The Resource Efficacy and safety of screening for postpartum depression, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Duke Evidence-based Practice Center ; investigators, Evan R. Myers, M.D., M.P.H., Nicki Aubuchon-Endsley, Ph.D., Lori A. Bastian, M.D., Jennifer M. Gierisch, Ph.D., M.P.H., Alex R. Kemper, M.D., M.P.H., M.S., Geeta K. Swamy, M.D., Marla F. Wald, M.D., Amanda J. McBroom, Ph.D., Kathryn R. Lallinger, M.S.L.S., Rebecca N. Gray, D.Phil., Cindy Green, Ph.D., and Gillian D. Sanders, Ph.D

Efficacy and safety of screening for postpartum depression, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Duke Evidence-based Practice Center ; investigators, Evan R. Myers, M.D., M.P.H., Nicki Aubuchon-Endsley, Ph.D., Lori A. Bastian, M.D., Jennifer M. Gierisch, Ph.D., M.P.H., Alex R. Kemper, M.D., M.P.H., M.S., Geeta K. Swamy, M.D., Marla F. Wald, M.D., Amanda J. McBroom, Ph.D., Kathryn R. Lallinger, M.S.L.S., Rebecca N. Gray, D.Phil., Cindy Green, Ph.D., and Gillian D. Sanders, Ph.D

