BACKGROUND The current study was conducted to evaluate the Patient-Reported Outcomes Measurement Information System Depression Short Form (PROMIS-D-SF) as a screening measure for young adult cancer survivors (YACS) compared with a structured diagnostic interview. METHODS A total of 249 YACS (aged 18-40 years) completed the PROMIS-D-SF and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (SCID). Based on the SCID, participants were classified as having: 1) an SCID depression diagnosis; 2) depression symptoms without an SCID diagnosis; or 3) no depression symptoms. Receiver operating characteristic analyses evaluated PROMIS-D-SF and SCID concordance and the sensitivity and specificity of PROMIS-D-SF cutoff t -scores. RESULTS The PROMIS-D-SF had overall good agreement with the SCID for both depression diagnosis (area under the curve, 0.89) and the presence of depressive symptoms (area under the curve, 0.83). A PROMIS-D-SF cutoff t-score of ≥53.2 came closest to meeting study criteria for detecting a SCID depression diagnosis (sensitivity ≥0.85 and specificity ≥0.75), with a sensitivity of 0.81 and a specificity of 0.74. For identifying survivors with depression symptoms, a t-score cutoff value of 49.4 was found to have slightly superior sensitivity (0.84) and inferior specificity (0.64). In hypothetical screening examples, these cutoff scores led to moderate levels of missed cases (15%-19%) and a high percentage of clinical referrals that were unnecessary by SCID criteria (56%-70%). CONCLUSIONS The PROMIS-D-SF demonstrated moderately strong concordance with depressive diagnoses and symptoms measured by the SCID, but cutoff t-scores did not meet study criteria for clinical screening. The PROMIS-D-SF may be useful for assessing depression in YACS, but the limitations in its sensitivity and specificity identified in the current study are likely to limit its usefulness as a stand-alone screening instrument in this population.

中文翻译：

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使用PROMIS抑郁症简易表格（PROMIS-D-SF）筛查年轻的成年癌症幸存者：与结构化临床诊断访谈进行比较。

背景技术进行本研究的目的是评估患者报告的结果测量信息系统抑郁简表（PROMIS-D-SF），作为与结构化诊断访谈相比较的年轻成年癌症幸存者（YACS）的筛查指标。方法共有249例YACS（年龄在18-40岁之间）完成了《精神疾病诊断和统计手册》第四版（SCID）的PROMIS-D-SF和结构化临床访谈。根据SCID，参与者被分类为具有：1）SCID抑郁症诊断；2）没有SCID诊断的抑郁症状；或3）没有抑郁症状。接收器工作特性分析评估了PROMIS-D-SF和SCID的一致性，以及PROMIS-D-SF截止t分数的敏感性和特异性。结果PROMIS-D-SF在抑郁症诊断（曲线下面积0.89）和抑郁症状（曲线下面积0.83）方面与SCID总体上吻合良好。≥53.2的PROMIS-D-SF截断t评分最接近用于检测SCID抑郁诊断的研究标准（敏感性≥0.85，特异性≥0.75），敏感性为0.81，特异性为0.74。为了鉴定具有抑郁症状的幸存者，发现t值截止值为49.4具有稍高的敏感性（0.84）和劣等的特异性（0.64）。在假设的筛查实例中，这些临界值导致漏诊病例的中等水平（15％-19％）和较高比例的临床转诊（SCID标准不需要）（56％-70％）。结论PROMIS-D-SF与SCID所测得的抑郁诊断和症状表现出中等程度的一致性，但截断的t分数不符合临床筛查的研究标准。PROMIS-D-SF可能有助于评估YACS中的抑郁症，但当前研究中确定的敏感性和特异性方面的局限性可能会限制其作为该人群中的独立筛查工具的有效性。