A Prospectively Validated Nomogram for Predicting the Risk of PHQ-9 Score ≥15 in Patients With Erectile Dysfunction: A Multi-Center Study
Background Although erectile dysfunction (ED) often occurs simultaneously with depression, not all patients with ED suffer major depression (MD), with a PHQ-9 score ≥15 indicating MD. Because the PHQ-9 questionnaire includes phrases such as “I think I am a loser” and “I want to commit suicide,” the...
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Published in | Frontiers in public health Vol. 10; p. 836898 |
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Main Authors | , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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17.06.2022
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Abstract | Background
Although erectile dysfunction (ED) often occurs simultaneously with depression, not all patients with ED suffer major depression (MD), with a PHQ-9 score ≥15 indicating MD. Because the PHQ-9 questionnaire includes phrases such as “I think I am a loser” and “I want to commit suicide,” the psychological burdens of ED patients are likely to increase inevitably after using the PHQ-9, which, in turn, may affect ED therapeutic effects. Accordingly, we endeavored to develop a nomogram to predict individual risk of PHQ-9 score ≥15 in these patients.
Methods
The data of 1,142 patients with ED diagnosed in Xijing Hospital and Northwest Women and Children's Hospital from January 2017 to May 2020 were analyzed. While the Least Absolute Shrinkage and Selection Operator regression was employed to screen PHQ-9 score ≥15 related risk factors, multivariate logistic regression analysis was performed to verify these factors and construct the nomogram. The training cohort and an independent cohort that comprised 877 prospectively enrolled patients were used to demonstrate the efficacy of the nomogram.
Results
The IIEF-5 score, PEDT score, physical pain score, frequent urination, and feeling of endless urination were found to be independent factors of PHQ-9 score ≥15 in patients with ED. The nomogram developed by these five factors showed good calibration and discrimination in internal and external validation, with a predictive accuracy of 0.757 and 0.722, respectively. The sensitivity and specificity of the nomogram in the training cohort were 0.86 and 0.52, respectively. Besides, the sensitivity and specificity of the nomogram in the validation cohort were 0.73 and 0.62, respectively. Moreover, based on the nomogram, the sample was divided into low-risk and high-risk groups.
Conclusion
This study established a nomogram to predict individual risk of PHQ-9 score ≥15 in patients with ED. It is deemed that the nomogram may be employed initially to avoid those with a low risk of MD completing questionnaires unnecessarily. |
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AbstractList | Background
Although erectile dysfunction (ED) often occurs simultaneously with depression, not all patients with ED suffer major depression (MD), with a PHQ-9 score ≥15 indicating MD. Because the PHQ-9 questionnaire includes phrases such as “I think I am a loser” and “I want to commit suicide,” the psychological burdens of ED patients are likely to increase inevitably after using the PHQ-9, which, in turn, may affect ED therapeutic effects. Accordingly, we endeavored to develop a nomogram to predict individual risk of PHQ-9 score ≥15 in these patients.
Methods
The data of 1,142 patients with ED diagnosed in Xijing Hospital and Northwest Women and Children's Hospital from January 2017 to May 2020 were analyzed. While the Least Absolute Shrinkage and Selection Operator regression was employed to screen PHQ-9 score ≥15 related risk factors, multivariate logistic regression analysis was performed to verify these factors and construct the nomogram. The training cohort and an independent cohort that comprised 877 prospectively enrolled patients were used to demonstrate the efficacy of the nomogram.
Results
The IIEF-5 score, PEDT score, physical pain score, frequent urination, and feeling of endless urination were found to be independent factors of PHQ-9 score ≥15 in patients with ED. The nomogram developed by these five factors showed good calibration and discrimination in internal and external validation, with a predictive accuracy of 0.757 and 0.722, respectively. The sensitivity and specificity of the nomogram in the training cohort were 0.86 and 0.52, respectively. Besides, the sensitivity and specificity of the nomogram in the validation cohort were 0.73 and 0.62, respectively. Moreover, based on the nomogram, the sample was divided into low-risk and high-risk groups.
