Effectiveness of Standardized Depression Questionnaires to identify Depression in adult patients with chronic pain Paper
| Evidence level and quality rating: |
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| Article title: Validity of self‐reporting depression in the Tabari cohort study population | Number: 4 |
| Author(s): Zarghami, M., Taghizadeh, F., Moosazadeh, M., Kheradmand, M., & Heydari, K. | Publication date: 19th September 2020 |
| Journal: Neuropsychopharmacology Report | |
| Setting: national cohort, Prospective Epidemiological Research in Iran | Sample (composition and size): 451 |
| Does this evidence address my EBP question?
Yes No-Do not proceed with appraisal of this evidence |
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Is this study:  Struggling to meet your deadline ?Get assistance on Effectiveness of Standardized Depression Questionnaires to identify Depression in adult patients with chronic pain Paper done on time by medical experts. Don’t wait – ORDER NOW! QuaNtitative (collection, analysis, and reporting of numerical data) Go to Section I: QuaNtitative QuaLitative (collection, analysis, and reporting of narrative data) Go to Section II: QuaLitative Mixed methods (results reported both numerically and narratively) Go to Section III: Mixed Methods |
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| Section I: QuaNtitative | ||
| Level of Evidence (Study Design) | ||
| Is this a report of a single research study? | üYes | o No Go to B |
| 1. Was there manipulation of an independent variable? | üYes | No |
| 2. Was there a control group? | üYes | o No |
| 3. Were study participants randomly assigned to the intervention and control groups? | üYes | o No |
| If Yes to questions 1, 2, and 3, this is a randomized controlled trial (RCT) or experimental study. | LEVEL I | |
| If Yes to questions 1 and 2 and No to question 3 or Yes to question 1 and No to questions 2 and 3, this is quasi-experimental. (Some degree of investigator control, some manipulation of an independent variable, lacks random assignment to groups, and may have a control group). |
LEVEL II | |
| If No to questions 1, 2, and 3, this is nonexperimental. (No manipulation of independent variable; can be descriptive, comparative, or correlational; often uses secondary data). |
LEVEL III | |
| Study Findings That Help Answer the EBP Question.
From the analysis, the self-reporting sensitivity and positive predictive value were found to be insufficient and lower compared to the standard BDI-II tool. This shows that the standards tools should be used |
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| Skip to the Appraisal of QuaNtitative Research Studies section | ||
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| Section I: QuaNtitative (continued) | ||||
| Is this a summary of multiple sources of research evidence? | o Yes Continue |
o No Use Appendix F |
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| 1. Does it employ a comprehensive search strategy and rigorous appraisal method?
If this study includes research, nonresearch, and experiential evidence, it is an integrative review (see Appendix F). |
o Yes Continue |
o No Use Appendix F |
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2. For systematic reviews and systematic reviews with meta-analysis |
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| a. Are all studies included RCTs? | LEVEL I | |||
| b. Are the studies a combination of RCTs and quasi-experimental, or quasi-experimental only? | LEVEL II | |||
| c. Are the studies a combination of RCTs, quasi-experimental, and nonexperimental, or non- experimental only? | LEVEL III | |||
| A systematic review employs a search strategy and a rigorous appraisal method, but does not generate an effect size.
