BackgroundDepression is a major cause of chronic ill-health and is managed in primary care. Indicators on depression severity assessment were introduced into the UK Quality and Outcomes Framework (QOF) in 2006 and 2009. QOF is a pay-forperformance scheme and indicators should have evidence to support their use; potential unintended consequences should also have been considered. AimTo review the effectiveness of routine assessment of depression severity using structured tools in primary care, and to determine the views of GPs and patients regarding their use. DesignSystematic review. MethodStudies were identified by searching electronic databases; study selection, data abstraction, and quality assessment were carried out by one reviewer, with checks from other authors and GRADE (grading of recommendations, assessment, development and evaluation) tables completed for included effectiveness studies. ResultsEight studies met the eligibility criteria. There was very low-quality evidence that assessing severity in a structured way at diagnosis using a validated tool led to interventions that were appropriate to the severity of depression. Patients and GPs had different perceptions of the assessment of depression at diagnosis, with patients being more positive. GPs highlighted unintended consequences. There was low-quality evidence that structured assessment at follow-up led to increased rates of remission and response, but changes to management were not seen. Patients used this assessment to measure their own response to treatment. ConclusionAny estimate of the effect of structured assessment of depression severity in UK general practice is uncertain. GPs consider routine use of questionnaires as incentivised by the QOF has unintended consequences, which could adversely affect patient care.

Objectives To work collaboratively with senior researchers to develop compelling cases for actions that could be taken to address the most significant gaps between research evidence and health policy/practice in Australia. Methods Faculty members will search literature, consult with stakeholder networks and debate issues in developing a paper of published evidence, recommending actions to address each prioritised gap and providing the rationale for prioritisation. Steering Groups will oversee the development of each Case for Action. Results This presentation will share the experiences and lessons learnt to-date in developing Cases for Action. Discussion There is a gap between what we know and what we do. Cases for Action will draw on the combined expertise of researchers to systematically consider and prioritise actions to best address these gaps. Possible actions that could be proposed include advice to government about health policy, clinical or public health guidelines, or opportunities to collaborate with strategic partners to leverage investment in health or to provide support in the implementation of heath strategies. Implications for Guideline Developers/Users The lessons learnt from the Cases for Action process will benefit attendees who are considering how to focus their effort to ensure that healthcare policy and practice best reflects available evidence.