We evaluated the usefulness of case-finding instruments for identifying @entity1 with @entity308 or dysthymia in primary care settings using English language literature from Medline, a specialized trials registry and bibliographies of selected papers. Studies were done in primary care settings with unselected @entity1 and compared case-finding instruments with accepted diagnostic criterion standards for @entity308 were selected. A total of 16 case-finding instruments were assessed in 38 studies. More than 32,000 @entity1 received screening with a case-finding instrument; approximately 12,900 of these received criterion standard assessment. Case-finding instruments ranged in length from 1 to 30 questions. Average administration times ranged from less than 2 min to 6 min. Median sensitivity for @entity308 was 85% (range 50% to 97%); median specificity was 74% (range 51% to 98%). No significant differences between instruments were found. However for individual instruments, estimates of sensitivity and specificity varied significantly between studies. For the combined diagnoses of @entity308 or dysthymia, overall sensitivity was 79% (CI, 74% to 83%) and overall specificity 75% (CI, 70% to 81%). Stratified analyses showed no significant effects on overall instrument performance for study methodology, criterion standard choice, or @entity1 characteristics. We found that multiple instruments with reasonable operating characteristics are available to help primary care clinicians identify @entity1 with @entity308 . Because operating characteristics of these instruments are similar, selection of a particular instrument should depend on issues such as feasibility, administration and scoring times, and the instruments' ability to serve additional purposes, such as monitoring severity or response to therapy.

Identifying XXXX in primary care: a literature synthesis of case-finding instruments.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity308 :: ('MESH:D003866', 'Disease') :: ['major depression']
@entity308 :: (MESH:D003866,Disease) :: ['depression']
