Background

This study's objective was to assess the diagnostic properties of the Whooley questions in identifying depression among perinatal women according to previously published studies. We conducted a systematic review and meta-analysis of studies investigating the diagnostic accuracy of the Whooley questions in perinatal women.

Methods

Nine databases were searched in October 2021. All primary studies evaluated the diagnostic properties of the Whooley questions compared with a diagnostic gold standard in women during the perinatal period or, if not identified as being in the perinatal stage within the study, women between 20 weeks' gestation to 4 weeks post-delivery. A bivariate mixed-effects meta-analysis was performed to estimate pooled diagnostic properties and measure heterogeneity. Meta-regression was conducted to evaluate factors contributing to heterogeneity.

Results

Six studies were included in the review; five were used in the meta-analysis. The pooled sensitivity (95 % confidence interval) was 0.95 (0.81–0.99), pooled specificity was 0.60 (0.44–0.74), pooled positive likelihood ratio was 2.4 (1.6–3.4), pooled negative likelihood ratio was 0.09 (0.02–0.32), and pooled diagnostic odds ratio was 27 (7–106); heterogeneity was substantial (I² = 0.90, 0.81–1.00). Participant age and setting (community vs. hospital) significantly contributed to heterogeneity.

Conclusions

The Whooley questions have high sensitivity but moderate specificity for perinatal women. The Whooley questions are a short and acceptable tool for identifying depression in perinatal women. However, a potential risk exists of incorrectly identifying a high proportion of women as positive. Using the Whooley questions followed by a secondary case-finding tool could reduce the misdiagnosis risk.

中文翻译：

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Whooley问题诊断特性的荟萃分析以识别围产期妇女的抑郁症

背景

本研究的目的是根据先前发表的研究评估 Whooley 问题在识别围产期妇女抑郁症方面的诊断特性。我们对调查围产期妇女 Whooley 问题诊断准确性的研究进行了系统回顾和荟萃分析。

方法

2021 年 10 月对九个数据库进行了搜索。所有主要研究都评估了 Whooley 问题的诊断特性，并与围产期女性的诊断金标准进行了比较，或者，如果在研究中未确定处于围产期，则为 20 周内的女性' 妊娠至分娩后 4 周。进行了双变量混合效应荟萃分析，以估计汇总的诊断特性并测量异质性。进行元回归以评估导致异质性的因素。

结果

六项研究被纳入审查；五个用于荟萃分析。汇总敏感性（95% 置信区间）为 0.95（0.81-0.99），汇总特异性为 0.60（0.44-0.74），汇总阳性似然比为 2.4（1.6-3.4），汇总阴性似然比为 0.09（0.02-0.32） , 合并诊断优势比为 27 (7–106)；异质性很大（I ²  = 0.90, 0.81–1.00）。参与者年龄和环境（社区与医院）显着导致异质性。

结论

Whooley 问题对围产期妇女的敏感性高，但特异性适中。Whooley 问题是一种简短且可接受的工具，可用于识别围产期妇女的抑郁症。但是，存在错误地将高比例的女性识别为阳性的潜在风险。使用 Whooley 问题和辅助病例发现工具可以降低误诊风险。