Background In individuals with chronic obstructive pulmonary disease (COPD), anxiety and depression contribute to increased mortality and exacerbations, decreased physical functioning, and deteriorated health-related quality of life. The Hospital Anxiety and Depression Scale (HADS) is a patient-reported tool developed to measure symptoms of anxiety and depression in clinical settings. The HADS has been frequently used with individuals with COPD; however, its measurement properties lack critical appraisal in this population. Objective This review aims to summarize and critically appraise the validity, reliability, and responsiveness of the HADS in individuals with COPD. Methods Five electronic databases (MEDLINE, Embase, Scopus, PsychINFO, and Web of Science) will be systematically searched. Articles will be included if they assessed the measurement properties of the HADS in COPD; were published in a peer-reviewed journal; and were written in English. The COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) guidelines will be used to assess the methodological quality and level of evidence in the selected studies. Results To date, 12 articles met the inclusion criteria and will be included in the systematic review. The results of the psychometric properties of HADS will be qualitatively summarized and compared against the criteria for good measurement properties. The overall quality of evidence will be graded using the modified Grading of Recommendations, Assessment, Development and Evaluation approach. We expect to complete the systematic review by December 2022. Conclusions This systematic review will be the first to evaluate the psychometric properties of the HADS in individuals with COPD. Given the negative impact of anxiety and depression on physical functioning and health-related quality of life, this systematic review provides an opportunity to use the HADS as a validated measurement tool for the assessment and treatment of anxiety and depression in individuals with COPD. Trial Registration PROSPERO CRD42022302064; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=302064 International Registered Report Identifier (IRRID) PRR1-10.2196/37854

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BACKGROUND In individuals with Chronic Obstructive Pulmonary Disease (COPD), anxiety and depression contribute to increased mortality and exacerbations, decreased physical functioning, and deteriorated health-related quality of life (HRQoL). The Hospital Anxiety and Depression Scale (HADS) is a patient-reported tool developed to measure symptoms of anxiety and depression in clinical settings. The HADS has been frequently used with individuals with COPD, however, its measurement properties lack critical appraisal in this population. OBJECTIVE To summarize and critically appraise the validity, reliability, and responsiveness of the HADS in individuals with COPD. METHODS Five electronic databases (MEDLINE, EMBASE, Scopus, PsychINFO, and Web of Science) will be systematically searched. Articles will be included if they assessed the measurement properties of the HADS in COPD, published in a peer-reviewed journal, and written in English, Arabic, Portuguese, or French. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines will be used to assess the methodological quality and level of evidence in the selected studies. RESULTS The results of the psychometric properties of HADS will be qualitatively summarized and compared against the criteria for good measurement properties. The overall quality of evidence will be graded using the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. CONCLUSIONS This systematic review will be the first to evaluate the psychometric properties of the HADS in individuals with COPD. Given the negative impact of anxiety and depression on physical functioning and HRQoL, this systematic review provides an opportunity to utilize the HADS as a validated measurement tool for the assessment and treatment of anxiety and depression in individuals with COPD. CLINICALTRIAL Protocol registration #: Under review with the International Prospective Register of Systematic Reviews (PROSPERO).