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Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
These are tumultuous times for policing in America. Deadly use of force by the police in large and small cities across the United States has led to protests, riots, and heated debates. Public criticism of policing, however, goes well beyond use of deadly force.
Technological advances in law enforcement can serve many goals related to both police accountability and public safety, but these advances also create a new set of issues and unintended consequences that policymakers should consider.
The Cambridge Handbook of Policing in the United States provides a comprehensive collection of essays on police and policing, written by leading experts in political theory, sociology, criminology, economics, law, public health, and critical theory. It unveils a range of experiences - from the police chief of a major metropolitan force to ordinary people targeted for policing on the street - and asks important questions about whether and why we need the police, before analyzing the law of policing, police use of force, and police violence, paying particular attention to the issue of discrimination against marginalized and vulnerable communities at the blunt end of police interference. The book also discusses technological innovations and proposals for reform. Written in accessible language, this interdisciplinary work will be a valuable resource for anyone interested in understanding the present and future of policing in the United States.
Our goal in the Cambridge Handbook of Policing in the United States is to provide a variety of different perspectives on the types of police organization, practice of policing, and the law of the police in the United States.