Research Question: Is Beck’s Depression Inventory Scale – Visayan (BDI-Visayan) an accurate and reliable depression screening tool among ambulatory hemodialysis patients validated against Semi-structured Clinical Interview for Depression for DSM IV? Background: Depressed dialysis patients are twice likely to die or require hospitalization. Unfortunately, there is a lack of a depression screening tool validated for Filipino patients. Objectives: Development and validation of Beck’s Depression Inventory Scale -Visayan version as a depression screening tool for ambulatory maintenance hemodialysis Filipino patients. General Study Design: This is a cross-cultural instrument translation and cross-sectional validation study. Participants: Using non-probability convenient sampling, patients >18years old with eGFR <60mL/min/1.73m2 based on CKD-Epi equation and on hemodialysis for ≥3 months were enrolled. Patients with hearing, speech or cognitive deficits, acute kidney injury, dementia, delirium or psychiatric disorders were excluded. Interventions: BDI Visayan was developed using combined translation technique with depression defined as a score of ≥14. Outcome measures: Structured Clinical Interview for Depression (SCID) for DSM IV was used as the gold standard. Analysis: Sensitivity, specificity, predictive values, and likelihood ratios of BDI-Visayan were compared to SCID. Cronbach’s alpha, Receiver Operator Characteristics and Area Under the Curve were used to determine reliability, optimal cut-off score, and overall accuracy, respectively. Results: BDI-Visayan has high reliability with Cronbach’s alpha of 0.904 and an accuracy of 0.80 AUC. The optimal cut-off for BDI-Visayan for major depressive disorder for ambulatory hemodialysis patients is 20 with 75% sensitivity, 55% specificity, 22% positive predictive value, 93% negative predictive value, 3.92 positive likelihood ratio, and 0.31 negative likelihood ratio. Conclusions BDI Visayan is a reliable and accurate depression screening tool for ambulatory maintenance hemodialysis Filipino patients with higher specificity at an optimum cut-off score of 20.
Humans ; Depressive Disorder, Major ; Renal Dialysis