J Korean Neuropsychiatr Assoc.  2016 Aug;55(3):234-244. 10.4306/jknpa.2016.55.3.234.

Measurement of Depression in Breast Cancer Patients by Using a Mobile Application : A Feasibility and Reliability Study

• Sim Y
• Sohn G
• Son BH
• Ahn SH
• Lee JW
• Shin YW

• KMID: 2351550
• DOI: http://doi.org/10.4306/jknpa.2016.55.3.234

Abstract

OBJECTIVES
This study examined feasibility and reliability of a mobile application to measure depression in breast cancer patients.
METHODS
Forty-two breast cancer patients from the Department of Surgery at Asan Medical Center were included in the study. The Beck Depression Inventory (BDI), EuroQol Five Dimensional Questionnaire, and EuroQol Visual Analogue Scale were assessed at baseline and twice after surgery at regular intervals. The Patient Health Questionnaire-9 (PHQ-9) was delivered by as a push notification via mobile application every two weeks for 12 months. Feasibility was calculated using number of respondents and total number of PHQ-9 completed. Reliability was calculated from the relationship between PHQ-9 and BDI scores obtained within each two week period. Agreement between PHQ-9 and BDI scores in the diagnosis of depression was evaluated by kappa statistic and McNemar's test.
RESULTS
One thousand and ninety-two notifications for PHQ-9 were sent, and 622 responses were reported (compliance rate=57%). The compliance rate was not related to demographic factors except for the date of the first use of the application. Pearson's r between PHQ-9 and BDI scores was 0.599 (p<0.001), and kappa analysis demonstrated moderate level of agreement in diagnosis of depression (κ=0.431).
CONCLUSION
The compliance rate for patients reporting their symptoms by mobile application is high and the scores of PHQ-9 and BDI are correlated, which suggests that the mobile data measuring depression is reliable. However, this is a preliminary study and further study is needed to determine other factors that influence compliance rate.

Keyword

Depression; Breast cancer; Mobile applications; Feasibility studies; Reliability

MeSH Terms

Breast Neoplasms*
Breast*
Chungcheongnam-do
Compliance
Demography
Depression*
Diagnosis
Feasibility Studies
Humans
Mobile Applications*
Surveys and Questionnaires

Figure

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  Fig. 1 Pit-a-Pat application showing psychological status. A: Sleep. B: Mood. C: Anxiety. All contents are in Korean. English caption is added for foreign readers.

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  Fig. 2 PHQ-9 in Pit-a-Pat application. All contents are originally in Korean. English caption is added for foreign readers. PHQ-9 : Patient Health Questionnaire-9.

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  Fig. 3 The process flowchart for selecting the study participants.

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  Fig. 4 Histogram of numbers of PHQ-9 completed. PHQ-9 : Patient Health Questionnaire-9.

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  Fig. 5 Changes in number of respondents to the PHQ-9 with time. PHQ-9 : Patient Health Questionnaire-9.

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  Fig. 6 Scatter plot showing the relationship between total scores of the BDI and PHQ-9. A : Total assessments (n=88, Pearson's r=0.599), B : 1st assessment (n=42, Pearson's r=0.653), C : 2nd assessment (n=28, Pearson's r=0.594), D : 3rd assessment (n=18, Pearson's r=0.351). BDI : Beck Depression Inventory, PHQ-9 : Patient Health Questionnaire-9.

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