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Quality of Life Research

, Volume 19, Issue 8, pp 1105–1113 | Cite as

Using the Short Form-36 mental summary score as an indicator of depressive symptoms in patients with coronary heart disease

  • Rosanna TavellaEmail author
  • Tracy Air
  • Graeme Tucker
  • Robert Adams
  • John F. Beltrame
  • Geoffrey Schrader
Article

Abstract

Background

Depression is common in patients with cardiac disease; however, the use of depression-specific health instruments is limited by their increased responder and analyst burden. The study aimed to define a threshold value on the Short Form-36 (SF-36) mental component summary score (MCS) that identified depressed cardiac patients as measured by the Centre for Epidemiologic Studies Depression Scale (CES-D).

Methods

An optimal threshold was determined using receiver-operating characteristic (ROC) curves on SF-36 and CES-D data from a large cardiac cohort (N = 1,221). The performance of this threshold was evaluated in a further two cardiac populations.

Results

In the index cohort, an SF-36 MCS score of ≤45 was revealed as an optimal threshold according to maximal Youden Index, with high sensitivity (77%, 95% CI = 74–80%) and specificity (73%, 95% CI = 69–77%). At this threshold, in a second sample of hospital cardiac patients, sensitivity was 93% (95% CI = 76–99%) and specificity was 64% (95% CI = 49–77%). In a final sample generated from a community population, specificity was 100% (95% CI = 85–100%) and sensitivity was 68% (95% CI = 61–74%) at the cut-off of 45.

Conclusion

The SF-36 MCS may be a useful research tool to aid in the classification of cardiac patients according to the presence or absence of depressive symptoms.

Keywords

Coronary heart disease Short-Form 36 mental summary score Centre for Epidemiologic Studies Depression Scale Depression Optimal threshold 

Abbreviations

AUC

Area under the curve

CABG

Coronary artery bypass grafting

CAD

Coronary artery disease

CES-D

Centre for Epidemiologic Studies Depression Scale

CHD

Coronary heart disease

DM

Diabetes mellitus

HRQoL

Health-related quality of life

HT/Chol

Hypertension and/or high cholesterol

IDACC

Identifying depression as a comorbid condition

NPV

Negative predictive value

NWAHS

North West Adelaide Health Service

PCI

Percutaneous coronary intervention

PPV

Positive predictive value

ROC

Receiver-operating characteristic

SF-36

Short-Form 36

SF-36 MCS

Short-Form 36 mental summary score

SF-36 PCS

Short-Form 36 physical summary score

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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Rosanna Tavella
    • 1
    Email author
  • Tracy Air
    • 2
  • Graeme Tucker
    • 4
  • Robert Adams
    • 3
  • John F. Beltrame
    • 1
  • Geoffrey Schrader
    • 2
  1. 1.Cardiology Research Unit, The Queen Elizabeth HospitalUniversity of AdelaideAdelaideAustralia
  2. 2.Discipline of PsychiatryUniversity of AdelaideAdelaideAustralia
  3. 3.Discipline of MedicineUniversity of AdelaideAdelaideAustralia
  4. 4.Health Statistics UnitDepartment of HealthAdelaideAustralia

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