Assessing the Impact of Different Depression Treatment Success Metrics on Organizational Performance

Objective: The Patient Health Questionnaire-9 (PHQ-9) is commonly used to assess depression symptoms, but its associated treatment success criteria (i.e., metrics) are inconsistently defined. The authors aimed to analyze the impact of metric choice on outcomes and discuss implications for clinical practice and research. Methods: Analyses included three overlapping and nonexclusive time cohorts of adult patients with depression treated in 33 organizations between 2008 and 2018. Average depression improvement rates were calculated according to eight metrics. Organization-level rank orders defined by these metrics were calculated and correlated. Results: The 12-month cohort had higher rates of metrics indicating treatment success than did the 3- and 6-month cohorts; the degree of improvement varied by metric, although all organization-level rank orders were highly correlated. Conclusions: Different PHQ-9 treatment metrics are associated with disparate improvement rates. Organization-level rankings defined by different metrics are highly correlated. Consistency of metric use may be more important than specific metric choice.