Label
Efficacy and safety of screening for postpartum depression
Title
Efficacy and safety of screening for postpartum depression
Statement of responsibility
prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Duke Evidence-based Practice Center ; investigators, Evan R. Myers, M.D., M.P.H., Nicki Aubuchon-Endsley, Ph.D., Lori A. Bastian, M.D., Jennifer M. Gierisch, Ph.D., M.P.H., Alex R. Kemper, M.D., M.P.H., M.S., Geeta K. Swamy, M.D., Marla F. Wald, M.D., Amanda J. McBroom, Ph.D., Kathryn R. Lallinger, M.S.L.S., Rebecca N. Gray, D.Phil., Cindy Green, Ph.D., and Gillian D. Sanders, Ph.D
Title variation
Effective health care program
Creator
Contributor
Author
Issuing body
Subject
Genre
Language
eng
Summary
OBJECTIVES: To describe the benefits and harms of specific tools and strategies for screening for postpartum depression. DATA SOURCES: We searched PubMed(r), Embase(r), PsycINFO(r), and the Cochrane Database of Systematic Reviews for relevant English-language studies published from January 1, 2004, to July 24, 2012, that evaluated the performance of screening instruments for postpartum depression, potential benefits and harms of screening, and impact on appropriate postscreening actions. REVIEW METHODS: Two investigators screened each abstract and full-text article for inclusion; abstracted data; and performed quality ratings, applicability ratings, and evidence grading. A simulation model was used to estimate the effects of screening for postpartum depression on the overall balance of benefits and harms. RESULTS: Forty studies (represented by 45 articles) were identified as relevant to this review. Eighteen studies provided sensitivity and specificity data on 9 screening instruments: 11 on the Edinburgh Postnatal Depression Scale, 4 on the Postpartum Depression Screening Scale, 4 on different versions of the Beck Depression Inventory, 2 on a "two-question" screen, and 1 each on 5 other instruments. Heterogeneity in setting, patient population, and choice of threshold prevented formal synthesis. For most tests in most studies, sensitivity and specificity were in the 80-90 percent range, with higher sensitivity associated with lower specificity; the two-question screen had 100 percent sensitivity but specificities of 45-65 percent. Fifteen studies analyzed the association between risk factors and postpartum depression. Although adverse pregnancy outcomes and chronic medical conditions (low strength of evidence) and past history of depression, poor relationship quality, and poor social support (moderate strength of evidence) were all associated with an increased risk of postpartum depression, only two studies directly reported an effect on test results. (Sensitivity was nonsignificantly increased in primigravidas compared with multigravidas.) Based on two studies, there was insufficient evidence to evaluate whether timing relative to delivery, setting, or provider affected test characteristics of screening instruments. Based on five studies, there was low to moderate strength of evidence that screening resulted in decreased depressive symptoms and improved mental health; in four of these studies, improvement in depressive symptoms was not accompanied by improvement in measures of parenting stress. Rates of referral and treatment for women with positive screening results were substantially higher in two studies where screening, diagnosis, and treatment were provided in the same setting; referral rates in other studies were all 50 percent or less. Modeling suggests that serial testing with a two-question screen followed by a second more specific instrument for those who have a positive result may be a reasonable strategy to reduce false positives while minimizing false negatives. CONCLUSIONS: The potential effectiveness of screening for postpartum depression appears to be related to the availability of systems to ensure adequate followup of women with positive results. The ideal characteristics of a screening test for postpartum depression, including sensitivity, specificity, timing, and frequency, have not been defined. Because the balance of benefits and harms, at both the individual level and health system level, is highly dependent on these characteristics, broad consensus on these characteristics is needed
Member of
Cataloging source
NLM
http://library.link/vocab/creatorName
Myers, Evan R
Funding information
Conducted by the Duke Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ).
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • surveys of literature
NLM call number
WQ 500
http://library.link/vocab/relatedWorkOrContributorName
  • Myers, Evan R.
  • Aubuchon-Endsley, Nicki
  • Bastian, Lori A.
  • Gierisch, Jennifer M.
  • Kemper, Alex R.
  • Swamy, Geeta K.
  • Wald, Marla F.
  • McBroom, Amanda J.
  • Lallinger, Kathryn R.
  • Gray, Rebecca N.
  • Green, Cindy
  • Sanders, Gillian D.
  • United States
  • Duke University Evidence-based Practice Center
  • Effective Health Care Program (U.S.)
Series statement
  • Comparative effectiveness review
  • AHRQ publication
Series volume
  • number 106
  • no. 13-EHC064-EF
http://library.link/vocab/subjectName
  • Depression, Postpartum
  • Comparative Effectiveness Research
  • Evidence-Based Practice
http://bibfra.me/vocab/relation/supportingbody
  • SGEpYsXqBGk
  • RzTDSdffmEM
Label
Efficacy and safety of screening for postpartum depression, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Duke Evidence-based Practice Center ; investigators, Evan R. Myers, M.D., M.P.H., Nicki Aubuchon-Endsley, Ph.D., Lori A. Bastian, M.D., Jennifer M. Gierisch, Ph.D., M.P.H., Alex R. Kemper, M.D., M.P.H., M.S., Geeta K. Swamy, M.D., Marla F. Wald, M.D., Amanda J. McBroom, Ph.D., Kathryn R. Lallinger, M.S.L.S., Rebecca N. Gray, D.Phil., Cindy Green, Ph.D., and Gillian D. Sanders, Ph.D
Instantiates
Publication
Note
"April 2013."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier.
Content category
text
Content type code
txt
Content type MARC source
rdacontent.
Control code
847523511
Extent
1 online resource (216 pages)
Form of item
online
Media category
computer
Media MARC source
rdamedia.
Media type code
c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)847523511
Label
Efficacy and safety of screening for postpartum depression, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Duke Evidence-based Practice Center ; investigators, Evan R. Myers, M.D., M.P.H., Nicki Aubuchon-Endsley, Ph.D., Lori A. Bastian, M.D., Jennifer M. Gierisch, Ph.D., M.P.H., Alex R. Kemper, M.D., M.P.H., M.S., Geeta K. Swamy, M.D., Marla F. Wald, M.D., Amanda J. McBroom, Ph.D., Kathryn R. Lallinger, M.S.L.S., Rebecca N. Gray, D.Phil., Cindy Green, Ph.D., and Gillian D. Sanders, Ph.D
Publication
Note
"April 2013."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier.
Content category
text
Content type code
txt
Content type MARC source
rdacontent.
Control code
847523511
Extent
1 online resource (216 pages)
Form of item
online
Media category
computer
Media MARC source
rdamedia.
Media type code
c
Other physical details
illustrations.
Specific material designation
remote
System control number
(OCoLC)847523511

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