Depression screening using the Patient Health Questionnaire‐9 administered on a touch screen computer

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Abstract
Objective: To (1) evaluate the feasibility of touch screen depression screening in cancer patients using the Patient Health Questionnaire‐9 (PHQ‐9), (2) evaluate the construct validity of the PHQ‐9 using the touch screen modality, and (3) examine the prevalence and severity of depression using this screening modality. Methods: The PHQ‐9 was placed in a web‐based survey within a study of the clinical impact of computerized symptom and quality of life screening. Patients in medical oncology, radiation oncology, and hematopoietic stem cell transplantation (HSCT) clinics used the program on a touch screen computer in waiting rooms prior to therapy (T1) and during therapy (T2). Responses of depressed mood or anhedonia (PHQ‐2 cardinal depression symptoms) triggered additional items. PHQ‐9 scores were provided to the oncology team in real time. Results: Among 342 patients enrolled, 33 (9.6%) at T1 and 69 (20.2%) at T2 triggered the full PHQ‐9 by endorsing at least one cardinal symptom. Feasibility was high, with at least 97% completing the PHQ‐2 and at least 96% completing the PHQ‐9 when triggered and a mean completion time of about 2 min. The PHQ‐9 had good construct validity. Medical oncology patients had the highest percent of positive screens (12.9%) at T1, while HSCT patients had the highest percent (30.5%) at T2. Using this method, 21 (6.1%) at T1 and 54 (15.8%) at T2 of the total sample had moderate to severe depression. Conclusions: The PHQ‐9 administered on a touch screen computer is feasible and provides valid depression data in a diverse cancer population. Copyright © 2008 John Wiley & Sons, Ltd.