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Table 5 Diagnostic performance of the 4DSQ and HADS depression scales with respect to detecting any major depressive disorder (prevalence 49%)*

From: Detecting depressive and anxiety disorders in distressed patients in primary care; comparative diagnostic accuracy of the Four-Dimensional Symptom Questionnaire (4DSQ) and the Hospital Anxiety and Depression Scale (HADS)

4DSQ depression sensitivity specificity PPV NPV
≥1 0.96 0.34 0.59 0.89
≥2 0.88 0.46 0.62 0.80
≥3 0.78 0.60 0.66 0.74
≥4 0.65 0.72 0.69 0.68
≥5 0.53 0.79 0.71 0.63
≥6 0.45 0.83 0.71 0.60
≥7 0.32 0.87 0.71 0.57
≥8 0.25 0.92 0.75 0.56
≥9 0.18 0.93 0.72 0.54
≥10 0.12 0.97 0.78 0.53
HADS depression
≥7 0.97 0.30 0.57 0.92
≥8 0.93 0.39 0.60 0.84
≥9 0.88 0.49 0.63 0.81
≥10 0.84 0.60 0.68 0.80
11 0.75 0.67 0.69 0.73
≥12 0.60 0.75 0.70 0.65
≥13 0.49 0.78 0.69 0.61
14 0.40 0.88 0.77 0.60
≥15 0.32 0.89 0.73 0.57
≥16 0.21 0.93 0.74 0.55
≥17 0.16 0.96 0.79 0.54
  1. * For each scale three cut-off points are highlighted in bold type: the optimal cut-off point with the best balance between sensitivity and specificity, the best lower cut-off point with a sensitivity ≥0.85, and the best higher cut-off point with a specificity ≥0.85
  2. 4DSQ = Four-Dimensional Symptom Questionnaire
  3. HADS = Hospital Anxiety and Depression Scale
  4. PPV = positive predictive value
  5. NPV = negative predictive value