A meta-analysis, or systematic review with meta-analysis, combines and analyzes results from studies to generate a new statistic: the effect size. |
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| Study Findings That Help Answer the EBP Question | ||||
| Skip to the Appraisal of Systematic Review (With or Without a Meta-Analysis) section | ||||
| Appraisal of QuaNtitative Research Studies | |||
| Does the researcher identify what is known and not known about the problem and how the study will address any gaps in knowledge? | üYes | o No | |
| Was the purpose of the study clearly presented? | üYes | o No | |
| Was the literature review current (most sources within the past five years or a seminal study)? | üYes | o No | |
| Was sample size sufficient based on study design and rationale? | üYes | o No | |
| If there is a control group:
· Were the characteristics and/or demographics similar in both the control and intervention groups? |
üYes | o No |
N/A |
| · If multiple settings were used, were the settings similar? | o Yes | o No | üN/A |
| · Were all groups equally treated except for the intervention group(s)? | üYes | o No | N/A |
| Are data collection methods described clearly? | üYes | o No | |
| Were the instruments reliable (Cronbach’s a[alpha] > 0.70)? | üYes | o No | N/A |
| Was instrument validity discussed? | üYes | o No | N/A |
| If surveys or questionnaires were used, was the response rate > 25%? |
üYes | o No | N/A |
| Were the results presented clearly? | üYes | o No | |
| If tables were presented, was the narrative consistent with the table content? | üYes | o No | N/A |
| Were study limitations identified and addressed? | üYes | o No | |
| Were conclusions based on results? | üYes | o No | |
| Complete the Quality Rating for QuaNtitative Studies section | |||
| Appraisal of Systematic Review (With or Without Meta-Analysis) | ||
| Were the variables of interest clearly identified? | o Yes | o No |
| Was the search comprehensive and reproducible?
· Key search terms stated |
o Yes | o No |
| · Multiple databases searched and identified | o Yes | o No |
| · Inclusion and exclusion criteria stated | o Yes | o No |
| Was there a flow diagram that included the number of studies eliminated at each level of review? | o Yes | o No |
| Were details of included studies presented (design, sample, methods, results, outcomes, strengths, and limitations)? | o Yes | o No |
| Were methods for appraising the strength of evidence (level and quality) described? | o Yes | o No |
| Were conclusions based on results? | o Yes | o No |
| · Results were interpreted | o Yes | o No |
| · Conclusions flowed logically from the interpretation and systematic review question | o Yes | o No |
| Did the systematic review include a section addressing limitations and how they were addressed? | o Yes | o No |
| Complete the Quality Rating for QuaNtitative Studies section (below) | ||
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| Quality Rating for QuaNtitative Studies |
| Circle the appropriate quality rating below:
A High quality: Consistent, generalizable results; sufficient sample size for the study design; adequate control; definitive conclusions; consistent recommendations based on comprehensive literature review that includes thorough reference to scientific evidence. B Good quality: Reasonably consistent results; sufficient sample size for the study design; some control, and fairly definitive conclusions; reasonably consistent recommendations based on fairly comprehensive literature review that includes some reference to scientific evidence. C Low quality or major flaws: Little evidence with inconsistent results; insufficient sample size for the study design; conclusions cannot be drawn. |
| Section II: QuaLitative | ||||
| Level of Evidence (Study Design) | ||||
Is this a report of a single research study? |
o Yes |
o No |
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| Study Findings That Help Answer the EBP Question
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| Complete the Appraisal of Single QuaLitative Research Study section (below) | ||||
| Appraisal of a Single QuaLitative Research Study | ||
| Was there a clearly identifiable and articulated:
· Purpose? |
❑ Yes | ❑ No |
| · Research question? | ❑ Yes | ❑ No |
| · Justification for method(s) used? | ❑ Yes | ❑ No |
| · Phenomenon that is the focus of the research? | ❑ Yes | ❑ No |
| Were study sample participants representative? | ❑ Yes | ❑ No |
| Did they have knowledge of or experience with the research area? | ❑ Yes | ❑ No |
| Were participant characteristics described? | ❑ Yes | ❑ No |
