Table 2. Studies on the Effect of Screening and Feedback

Screening for Depression in Adults: Summary of the Evidence

The summaries of the evidence briefly present evidence of effectiveness for preventive health services used in primary care clinical settings, including screening tests, counseling, and chemoprevention. They summarize the more detailed Systematic Evidence Reviews, which are used by the U.S. Preventive Services Task Force (USPSTF) to make recommendations.
Author, Year (Reference) Screening Instrument Participants, n Mode of Administration Confirmatory Diagnostic Interview? Feedback to Provider Quality Rating1
Internal Validity External Validity
Johnstone and Goldberg, 1976 (14) GHQ 119 Self Yes Immediate feedback Good Fair
Moore et al., 1978 (15) SDS 212 Self No Immediate written feedback Good Fair
Linn and Yager, 1980 (16) SDS 150 Self No Immediate written feedback Good Good
Zung and King, 1983 (17) SDS and immediate diagnostic interview 49 Psychiatrist Yes2 Immediate feedback Fair Poor
Magruder-Habib et al., 1990 (18) SDS 100 Research assistant Yes2 Immediate written feedback Good Good
Callahan et al., 1994 (19) and 1996 (21) CES-D 175, 222 Research assistant Yes (HAM-D)2 Feedback to schedule 3 additional visits within 3 months Good Fair
Dowrick, 1995 (20) BDI 116 Self No Written feedback to provider 1 week after visit, plus chart note Fair Fair
Lewis et al., 1996 (22) GHQ 681 Self PROQSY group only Immediate on GHQ results; participants asked to complete PROQSY and, if positive, to schedule follow-up in 1 week Fair Fair
Reifler et al., 1996 (23) SDDS 358 Self Yes3 Providers given diagnostic worksheet at same visit for participants who screened positive Good Good
Williams et al., 1999 (11) CES-D, blinded DSM-III-R 969 Self Yes3 Immediate written feedback Good Good
Katzelnick et al., 2000 (12) SCID + HAM-D 407 Telephone by research assistant No Immediate written feedback and additional support Good Good
Wells et al., 2000 (24) Two-item instrument 1,356 Research assistant Yes (subset)3 Providers notified and asked to schedule visit within 2 weeks Good Fair
Whooley et al., 2000 (25) GDS 2,346 Research assistant No Intervention providers notified same day (before visit, 74%; after visit, 26%) Fair Fair
Rost et al., 2001 (13) Sadness or anhedonia within 2 weeks 479 (189 not recently treated) Nurse Yes Feedback to provider; nurse-centered follow-up weekly for 5 weeks Fair Good

Note: BDI indicates Beck Depression Inventory; CES-D, Center for Epidemiologic Study Depression scale; GDS, Geriatric Depression Scale; GHQ, General Health Questionnaire; PROSQY, self-administered computerized assessment; SDS, Zung Self-Depression Scale; SDDS, Symptom-Driven Diagnostic System for Primary Care.

1 The definitions of the quality ratings are as follows. Good: evidence includes consistent results from well-designed, well-conducted studies in representative populations that directly assess effects on health outcomes. Fair: Evidence is sufficient to determine effects on health outcomes, but the strength of the evidence is limited by the number, quality, or consistency of the individual studies, generalizability to routine practice, or indirect nature of the evidence on health outcomes. Poor: Evidence is insufficient to assess the effects on health outcomes because of limited number or power of studies, important flaws in their design or conduct, gaps in the chain of evidence, or lack of information on important health outcomes.
2 Required before randomization.
3 Not related to randomization.

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Page last reviewed April 2013
Page originally created April 2013
Internet Citation: Table 2. Studies on the Effect of Screening and Feedback. Content last reviewed April 2013. Agency for Healthcare Research and Quality, Rockville, MD.
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