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Diagnostic Accuracy of Screening Tests and Treatment for Post-Acute Coronary Syndrome Depression: A Systematic Review.

Publication ,  Journal Article
Nieuwsma, JA; Williams, JW; Namdari, N; Washam, JB; Raitz, G; Blumenthal, JA; Jiang, W; Yapa, R; McBroom, AJ; Lallinger, K; Schmidt, R ...
Published in: Ann Intern Med
November 21, 2017

BACKGROUND: Patients who have had an acute coronary syndrome (ACS) event have an increased risk for depression. PURPOSE: To evaluate the diagnostic accuracy of depression screening instruments and to compare safety and effectiveness of depression treatments in adults within 3 months of an ACS event. DATA SOURCES: MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Database of Systematic Reviews from January 2003 to August 2017, and a manual search of citations from key primary and review articles. STUDY SELECTION: English-language studies of post-ACS patients that evaluated the diagnostic accuracy of depression screening tools or compared the safety and effectiveness of a broad range of pharmacologic and nonpharmacologic depression treatments. DATA EXTRACTION: 2 investigators independently screened each article for inclusion; abstracted the data; and rated the quality, applicability, and strength of evidence. DATA SYNTHESIS: Evidence from 6 of the 10 included studies showed that a range of depression screening instruments produces acceptable levels of diagnostic sensitivity, specificity, and negative predictive values (70% to 100%) but low positive predictive values (below 50%). The Beck Depression Inventory-II was the most studied tool. A large study found that a combination of cognitive behavioral therapy (CBT) and antidepressant medication improved depression symptoms, mental health-related function, and overall life satisfaction more than usual care. LIMITATION: Few studies, no evaluation of the influence of screening on clinical outcomes, and no studies addressing several clinical interventions of interest. CONCLUSION: Depression screening instruments produce diagnostic accuracy metrics that are similar in post-ACS patients and other clinical populations. Depression interventions have an uncertain effect on cardiovascular outcomes, but CBT combined with antidepressant medication produces modest improvement in psychosocial outcomes. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality (PROSPERO: CRD42016047032).

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Published In

Ann Intern Med

DOI

EISSN

1539-3704

Publication Date

November 21, 2017

Volume

167

Issue

10

Start / End Page

725 / 735

Location

United States

Related Subject Headings

  • Risk Factors
  • Psychological Tests
  • Humans
  • General & Internal Medicine
  • Depressive Disorder
  • Cognitive Behavioral Therapy
  • Antidepressive Agents
  • Acute Coronary Syndrome
  • 3202 Clinical sciences
  • 11 Medical and Health Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Nieuwsma, J. A., Williams, J. W., Namdari, N., Washam, J. B., Raitz, G., Blumenthal, J. A., … Sanders, G. D. (2017). Diagnostic Accuracy of Screening Tests and Treatment for Post-Acute Coronary Syndrome Depression: A Systematic Review. Ann Intern Med, 167(10), 725–735. https://doi.org/10.7326/M17-1811
Nieuwsma, Jason A., John W. Williams, Natasha Namdari, Jeffrey B. Washam, Giselle Raitz, James A. Blumenthal, Wei Jiang, et al. “Diagnostic Accuracy of Screening Tests and Treatment for Post-Acute Coronary Syndrome Depression: A Systematic Review.Ann Intern Med 167, no. 10 (November 21, 2017): 725–35. https://doi.org/10.7326/M17-1811.
Nieuwsma JA, Williams JW, Namdari N, Washam JB, Raitz G, Blumenthal JA, et al. Diagnostic Accuracy of Screening Tests and Treatment for Post-Acute Coronary Syndrome Depression: A Systematic Review. Ann Intern Med. 2017 Nov 21;167(10):725–35.
Nieuwsma, Jason A., et al. “Diagnostic Accuracy of Screening Tests and Treatment for Post-Acute Coronary Syndrome Depression: A Systematic Review.Ann Intern Med, vol. 167, no. 10, Nov. 2017, pp. 725–35. Pubmed, doi:10.7326/M17-1811.
Nieuwsma JA, Williams JW, Namdari N, Washam JB, Raitz G, Blumenthal JA, Jiang W, Yapa R, McBroom AJ, Lallinger K, Schmidt R, Kosinski AS, Sanders GD. Diagnostic Accuracy of Screening Tests and Treatment for Post-Acute Coronary Syndrome Depression: A Systematic Review. Ann Intern Med. 2017 Nov 21;167(10):725–735.

Published In

Ann Intern Med

DOI

EISSN

1539-3704

Publication Date

November 21, 2017

Volume

167

Issue

10

Start / End Page

725 / 735

Location

United States

Related Subject Headings

  • Risk Factors
  • Psychological Tests
  • Humans
  • General & Internal Medicine
  • Depressive Disorder
  • Cognitive Behavioral Therapy
  • Antidepressive Agents
  • Acute Coronary Syndrome
  • 3202 Clinical sciences
  • 11 Medical and Health Sciences