| Was sampling adequate, as evidenced by achieving saturation of data? | ❑ Yes | ❑ No |
| Data analysis:
· Was a verification process used in every step by checking and confirming with participants the trustworthiness of analysis and interpretation? |
❑ Yes |
❑ No |
| · Was there a description of how data were analyzed (i.e., method), by computer or manually? | ❑ Yes | ❑ No |
| Do findings support the narrative data (quotes)? | ❑ Yes | ❑ No |
| Do findings flow from research question to data collected to analysis undertaken? | ❑ Yes | ❑ No |
| Are conclusions clearly explained? | ❑ Yes | ❑ No |
| Skip to the Quality Rating for QuaLitative Studies section | ||
For summaries of multiple quaLitative research studies (meta-synthesis), was a comprehensive search strategy and rigorous appraisal method used? |
o Yes Level III |
o No go to Appendix F |
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| Study Findings That Help Answer the EBP Question | ||||
| Complete the Appraisal of Meta-Synthesis Studies section (below) | ||||
| Appraisal of Meta-Synthesis Studies | ||
| Were the search strategy and criteria for selecting primary studies clearly defined? | ❑ Yes | ❑ No |
| Were findings appropriate and convincing? | ❑ Yes | ❑ No |
| Was a description of methods used to:
· Compare findings from each study? |
❑ Yes | ❑ No |
| · Interpret data? | ❑ Yes | ❑ No |
| Did synthesis reflect: | ❑ Yes | ❑ No |
| · New insights? | ❑ Yes | ❑ No |
| · Discovery of essential features of phenomena? | ❑ Yes | ❑ No |
| · A fuller understanding of the phenomena? | ❑ Yes | ❑ No |
| Was sufficient data presented to support the interpretations? | ❑ Yes | ❑ No |
| Complete the Quality Rating for QuaLititative Studies section (below) | ||
| Quality Rating for QuaLitative Studies |
| Circle the appropriate quality rating below:
No commonly agreed-on principles exist for judging the quality of quaLitative studies. It is a subjective process based on the extent to which study data contributes to synthesis and how much information is known about the researchers’ efforts to meet the appraisal criteria. For meta-synthesis, there is preliminary agreement that quality assessments should be made before synthesis to screen out poor-quality studies1. A/B High/Good quality is used for single studies and meta-syntheses2. The report discusses efforts to enhance or evaluate the quality of the data and the overall inquiry in sufficient detail; and it describes the specific techniques used to enhance the quality of the inquiry. Evidence of some or all of the following is found in the report: · Transparency: Describes how information was documented to justify decisions, how data were reviewed by others, and how themes and categories were formulated. · Diligence: Reads and rereads data to check interpretations; seeks opportunity to find multiple sources to corroborate evidence. · Verification: The process of checking, confirming, and ensuring methodologic coherence. · Self-reflection and self-scrutiny: Being continuously aware of how a researcher’s experiences, background, or prejudices might shape and bias analysis and interpretations. · Participant-driven inquiry: Participants shape the scope and breadth of questions; analysis and interpretation give voice to those who participated. · Insightful interpretation: Data and knowledge are linked in meaningful ways to relevant literature. C Lower-quality studies contribute little to the overall review of findings and have few, if any, of the features listed for High/Good quality. |
1 https://www.york.ac.uk/crd/SysRev/!SSL!/WebHelp/6_4_ASSESSMENT_OF_QUALITATIVE_RESEARCH.htm
2 Adapted from Polit & Beck (2017).
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| Section III: Mixed Methods | ||
| Level of Evidence (Study Design) | ||
| You will need to appraise both the quaNtitative and quaLitative parts of the study independently, before appraising the study in its entirety. | ||
| 1. Evaluate the quaNitative part of the study using Section I. | Level | Quality |
| Insert here the level of evidence and overall quality for this part: | ||
| 2. Evaluate the quaLitative part of the study using Section II. | Level | Quality |
| Insert here the level of evidence and overall quality for this part: | ||
| 3. To determine the level of evidence, circle the appropriate study design: | ||
| · Explanatory sequential designs collect quaNtitative data first, followed by the quaLitative data; and their purpose is to explain quaNtitative results using quaLitative findings. The level is determined based on the level of the quaNtitative part.
