Abstract：
BACKGROUND: This study\'s objective was to assess the diagnostic properties of the Whooley questions in identifying depression among perinatal women according to previously published studies. We conducted a systematic review and meta-analysis of studies investigating the diagnostic accuracy of the Whooley questions in perinatal women.
METHODS: Nine databases were searched in October 2021. All primary studies evaluated the diagnostic properties of the Whooley questions compared with a diagnostic gold standard in women during the perinatal period or, if not identified as being in the perinatal stage within the study, women between 20 weeks\' gestation to 4 weeks post-delivery. A bivariate mixed-effects meta-analysis was performed to estimate pooled diagnostic properties and measure heterogeneity. Meta-regression was conducted to evaluate factors contributing to heterogeneity.
RESULTS: Six studies were included in the review; five were used in the meta-analysis. The pooled sensitivity (95 % confidence interval) was 0.95 (0.81-0.99), pooled specificity was 0.60 (0.44-0.74), pooled positive likelihood ratio was 2.4 (1.6-3.4), pooled negative likelihood ratio was 0.09 (0.02-0.32), and pooled diagnostic odds ratio was 27 (7-106); heterogeneity was substantial (I2 = 0.90, 0.81-1.00). Participant age and setting (community vs. hospital) significantly contributed to heterogeneity.
CONCLUSIONS: The Whooley questions have high sensitivity but moderate specificity for perinatal women. The Whooley questions are a short and acceptable tool for identifying depression in perinatal women. However, a potential risk exists of incorrectly identifying a high proportion of women as positive. Using the Whooley questions followed by a secondary case-finding tool could reduce the misdiagnosis risk.
METHODS: Nine databases were searched in October 2021. All primary studies evaluated the diagnostic properties of the Whooley questions compared with a diagnostic gold standard in women during the perinatal period or, if not identified as being in the perinatal stage within the study, women between 20 weeks\' gestation to 4 weeks post-delivery. A bivariate mixed-effects meta-analysis was performed to estimate pooled diagnostic properties and measure heterogeneity. Meta-regression was conducted to evaluate factors contributing to heterogeneity.
RESULTS: Six studies were included in the review; five were used in the meta-analysis. The pooled sensitivity (95 % confidence interval) was 0.95 (0.81-0.99), pooled specificity was 0.60 (0.44-0.74), pooled positive likelihood ratio was 2.4 (1.6-3.4), pooled negative likelihood ratio was 0.09 (0.02-0.32), and pooled diagnostic odds ratio was 27 (7-106); heterogeneity was substantial (I2 = 0.90, 0.81-1.00). Participant age and setting (community vs. hospital) significantly contributed to heterogeneity.
CONCLUSIONS: The Whooley questions have high sensitivity but moderate specificity for perinatal women. The Whooley questions are a short and acceptable tool for identifying depression in perinatal women. However, a potential risk exists of incorrectly identifying a high proportion of women as positive. Using the Whooley questions followed by a secondary case-finding tool could reduce the misdiagnosis risk.
摘要：
背景：本研究的目的是根据先前发表的研究，评估Wooley问题在确定围产期妇女抑郁症中的诊断特性。我们对围产期妇女中Wooley问题的诊断准确性进行了系统评价和荟萃分析。
方法：2021年10月检索了9个数据库。所有主要研究都评估了Wooley问题的诊断特性，与围产期女性的诊断金标准相比，如果在研究中未确定为处于围产期，妊娠20周至分娩后4周的女性。进行了双变量混合效应荟萃分析，以评估合并的诊断特性并测量异质性。进行元回归以评估导致异质性的因素。
结果：6项研究纳入综述，5项纳入荟萃分析。合并灵敏度(95%置信区间)为0.95(0.81-0.99)，合并特异性为0.60（0.44-0.74），合并正似然比为2.4（1.6-3.4），合并负似然比为0.09（0.02-0.32），合并诊断比值比为27(7-106);异质性显著(I2=0.90,0.81-1.00).参与者年龄和背景(社区与医院)显著促成了异质性。
结论：Wooley问题对围产期妇女具有较高的敏感性，但具有中等的特异性。Whooley问题是识别围产期妇女抑郁症的简短且可接受的工具。然而,存在错误地将高比例的女性识别为阳性的潜在风险。使用Wooley问题，然后使用辅助病例发现工具可以降低误诊风险。
方法：2021年10月检索了9个数据库。所有主要研究都评估了Wooley问题的诊断特性，与围产期女性的诊断金标准相比，如果在研究中未确定为处于围产期，妊娠20周至分娩后4周的女性。进行了双变量混合效应荟萃分析，以评估合并的诊断特性并测量异质性。进行元回归以评估导致异质性的因素。
结果：6项研究纳入综述，5项纳入荟萃分析。合并灵敏度(95%置信区间)为0.95(0.81-0.99)，合并特异性为0.60（0.44-0.74），合并正似然比为2.4（1.6-3.4），合并负似然比为0.09（0.02-0.32），合并诊断比值比为27(7-106);异质性显著(I2=0.90,0.81-1.00).参与者年龄和背景(社区与医院)显著促成了异质性。
结论：Wooley问题对围产期妇女具有较高的敏感性，但具有中等的特异性。Whooley问题是识别围产期妇女抑郁症的简短且可接受的工具。然而,存在错误地将高比例的女性识别为阳性的潜在风险。使用Wooley问题，然后使用辅助病例发现工具可以降低误诊风险。
