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. 2019 Jan 22;7(1):1562860.
doi: 10.1080/20016689.2018.1562860. eCollection 2019.

Results and validation of an index to measure health state of patients with depression in automated healthcare databases

François-Xavier Lamy  1 , Bruno Falissard  2 , Clément François  3 , Christophe Lançon  4 , Pierre Michel Llorca  5 , Adrian Tanasescu  6 , Maëlys Touya  3 , Patrice Verpillat  7 , Alan G Wade  8 , Delphine Saragoussi  7
Affiliations

Results and validation of an index to measure health state of patients with depression in automated healthcare databases

François-Xavier Lamy et al. J Mark Access Health Policy. .

Abstract

Background and objective: A Depressive Health State Index (DHSI) based on 29 parameters routinely collected in an automated healthcare database (AHDB) was developed to evaluate the health state of depressive patients, and its evolution. The study objective was to describe and validate this DHSI. Methods: A historical cohort of patients with at least one episode of depression was identified in the Clinical Practice Research Datalink (CPRD). The DHSI was calculated for each episode of depression. Validation was performed by comparing the DHSI between subgroups and using validated definitions of remission (proxy and PHQ-9). Robustness was studied by assessing the impact of modifying parameters of the DHSI. Results: 309,279 episodes of depression were identified in the CPRD between 1 January 2006 and 31 December 2012. Remission was observed in 8% of the patients showing the lower DHSI scores and in 88% of the patients showing the higher DHSI scores. The DHSI was robust to a modification of the most frequent variables and to the removal of rare parameters. Conclusion: The DHSI is specific to depression severity (with remission rates in accordance with the expected variations of the DHSI) and robust. It represents a promising tool for the analysis of AHDBs.

Keywords: Database; cohort; depression; health state; index; outcome.

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Figures

Figure 1.
Figure 1.
Study design. The index date was the date of the first prescription of antidepressant for a patient meeting the inclusion and exclusion criteria in the database [5].
Figure 2.
Figure 2.
Density histogram of the Depression Health State Index (DHSI).
Figure 3.
Figure 3.
Percentages of remission, relapse and non-remission of the episodes of depression according to the DHSI deciles.
See this image and copyright information in PMC

References

    1. Strom BL, Carson JL.. Use of automated databases for pharmacoepidemiology research. Epidemiol Rev. 1990;12:87–10. - PubMed
    1. Byford S, Barrett B, Despiegel N, et al. Impact of treatment success on health service use and cost in depression: longitudinal database analysis. Pharmacoeconomics. 2011;29(2):157–170. - PubMed
    1. Sicras-Mainar A, Blanca-Tamayo M, Gutierrez-Nicuesa L, et al. Clinical validity of a population database definition of remission in patients with major depression. BMC Public Health. 2010;10:64. - PMC - PubMed
    1. Kelsey JE. Achieving remission in major depressive disorder: the first step to long-term recovery. J Am Osteopath Assoc. 2004;104(3 Suppl. 3):S6–10. - PubMed
    1. Francois C, Tanasescu A, Lamy FX, et al. Creating an index to measure health state of depressed patients in automated healthcare databases: the methodology. J Mark Access Health Policy. 2017;5(1):1372025. - PMC - PubMed

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