· Exploratory sequential designs collect quaLitative data first, followed by the quaNtitative data; and their purpose is to explain quaLitative findings using the quaNtitative results. The level is determined based on the level of the quaLitative part, and it is always Level III. · Convergent parallel designs collect the quaLitative and quaNtitative data concurrently for the purpose of providing a more complete understanding of a phenomenon by merging both datasets. These designs are Level III. · Multiphasic designs collect quaLitative and quaNtitative data over more than one phase, with each phase informing the next phase. These designs are Level III. |
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| Study Findings That Help Answer the EBP Question | ||
| Complete the Appraisal of Mixed Methods Studies section (below) | ||
| Appraisal of Mixed Methods Studies3 | |||
| Was the mixed-methods research design relevant to address the quaNtitative and quaLitative research questions (or objectives)? | ❑ Yes | ❑ No | ❑ N/A |
| Was the research design relevant to address the quaNtitative and quaLitative aspects of the mixed-methods question (or objective)? | ❑ Yes | ❑ No | ❑ N/A |
| For convergent parallel designs, was the integration of quaNtitative and quaLitative data (or results) relevant to address the research question or objective? | ❑ Yes | ❑ No | ❑ N/A |
| For convergent parallel designs, were the limitations associated with the integration (for example, the divergence of quaLitative and quaNtitative data or results) sufficiently addressed? | ❑ Yes | ❑ No | ❑ N/A |
| Complete the Quality Rating for Mixed-Method Studies section (below) | |||
3 National Collaborating Centre for Methods and Tools. (2015). Appraising Qualitative, Quantitative, and Mixed Methods Studies included in Mixed Studies Reviews: The MMAT. Hamilton, ON: McMaster University. (Updated 20 July, 2015) Retrieved from http://www.nccmt.ca/ resources/search/232
| Quality Rating for Mixed-Methods Studies |
| Circle the appropriate quality rating below
A High quality: Contains high-quality quaNtitative and quaLitative study components; highly relevant study design; relevant integration of data or results; and careful consideration of the limitations of the chosen approach. B Good quality: Contains good-quality quaNtitative and quaLitative study components; relevant study design; moderately relevant integration of data or results; and some discussion of limitations of integration. C Low quality or major flaws: Contains low quality quaNtitative and quaLitative study components; study design not relevant to research questions or objectives; poorly integrated data or results; and no consideration of limits of integration. |
Article summary The study Zarghami et al., 2020 was conducted with the purpose of comparing a self-reporting depression and a standard depression screening tool, BDI-II scoring for screening depression. This was a cross-sectional study with data collected from the Tabari cohort. A standardized questionnaire was used in recruiting participants. To get the sample, a general question of “ Are you depressed?” was asked, where a total of one hundred and fifty-five had a history of depression and, therefore, put as the case group. Three hundred and ten who did not have such a history were placed into the control group. The researchers used questionnaires to collect data. The study findings helped in answering the research question. Negative predictive, positive, false negative, false positive, accuracy, specificity, and sensitivity were calculated as 83.2, 51.8, 41.6, 20.8, 79.1, and 58.4%, respectively, for self-reporting. The self-reporting was found to be insufficient in detecting depression among patients. Therefore, standard instruments like BDI-II should be used. This study had various strengths. For example, the self-reporting protocol used has good average predictive values hence can be applied even in non-depressant people. On the other hand, this study also has limitations. For example, it is possible that patients who were not impacted by moderate or mild depression were not identified as depressed persons, hence biased results.
References
Zarghami, M., Taghizadeh, F., Moosazadeh, M., Kheradmand, M., & Heydari, K. (2020). Validity of self‐reporting depression in the Tabari cohort study population. Neuropsychopharmacology Reports, 40(4), 342-347. https://doi.org/10.1002/npr2.12138
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With new information continually emerging, professional nurses must be equipped to critique scholarly literature and discern its value for practice. Select one current, quantitative scholarly nursing article related to your PICOT question and determine its strengths, limitations, and potential application.
PICOT Question: In adult patients with chronic pain, is the of utilization of standard depression questionnaires more accurate in the diagnosis/identification of depression, in comparison to the use of voluntary self-reporting of depressive symptoms within 30 days of initial inquiry?
Once you’ve completed the tool, use your own words to summarize your appraisal of the article.
Include the following:
Description of the purpose
Explanation of research design
Discussion of sample
Description of data collection methods
Summary of findings
Strengths of the study (minimum of 1)
Limitations of the study (minimum of 1)
Recommendations regarding potential application for future practice that are insightful and appropriate.
Attach the article to your post, in addition to including the full reference for the article in your post.