Developing a common metric for depression across adulthood: Linking PROMIS depression with the Edinburgh Postnatal Depression Scale.

Abstract

Depression is a leading mental health concern across the U.S. and worldwide. There are myriad assessments to evaluate depressive symptoms, including the Edinburgh Postnatal Depression Scale (EPDS), which is widely used to evaluate women’s pre- and postnatal depression but not as prevalent at other timepoints in adulthood, limiting its utility for longitudinal research. As part of the National Institutes of Health’s (NIH) Environmental influences on Child Health Outcomes (ECHO) Research Program, the current study sought to develop a common metric so that scores on the EPDS can be converted to the standardized Patient-Reported Measurement Information System (PROMIS®) T-score metric. Drawing on data from the ECHO—Prenatal Alcohol in SIDS and Stillbirth cohort, this study used a single-group linking design, where 1,263 mothers completed the EPDS and PROMIS-Depression measures at the same time. Score linking was conducted using equipercentile and item response theory (IRT) methods. Results showed both linking methods provide robust, congruent results, and subgroup invariance held across age, race, ethnicity, education, and geographic location. The IRT-based unidimensional fixed-parameter calibration was selected due to its model simplicity, and a crosswalk table was established to convert scores from the EPDS to PROMIS T-scores. Overall, this study provides a way to aggregate data across various depression measures and timepoints, such that researchers and clinicians now have the ability to directly compare and combine EPDS data with PROMIS and other depression measures already score-linked to PROMIS.

Prenatal PFAS and psychosocial stress exposures in relation to fetal growth in two pregnancy cohorts: Applying environmental mixture methods to chemical and non-chemical stressors

“…Depression was assessed using the Center for Epidemiologic Studies-Depression (CES-D) scale in CIOB and the Edinburg Postnatal Depression Scale (EPDS) in IKIDS ( Radloff, 1977 ; Cox et al, 1987 ). Depression scores were similarly converted to t-scores by using crosswalk tables to convert non-PROMIS measures to scores on the PROMIS Emotional Distress—Depression: Short Form T-score metric ( Blackwell et al, 2021 ). Content analyses revealed substantial overlap between the PROMIS and the EPDS and CES-D, and scores were highly correlated indicating that linkage was appropriate ( r = 0.81 and 0.94 for EPDS and CES-D, respectively) ( Blackwell et al, 2021 ).…”

“…Depression scores were similarly converted to t-scores by using crosswalk tables to convert non-PROMIS measures to scores on the PROMIS Emotional Distress—Depression: Short Form T-score metric ( Blackwell et al, 2021 ). Content analyses revealed substantial overlap between the PROMIS and the EPDS and CES-D, and scores were highly correlated indicating that linkage was appropriate ( r = 0.81 and 0.94 for EPDS and CES-D, respectively) ( Blackwell et al, 2021 ). Higher PSS t-scores and higher depression t-scores indicate higher perceived stress and depression levels, respectively.…”

Gestational diabetes mellitus, prenatal maternal depression, and risk for postpartum depression: an Environmental influences on Child Health Outcomes (ECHO) Study

“…PROMIS-D cutoff scores were derived from item response theory (IRT)-based differential item function (DIF) analyses suggesting specific cutoffs based on the original assessment scale harmonized to PROMIS-D T-scores (see supplement ). In the absence of IRT based cutoff scores, a PROMIS-D T-score cutoff of 60 or higher was utilized to indicate clinical levels of depression based on existing literature [ 33 – 35 ].…”

Can a linking crosswalk table be applied to a different population? An independent validation study for a crosswalk between BSI depression and PROMIS depression scales

“…PRO linking studies are often based on data from a single patient or general population sample [ 16 , 28 , 30 , 32 , 33 ]. As stated above, the linking results may be variable across different samples [ 17 ]; therefore, to better facilitate comparative clinical research and practice in terms of generalizability, linking researchers have recommended validation of linking crosswalks in multiple samples [ 15 , 16 , 31 , 34 ]. Hence, it is important to investigate if the linking of two PROMs derived from one patient group can be applicable to another group.…”

“…For this reason, the group invariance assumption should be investigated for each linking analysis. Several linking studies [16,[28][29][30][31] have computed the standardized root-mean-square deviation (RMSD) to evaluate subpopulation invariance [25] to determine if the linking relationship performs differently in diverse samples. However, this calculation is limited to the subpopulation groups existing in the analyzed dataset.…”