Real-World Lessons From the Implementation of a Depression Screening Protocol in Acute Myocardial Infarction Patients: Implications For the AHA Depression Screening Advisory

A formal 2-step depression screening protocol implemented at one AMI center did not significantly improve overall depression recognition rates compared with 23 centers without a formal screening proto

Effect: null; 38.3% vs 31.5%

The full PHQ-9 showed substantially better test-retest concordance than the PHQ-2 alone for identifying depressed AMI patients, with moderate agreement (Kappa 0.51) versus only fair agreement (Kappa 0

Effect: improvement; Kappa = 0.51 (PHQ-9) vs Kappa = 0.29 (PHQ-2); CI: 95% CI 42.8%-80.2% (PHQ-9 positive case agreement)

More than one in four eligible AMI patients (26.8%) were not screened for depression despite a mandated quality improvement protocol, with unscreened patients being disproportionately female, having m

Effect: decline; 26.8% not screened (135 of 503)