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J Am Board Fam Med. 2017 May-Jun;30(3):281-287. doi: 10.3122/jabfm.2017.03.160313.

Prediction of Primary Care Depression Outcomes at Six Months: Validation of DOC-6 ©.

Author information

1
From the Departments of Family Medicine (KBA, GMG, CAG), Information Technology (DWC), and Psychiatry and Psychology, Division of Integrated Behavioral Health (CAG, DJK), Mayo Clinic, Rochester, MN; and the Department of Family Medicine, Mayo Clinic, Zumbrota (EWC). angstman.kurt@mayo.edu.
2
From the Departments of Family Medicine (KBA, GMG, CAG), Information Technology (DWC), and Psychiatry and Psychology, Division of Integrated Behavioral Health (CAG, DJK), Mayo Clinic, Rochester, MN; and the Department of Family Medicine, Mayo Clinic, Zumbrota (EWC).

Abstract

BACKGROUND:

The goal of this study was to develop and validate an assessment tool for adult primary care patients diagnosed with depression to determine predictive probability of clinical outcomes at 6 months.

METHODS:

We retrospectively reviewed 3096 adult patients enrolled in collaborative care management (CCM) for depression. Patients enrolled on or before December 31, 2013, served as the training set (n = 2525), whereas those enrolled after that date served as the preliminary validation set (n = 571).

RESULTS:

Six variables (2 demographic and 4 clinical) were statistically significant in determining clinical outcomes. Using the validation data set, the remission classifier produced the receiver operating characteristics (ROC) curve with a c-statistic or area under the curve (AUC) of 0.62 with predicted probabilities than ranged from 14.5% to 79.1%, with a median of 50.6%. The persistent depressive symptoms (PDS) classifier produced an ROC curve with a c-statistic or AUC of 0.67 and predicted probabilities that ranged from 5.5% to 73.1%, with a median of 23.5%.

CONCLUSIONS:

We were able to identify readily available variables and then validated these in the prediction of depression remission and PDS at 6 months. The DOC-6 tool may be used to predict which patients may be at risk for worse outcomes.

KEYWORDS:

Depression; Primary Health Care; ROC Curve; Retrospective Studies

PMID:
28484060
DOI:
10.3122/jabfm.2017.03.160313
[Indexed for MEDLINE]
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