Telemed J E Health - Psychometric properties of an automated telephone-based PHQ-9.

Tópicos

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Resumo

JECTIVE: This study aims to evaluate the psychometric properties of an automated version of the Patient Health Questionnaire-9 (PHQ-9) to further facilitate its use in primary care. We automated the PHQ-9 using a computer telephony modality (interactive voice response system) called telephone-linked communication (TLC).SUBJECTS AND METHODS: Eighty subjects were divided into four depression categories: none, mild, moderate, and severe. The automated questionnaire, TLC-PHQ-9, was administered to all subjects five times over a 3-month period, at intervals of 0 (T1), 1, 3, 4, and 4 (T5) weeks, respectively. The Inventory of Depressive Symptomatology (IDS) was administered (paper-and-pencil) at T1 and T5. We examined (1) reliability, (2) validity, (3) sensitivity and specificity, and (4) sensitivity to change.RESULTS: (1) Test-retest reliability showed substantial agreement between T1 and T2, with a weighted kappa of 0.76 (95% confidence interval [CI] 0.67-0.85). Cronbach's coefficient alpha values ranged from 0.913 to 0.918 for each TLC-PHQ-9 assessment. (2) The weighted kappa of 0.78 (95% CI 0.70-0.87) for T1 and 0.73 (95% CI 0.63-0.83) for T5 showed strong agreement between TLC-PHQ-9 and IDS in all depression categories. (3) TLC-PHQ-9 demonstrated good sensitivity (82.4%) and very good specificity (90.7%) for moderate-plus depression and poorer sensitivity (54.2%) but very good specificity (97.8%) for severe-plus depression. (4) The weighted kappa of 0.53 (95% CI 0.35-0.70) indicated moderate agreement between TLC-PHQ-9 and IDS.CONCLUSIONS: An automated telephony administration of the PHQ-9 appears to be a valid and reliable tool for monitoring depression symptoms and has strong fidelity across patients.

Resumo Limpo

jectiv studi aim evalu psychometr properti autom version patient health questionnair phq facilit use primari care autom phq use comput telephoni modal interact voic respons system call telephonelink communic tlcsubject method eighti subject divid four depress categori none mild moder sever autom questionnair tlcphq administ subject five time month period interv t t week respect inventori depress symptomatolog id administ paperandpencil t t examin reliabl valid sensit specif sensit changeresult testretest reliabl show substanti agreement t t weight kappa confid interv ci cronbach coeffici alpha valu rang tlcphq assess weight kappa ci t ci t show strong agreement tlcphq id depress categori tlcphq demonstr good sensit good specif moderateplus depress poorer sensit good specif severeplus depress weight kappa ci indic moder agreement tlcphq idsconclus autom telephoni administr phq appear valid reliabl tool monitor depress symptom strong fidel across patient

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