressed in future revisions of the MDI.

Project description:ObjectiveThis study aims to assess the measurement properties of the Major Depression Inventory (MDI) in a clinical sample of primary care patients.DesignGeneral practitioners (GPs) handed out the MDI to patients aged 18-65 years on clinical suspicion of depression.SettingThirty-seven general practices in the Central Denmark Region participated in the study.PatientsData for 363 patients (65% females, mean age: 49.8 years, SD: 17.7) consulting their GP were included in the analysis.Main outcome measuresThe overall fit to the Rasch model, individual item and person fit, and adequacy of response categories were tested. Statistical tests for local dependency, unidimensionality, differential item functioning, and correct targeting of the scale were performed. The person separation reliability index was calculated. All analyses were performed using RUMM2030 software.ResultsItems 9 and 10 demonstrated misfit to the Rasch model, and all items demonstrated disordered response categories. After modifying the original six-point to a five-point scoring system, ordered response categories were achieved for all 10 items. The MDI items seemed well targeted to the population approached. Model fit was also achieved for core symptoms of depression (items 1-3) and after dichotomization of items according to diagnostic procedure.ConclusionDespite some minor problems with its measurement structure, the MDI seems to be a valid instrument for identification of depression among adults in primary care. The results support screening for depression based on core symptoms and dichotomization of items according to diagnostic procedure. Key points The Major Depression Inventory (MDI) is widely used for screening, diagnosis and monitoring of depression in general practice. This study demonstrates misfit of items 9 and 10 to the Rasch model and a need to modify the scoring system The findings support screening for depression based on core symptoms and dichotomization of items according to diagnostic procedure. Minor problems with measurement structure should be addressed in future revisions of the MDI.

Dataset Information

The criterion validity of the web-based Major Depression Inventory when used on clinical suspicion of depression in primary care.

Background

Materials and methods

Results

Conclusion

Publications

The criterion validity of the web-based Major Depression Inventory when used on clinical suspicion of depression in primary care.

Similar Datasets

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