Test Characteristics

 

The Whooley Questions are used as a screening tool for major depressive disorder. A no response to both questions (negative test) essentially rules out depression, and a yes response to one or both questions (positive test) identifies virtually all persons who may benefit from further evaluation. Importantly, less than half of patients who test positive on the Whooley Questions will actually have a major depressive disorder. Thus, a positive test does not establish the diagnosis of depression or determine which patients would benefit from treatment.

 

 

At least ten studies have compared the test characteristics of the “Whooley Questions” with a gold standard diagnostic interview for depression. In a formal meta-analysis, Bosanquet and colleagues found that the pooled sensitivity for a cut point of at least 1 (out of 2 possible points) was 0.95 (95% Confidence Interval, 0.88-0.97), and the pooled specificity was 0.65 (95% Confidence Interval, 0.56-0.74). This means that the probability of a major depressive disorder in patients who test negative on the Whooley Questions is negligible (i.e., there are few false negatives), but there are many false positives.