{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Dano S"],"funding":["Kidney Foundation of Canada","Canadian Institutes of Health Research","Toronto General and Western Hospital Foundation","CIHR"],"pagination":["1318-1326"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC10157790"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["38(5)"],"pubmed_abstract":["<h4>Background</h4>Systematic screening for depressive symptoms may identify patients who may benefit from clinical assessment and psychosocial support. Here we assess a two-step screening using ultrabrief pre-screeners [Edmonton Symptom Assessment Survey-revised Depression item (ESASr-D) or Patient Health Questionnaire-2 (PHQ-2)] followed by the Patient-Reported Outcomes Measurement Information System Depression questionnaire (PROMIS-D) to identify depressive symptoms in patients on kidney replacement therapies.<h4>Methods</h4>We conducted a cross-sectional study of adults (kidney transplant recipients or treated with dialysis) in Toronto, ON, Canada. We simulated various two-step screening scenarios where only patients above a pre-screening cut-off score on the ESASr-D or PHQ-2 would move to step 2 (PROMIS-D). Screening performance was evaluated by sensitivity, specificity and positive and negative predictive values using the Patient Health Questionnaire-9 (PHQ-9) as the referent. The average number of items completed by patients in different scenarios was reported.<h4>Results</h4>Of 480 participants, 60% were male with a mean age of 55 years. Based on PHQ-9, 19% of patients had moderate or severe depressive symptoms. Pre-screening with a PHQ-2 score ≥1 combined with a PROMIS-D score of ≥53 provided the best two-step results (sensitivity 0.81, specificity 0.84, NPV 0.95). Two-step screening also reduces question burden.<h4>Conclusions</h4>A two-step screening using a PHQ-2 score ≥1 followed by a PROMIS-D score ≥53 has good sensitivity and specificity for identifying potentially significant depressive symptoms among patients on kidney replacement therapies. This approach has lower question burden. Screened-in patients will need further clinical assessment to establish a diagnosis."],"journal":["Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association"],"pubmed_title":["Two-step screening for depressive symptoms in patients treated with kidney replacement therapies: a cross-sectional analysis."],"pmcid":["PMC10157790"],"funding_grant_id":["PJT 165915","KFOC190008"],"pubmed_authors":["Novak M","Peipert JD","Howell D","Dano S","Mucsi I","Bartlett S","Hanmer J","Macanovic S","Lan HH","Li M"],"additional_accession":[]},"is_claimable":false,"name":"Two-step screening for depressive symptoms in patients treated with kidney replacement therapies: a cross-sectional analysis.","description":"<h4>Background</h4>Systematic screening for depressive symptoms may identify patients who may benefit from clinical assessment and psychosocial support. Here we assess a two-step screening using ultrabrief pre-screeners [Edmonton Symptom Assessment Survey-revised Depression item (ESASr-D) or Patient Health Questionnaire-2 (PHQ-2)] followed by the Patient-Reported Outcomes Measurement Information System Depression questionnaire (PROMIS-D) to identify depressive symptoms in patients on kidney replacement therapies.<h4>Methods</h4>We conducted a cross-sectional study of adults (kidney transplant recipients or treated with dialysis) in Toronto, ON, Canada. We simulated various two-step screening scenarios where only patients above a pre-screening cut-off score on the ESASr-D or PHQ-2 would move to step 2 (PROMIS-D). Screening performance was evaluated by sensitivity, specificity and positive and negative predictive values using the Patient Health Questionnaire-9 (PHQ-9) as the referent. The average number of items completed by patients in different scenarios was reported.<h4>Results</h4>Of 480 participants, 60% were male with a mean age of 55 years. Based on PHQ-9, 19% of patients had moderate or severe depressive symptoms. Pre-screening with a PHQ-2 score ≥1 combined with a PROMIS-D score of ≥53 provided the best two-step results (sensitivity 0.81, specificity 0.84, NPV 0.95). Two-step screening also reduces question burden.<h4>Conclusions</h4>A two-step screening using a PHQ-2 score ≥1 followed by a PROMIS-D score ≥53 has good sensitivity and specificity for identifying potentially significant depressive symptoms among patients on kidney replacement therapies. This approach has lower question burden. Screened-in patients will need further clinical assessment to establish a diagnosis.","dates":{"release":"2023-01-01T00:00:00Z","publication":"2023 May","modification":"2025-04-18T13:17:00.544Z","creation":"2025-04-06T22:53:46.571Z"},"accession":"S-EPMC10157790","cross_references":{"pubmed":["36095145"],"doi":["10.1093/ndt/gfac262"]}}