Accuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis.

<h4>Background</h4>The Geriatric Depression Scale (GDS) is a widely used instrument to assess depression in older adults. The short GDS versions that have four (GDS-4) and five items (GDS-5) represent alternatives for depression screening in limited-resource settings. However, their accu...

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Autores principales:	Ana Brañez-Condorena, David R Soriano-Moreno, Alba Navarro-Flores, Blanca Solis-Chimoy, Mario E Diaz-Barrera, Alvaro Taype-Rondan
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e649c1de7e88431080cdcda4ca4a222f
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spelling	oai:doaj.org-article:e649c1de7e88431080cdcda4ca4a222f2021-12-02T20:09:46ZAccuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis.1932-620310.1371/journal.pone.0253899https://doaj.org/article/e649c1de7e88431080cdcda4ca4a222f2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253899https://doaj.org/toc/1932-6203<h4>Background</h4>The Geriatric Depression Scale (GDS) is a widely used instrument to assess depression in older adults. The short GDS versions that have four (GDS-4) and five items (GDS-5) represent alternatives for depression screening in limited-resource settings. However, their accuracy remains uncertain.<h4>Objective</h4>To assess the accuracy of the GDS-4 and GDS-5 versions for depression screening in older adults.<h4>Methods</h4>Until May 2020, we systematically searched PubMed, PsycINFO, Scopus, and Google Scholar; for studies that have assessed the sensitivity and specificity of GDS-4 and GDS-5 for depression screening in older adults. We conducted meta-analyses of the sensitivity and specificity of those studies that used the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases-10 (ICD-10) as reference standard. Study quality was assessed with the QUADAS-2 tool. We performed bivariate random-effects meta-analyses to calculate the pooled sensitivity and specificity with their 95% confidence intervals (95% CI) at each reported common cut-off. For the overall meta-analyses, we evaluated each GDS-4 version or GDS-5 version separately by each cut-off, and for investigations of heterogeneity, we assessed altogether across similar GDS versions by each cut-off. Also, we assessed the certainty of evidence using the GRADE methodology.<h4>Results</h4>Twenty-three studies were included and meta-analyzed, assessing eleven different GDS versions. The number of participants included was 5048. When including all versions together, at a cut-off 2, GDS-4 had a pooled sensitivity of 0.77 (95% CI: 0.70-0.82) and a pooled specificity of 0.75 (0.68-0.81); while GDS-5 had a pooled sensitivity of 0.85 (0.80-0.90) and a pooled specificity of 0.75 (0.69-0.81). We found results for more than one GDS-4 version at cut-off points 1, 2, and 3; and for more than one GDS-5 version at cut-off points 1, 2, 3, and 4. Mostly, significant subgroup differences at different test thresholds across versions were found. The accuracy of the different GDS-4 and GDS-5 versions showed a high heterogeneity. There was high risk of bias in the index test domain. Also, the certainty of the evidence was low or very low for most of the GDS versions.<h4>Conclusions</h4>We found several GDS-4 and GDS-5 versions that showed great heterogeneity in estimates of sensitivity and specificity, mostly with a low or very low certainty of the evidence. Altogether, our results indicate the need for more well-designed studies that compare different GDS versions.Ana Brañez-CondorenaDavid R Soriano-MorenoAlba Navarro-FloresBlanca Solis-ChimoyMario E Diaz-BarreraAlvaro Taype-RondanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253899 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ana Brañez-Condorena David R Soriano-Moreno Alba Navarro-Flores Blanca Solis-Chimoy Mario E Diaz-Barrera Alvaro Taype-Rondan Accuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis.
description	<h4>Background</h4>The Geriatric Depression Scale (GDS) is a widely used instrument to assess depression in older adults. The short GDS versions that have four (GDS-4) and five items (GDS-5) represent alternatives for depression screening in limited-resource settings. However, their accuracy remains uncertain.<h4>Objective</h4>To assess the accuracy of the GDS-4 and GDS-5 versions for depression screening in older adults.<h4>Methods</h4>Until May 2020, we systematically searched PubMed, PsycINFO, Scopus, and Google Scholar; for studies that have assessed the sensitivity and specificity of GDS-4 and GDS-5 for depression screening in older adults. We conducted meta-analyses of the sensitivity and specificity of those studies that used the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases-10 (ICD-10) as reference standard. Study quality was assessed with the QUADAS-2 tool. We performed bivariate random-effects meta-analyses to calculate the pooled sensitivity and specificity with their 95% confidence intervals (95% CI) at each reported common cut-off. For the overall meta-analyses, we evaluated each GDS-4 version or GDS-5 version separately by each cut-off, and for investigations of heterogeneity, we assessed altogether across similar GDS versions by each cut-off. Also, we assessed the certainty of evidence using the GRADE methodology.<h4>Results</h4>Twenty-three studies were included and meta-analyzed, assessing eleven different GDS versions. The number of participants included was 5048. When including all versions together, at a cut-off 2, GDS-4 had a pooled sensitivity of 0.77 (95% CI: 0.70-0.82) and a pooled specificity of 0.75 (0.68-0.81); while GDS-5 had a pooled sensitivity of 0.85 (0.80-0.90) and a pooled specificity of 0.75 (0.69-0.81). We found results for more than one GDS-4 version at cut-off points 1, 2, and 3; and for more than one GDS-5 version at cut-off points 1, 2, 3, and 4. Mostly, significant subgroup differences at different test thresholds across versions were found. The accuracy of the different GDS-4 and GDS-5 versions showed a high heterogeneity. There was high risk of bias in the index test domain. Also, the certainty of the evidence was low or very low for most of the GDS versions.<h4>Conclusions</h4>We found several GDS-4 and GDS-5 versions that showed great heterogeneity in estimates of sensitivity and specificity, mostly with a low or very low certainty of the evidence. Altogether, our results indicate the need for more well-designed studies that compare different GDS versions.
format	article
author	Ana Brañez-Condorena David R Soriano-Moreno Alba Navarro-Flores Blanca Solis-Chimoy Mario E Diaz-Barrera Alvaro Taype-Rondan
author_facet	Ana Brañez-Condorena David R Soriano-Moreno Alba Navarro-Flores Blanca Solis-Chimoy Mario E Diaz-Barrera Alvaro Taype-Rondan
author_sort	Ana Brañez-Condorena
title	Accuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis.
title_short	Accuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis.
title_full	Accuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis.
title_fullStr	Accuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis.
title_full_unstemmed	Accuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis.
title_sort	accuracy of the geriatric depression scale (gds)-4 and gds-5 for the screening of depression among older adults: a systematic review and meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/e649c1de7e88431080cdcda4ca4a222f
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Accuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis.

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