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Table 6 Diagnostic performance of the 4DSQ and HADS depression scales with respect to detecting moderate and severe major depressive disorder (prevalence 26%)*

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
≥2 0.96 0.38 0.36 0.97
≥3 0.87 0.52 0.39 0.92
≥4 0.78 0.65 0.45 0.89
≥5 0.64 0.73 0.46 0.85
≥6 0.59 0.79 0.51 0.84
≥7 0.46 0.87 0.55 0.82
≥8 0.39 0.91 0.61 0.81
≥9 0.27 0.93 0.58 0.78
≥10 0.21 0.97 0.70 0.77
HADS depression     
≥8 0.96 0.30 0.33 0.96
≥9 0.91 0.38 0.35 0.92
≥10 0.87 0.48 0.37 0.91
≥11 0.81 0.56 0.40 0.89
≥12 0.64 0.65 0.40 0.84
≥13 0.56 0.72 0.42 0.82
≥14 0.49 0.82 0.49 0.82
≥15 0.39 0.85 0.48 0.79
≥16 0.27 0.90 0.50 0.77
≥17 0.22 0.95 0.59 0.77
  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