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October 19, 2021

Newer depression screeners successfully measure symptoms and follow progress of treatment

Newer depression screeners successfully measure symptoms and follow progress of treatment

Screening especially important in light of COVID-19 pandemic

Depression is the second most disabling condition in the world, after pain, so screening and diagnosis are crucial to improving outcomes for patients, especially in light of the COVID-19 pandemic. Research from Regenstrief Institute and Indiana University School of Medicine shows that the Patient Reported Outcomes Measurement Information Systems (PROMIS) scale for depression developed by the National Institutes of Health accurately measures depression symptoms and severity.

“Depression is treatable, that’s why routine screening is strongly recommended,” said study lead author Kurt Kroenke, M.D., Regenstrief research scientist and IU School of Medicine professor of medicine. “Measurement-based care is important to track a patient’s progress in order to make adjustments to care when needed. This study found that the PROMIS scales are an accurate measure of depression to aid in diagnosis and treatment.”

The research team analyzed data from three randomized clinical trials involving about 650 patients. It compared the results of the PROMIS scale, which is a survey where patients report their symptoms, to the results of a structured psychiatric interview. They also compared the diagnostic performance of the PROMIS scale and Patient Health Questionnaire nine-item depression scale (PHQ-9), which has been validated and widely adopted around the world, to benchmark the PROMIS measures. The PHQ-9 was developed by Dr. Kroenke.

Data analysis showed that PROMIS and PHQ-9 depression scales have similar accuracy when diagnosing depression.

“PROMIS scales are already commonly in use, and both PROMIS and PHQ scales are accessible and free in the public domain. This research supports both as viable screening options,” said Dr. Kroenke.

“The pandemic has taken a substantial toll on mental health, and there will likely be a lingering effect. Screening has become all the more important because we must be able to diagnose and treat patients who are suffering. Monitoring depression is no different than monitoring blood pressure, so these scales are important tools that are proven to work.”

The paper “Diagnostic operating characteristics of PROMIS scales in screening for depression” is published in the August 2021 print issue of the Journal of Psychosomatic Research. In addition to Dr. Kroenke, the authors are Timothy Stump, M.A., of the Indiana University Richard M. Fairbanks School of Public Health and IU School of Medicine; Jacob Kean, PhD of University of Utah School of Medicine; Erin E. Krebs, M.D., MPH of the Minneapolis VA Health Care System and the University of Minnesota Medical School; Teresa M. Damush, PhD, M.A., and Matthew J. Bair, M.D., both of Regenstrief, IU School of Medicine and the VA Health Services Research and Development Center for Health Information and Communication; and Patrick O. Monahan, PhD, of IU School of Medicine.

This work was supported by a National Institute of Arthritis and Musculoskeletal and Skin Diseases award to Dr. Monahan (R01 AR064081) and Department of Veterans Affairs Health Services Research and
Development Merit Review awards to Drs. Krebs (IIR 11-125), Bair (IIR 10-128), and Damush VA HSRD QUERI Service Directed Project (SDP-10-379).

About Regenstrief Institute

Founded in 1969 in Indianapolis, the Regenstrief Institute is a local, national and global leader dedicated to a world where better information empowers people to end disease and realize true health. A key research partner to Indiana University, Regenstrief and its research scientists are responsible for a growing number of major healthcare innovations and studies. Examples range from the development of global health information technology standards that enable the use and interoperability of electronic health records to improving patient-physician communications, to creating models of care that inform practice and improve the lives of patients around the globe.

Sam Regenstrief, a nationally successful entrepreneur from Connersville, Indiana, founded the institute with the goal of making healthcare more efficient and accessible for everyone. His vision continues to guide the institute’s research mission.

About IU School of Medicine

IU School of Medicine is the largest medical school in the U.S. and is annually ranked among the top medical schools in the nation by U.S. News & World Report. The school offers high-quality medical education, access to leading medical research and rich campus life in nine Indiana cities, including rural and urban locations consistently recognized for livability.

About Richard L. Roudebush Veterans Affairs (VA) Medical Center

Established in 1932, the Richard L. Roudebush VA Medical Center serves Veterans from across Indiana and western Illinois. The Roudebush VAMC is one of the largest and most complex medical centers in the Department of Veterans Affairs, and provides acute inpatient medical, surgical, psychiatric, rehabilitation, and neurological care to more than 60,000 Veterans annually. Some of the many services available to Veterans include emergency medicine, primary care, cardiac care, radiation oncology, audiology, community-based extended care and community VA clinics.

About Kurt Kroenke, M.D.

In addition to his role as a research scientist at Regenstrief Institute, Kurt Kroenke, M.D., MACP, is also a professor of medicine at Indiana University School of Medicine.

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