Conclusion
This study established a nomogram to predict individual risk of PHQ-9 score ≥15 in patients with ED. It is deemed that the nomogram may be employed initially to avoid those with a low risk of MD completing questionnaires unnecessarily. BackgroundAlthough erectile dysfunction (ED) often occurs simultaneously with depression, not all patients with ED suffer major depression (MD), with a PHQ-9 score ≥15 indicating MD. Because the PHQ-9 questionnaire includes phrases such as “I think I am a loser” and “I want to commit suicide,” the psychological burdens of ED patients are likely to increase inevitably after using the PHQ-9, which, in turn, may affect ED therapeutic effects. Accordingly, we endeavored to develop a nomogram to predict individual risk of PHQ-9 score ≥15 in these patients.MethodsThe data of 1,142 patients with ED diagnosed in Xijing Hospital and Northwest Women and Children's Hospital from January 2017 to May 2020 were analyzed. While the Least Absolute Shrinkage and Selection Operator regression was employed to screen PHQ-9 score ≥15 related risk factors, multivariate logistic regression analysis was performed to verify these factors and construct the nomogram. The training cohort and an independent cohort that comprised 877 prospectively enrolled patients were used to demonstrate the efficacy of the nomogram.ResultsThe IIEF-5 score, PEDT score, physical pain score, frequent urination, and feeling of endless urination were found to be independent factors of PHQ-9 score ≥15 in patients with ED. The nomogram developed by these five factors showed good calibration and discrimination in internal and external validation, with a predictive accuracy of 0.757 and 0.722, respectively. The sensitivity and specificity of the nomogram in the training cohort were 0.86 and 0.52, respectively. Besides, the sensitivity and specificity of the nomogram in the validation cohort were 0.73 and 0.62, respectively. Moreover, based on the nomogram, the sample was divided into low-risk and high-risk groups.ConclusionThis study established a nomogram to predict individual risk of PHQ-9 score ≥15 in patients with ED. It is deemed that the nomogram may be employed initially to avoid those with a low risk of MD completing questionnaires unnecessarily. |
Author | Hou, Guangdong Gao, Ming Wang, Fuli Hou, Niuniu Wei, Di Yuan, Jianlin Zhang, Lei Meng, Ping Zheng, Wanxiang Zhang, Geng Feng, Xiao Zheng, Yu Dun, Xinlong Jannini, Tommaso B. Jannini, Emmanuele A. |
AuthorAffiliation | 1 Department of Urology, Xijing Hospital, Air Force Medical University , Xi'an , China 3 Medical Innovation Center, Air Force Medical University , Xi'an , China 2 Department of Anatomy, Histology and Embryology, Air Force Medical University , Xi'an , China 6 Department of Systems Medicine, University of Rome Tor Vergata , Rome , Italy 5 Department of General Surgery, Eastern Theater Air Force Hospital of PLA , Nanjing , China 4 Department of Andrology, Xi'an Daxing Hospital, Shaanxi University of Chinese Medicine , Xi'an , China |
AuthorAffiliation_xml | – name: 3 Medical Innovation Center, Air Force Medical University , Xi'an , China – name: 6 Department of Systems Medicine, University of Rome Tor Vergata , Rome , Italy – name: 4 Department of Andrology, Xi'an Daxing Hospital, Shaanxi University of Chinese Medicine , Xi'an , China – name: 1 Department of Urology, Xijing Hospital, Air Force Medical University , Xi'an , China – name: 5 Department of General Surgery, Eastern Theater Air Force Hospital of PLA , Nanjing , China – name: 2 Department of Anatomy, Histology and Embryology, Air Force Medical University , Xi'an , China |
Author_xml | – sequence: 1 givenname: Yu surname: Zheng fullname: Zheng, Yu – sequence: 2 givenname: Ming surname: Gao fullname: Gao, Ming – sequence: 3 givenname: Guangdong surname: Hou fullname: Hou, Guangdong – sequence: 4 givenname: Niuniu surname: Hou fullname: Hou, Niuniu – sequence: 5 givenname: Xiao surname: Feng fullname: Feng, Xiao – sequence: 6 givenname: Tommaso B. surname: Jannini fullname: Jannini, Tommaso B. – sequence: 7 givenname: Di surname: Wei fullname: Wei, Di – sequence: 8 givenname: Wanxiang surname: Zheng fullname: Zheng, Wanxiang – sequence: 9 givenname: Lei surname: Zhang fullname: Zhang, Lei – sequence: 10 givenname: Xinlong surname: Dun fullname: Dun, Xinlong – sequence: 11 givenname: Geng surname: Zhang fullname: Zhang, Geng – sequence: 12 givenname: Fuli surname: Wang fullname: Wang, Fuli – sequence: 13 givenname: Ping surname: Meng fullname: Meng, Ping – sequence: 14 givenname: Emmanuele A. surname: Jannini fullname: Jannini, Emmanuele A. – sequence: 15 givenname: Jianlin surname: Yuan fullname: Yuan, Jianlin |
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Copyright | Copyright © 2022 Zheng, Gao, Hou, Hou, Feng, Jannini, Wei, Zheng, Zhang, Dun, Zhang, Wang, Meng, Jannini and Yuan. 2022 Zheng, Gao, Hou, Hou, Feng, Jannini, Wei, Zheng, Zhang, Dun, Zhang, Wang, Meng, Jannini and Yuan |
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Snippet | Background
Although erectile dysfunction (ED) often occurs simultaneously with depression, not all patients with ED suffer major depression (MD), with a PHQ-9... BackgroundAlthough erectile dysfunction (ED) often occurs simultaneously with depression, not all patients with ED suffer major depression (MD), with a PHQ-9... |
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StartPage | 836898 |
SubjectTerms | erectile dysfunction major depression nomogram prognostic factor Public Health risk factor |
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Title | A Prospectively Validated Nomogram for Predicting the Risk of PHQ-9 Score ≥15 in Patients With Erectile Dysfunction: A Multi-Center Study |
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