Systematic Review: Which Patient-Reported Screening Tool is Best for Postpartum Depression?
BACKGROUND AND PURPOSE:
Sultan et al. (JAMA Network Open, 2022) evaluated psychometric measurement properties of existing postpartum depression (PPD) patient-reported outcome measures (PROMs), with the goal of identifying the best available patient-reported screening measure
Studies on validated PROMs of postpartum depression
Eligible studies evaluated ≥1 psychometric measurement properties of the PROMs
A risk-of-bias assessment was performed to evaluate methods of each included study
Psychometric measurement properties of each PROM were rated according to Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria
Modified GRADE criteria were used to assess the level of evidence supporting each rating
Recommendation class based on quality of each included PROM
A: Recommended for use
B: Further research required
C: Not recommended
10 PROMs met inclusion criteria
43 studies | 22,095 postpartum women
Content validity was sufficient in all PROMs
Recommendation class A
The Edinburgh Postnatal Depression Scale (EPDS)
Adequate content validity
Moderate level of evidence for sufficient internal consistency (with sufficient structural validity)
Recommendation class B
All 9 other analyzed PROMs
e.g. Hospital Anxiety and Depression Scale, Postpartum Depression Screening Scale, Hopkins Symptom Checklist-10
The best available patient-reported PPD screening tool is the Edinburgh Postnatal Depression Scale
The authors suggest that follow-up studies assess the cross-cultural validity of the EPDS, as well as reliability and measurement error
The authors state
The Edinburgh Postnatal Depression Scale demonstrated adequate content validity and moderate evidence for sufficient internal consistency; the other PROMs demonstrated sufficient content validity but not sufficient internal consistency
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