Assessing the depression risk in the U.S. adults using nomogram

医学 列线图 逻辑回归 萧条(经济学) 婚姻状况 生物统计学 队列 流行病学 病人健康调查表 人口学 精神科 环境卫生 人口 内科学 焦虑 抑郁症状 经济 社会学 宏观经济学
作者
Yafeng Zhang,Wei Tian,Xinhao Han,Guangcan Yan,Yuanshuo Ma,Shan Huo,Yu Shi,Shanshan Dai,Xin Ni,Zhe Li,Lihua Fan,Qiuju Zhang
出处
期刊:BMC Public Health [Springer Nature]
卷期号:22 (1) 被引量:8
标识
DOI:10.1186/s12889-022-12798-6
摘要

Abstract Background Depression has received a lot of attention as a common and serious illness. However, people are rarely aware of their current depression risk probabilities. We aimed to develop and validate a predictive model applicable to the risk of depression in US adults. Methods This study was conducted using the database of the National Health and Nutrition Examination Survey (NHANES, 2017–2012). In particular, NHANES (2007–2010) was used as the training cohort ( n = 6015) for prediction model construction and NHANES (2011–2012) was used as the validation cohort ( n = 2812) to test the model. Depression was assessed (defined as a binary variable) by the Patient Health Questionnaire (PHQ-9). Socio-demographic characteristics, sleep time, illicit drug use and anxious days were assessed using a self-report questionnaire. Logistic regression analysis was used to evaluate independent risk factors for depression. The nomogram has the advantage of being able to visualize complex statistical prediction models as risk estimates of individualized disease probabilities. Then, we developed two depression risk nomograms based on the results of logistic regression. Finally, several validation methods were used to evaluate the prediction performance of nomograms. Results The predictors of model 1 included gender, age, income, education, marital status, sleep time and illicit drug use, and model 2, furthermore, included anxious days. Both model 1 and model 2 showed good discrimination ability, with a bootstrap-corrected C index of 0.71 (95% CI, 0.69–0.73) and 0.85 (95% CI, 0.83–0.86), and an externally validated C index of 0.71 (95% CI, 0.68–0.74) and 0.83 (95% CI, 0.81–0.86), respectively, and had well-fitted calibration curves. The area under the receiver operating characteristic curve (AUC) values of the models with 1000 different weighted random sampling and depression scores of 10–17 threshold range were higher than 0.7 and 0.8, respectively. Calculated net reclassification improvement (NRI) and integrated discrimination improvement (IDI) showed the discrimination or accuracy of the prediction models. Decision curve analysis (DCA) demonstrated that the depression models were practically useful. The network calculators work for participants to make personalized predictions. Conclusions This study presents two prediction models of depression, which can effectively and accurately predict the probability of depression as well as helping the U.S. civilian non-institutionalized population to make optimal treatment decisions.
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