Systematic review is incomplete

EDITOR—Gilbody et al published a systematic review of the effect in primary care settings of routinely administered questionnaires on the recognition, treatment, and outcome of psychiatric disorders, particularly depression.1 They reviewed randomised trials published throughout 2000 and concluded that the routine administration of such questionnaires is a costly exercise that has not been shown to influence clinicians' behaviour.

On behalf of the United States Preventive Services Task Force, we performed a broader systematic review of the effectiveness of routine screening for depression. In addition to those reported in Gilbody et al, we identified six randomised trials of screening that examined recognition, treatment, or clinical outcomes.2^–7 Each study used a validated screening instrument and gave feedback to providers of the screening results; some also confirmed results from the screening instrument with a criterion standard or gave systematic support to providers and patients to improve the quality of care after recognition of the diagnosis or condition. Gilbody et al cited the study by Wells et al in their discussion but did not include it in their analysis; other studies were not addressed in the report. Since several of these studies had positive impact on at least one major outcome, we are concerned that not including them may have affected the conclusions of the review. Gilbody et al included one study of depression …