/*
Copyright (C) 2012, University of Cambridge, Department of Psychiatry.
Created by Rudolf Cardinal (rnc1001@cam.ac.uk).
This file is part of CamCOPS.
CamCOPS is free software: you can redistribute it and/or modify
it under the terms of the GNU General Public License as published by
the Free Software Foundation, either version 3 of the License, or
(at your option) any later version.
CamCOPS is distributed in the hope that it will be useful,
but WITHOUT ANY WARRANTY; without even the implied warranty of
MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
GNU General Public License for more details.
You should have received a copy of the GNU General Public License
along with CamCOPS. If not, see <https://www.gnu.org/licenses/>.
*/
#include "phq8.h"
#include "common/textconst.h"
#include "maths/mathfunc.h"
#include "lib/stringfunc.h"
#include "lib/uifunc.h"
#include "questionnairelib/questionnaire.h"
#include "questionnairelib/qumcqgrid.h"
#include "questionnairelib/qutext.h"
#include "tasklib/taskfactory.h"
#include "tasklib/taskregistrar.h"
using mathfunc::anyNull;
using mathfunc::sumInt;
using mathfunc::totalScorePhrase;
using stringfunc::strnum;
using stringfunc::strseq;
const int FIRST_Q = 1;
const int N_QUESTIONS = 8;
const int MAX_QUESTION_SCORE = 24; // 8 * 3
const QString QPREFIX(QStringLiteral("q"));
const QString Phq8::PHQ8_TABLENAME(QStringLiteral("phq8"));
void initializePhq8(TaskFactory& factory)
{
static TaskRegistrar<Phq8> registered(factory);
}
Phq8::Phq8(CamcopsApp& app, DatabaseManager& db, const int load_pk,
QObject* parent) :
Task(app, db, PHQ8_TABLENAME, false, false, false, parent), // ... anon, clin, resp
m_questionnaire(nullptr)
{
addFields(strseq(QPREFIX, FIRST_Q, N_QUESTIONS), QMetaType::fromType<int>());
load(load_pk); // MUST ALWAYS CALL from derived Task constructor.
}
// ============================================================================
// Class info
// ============================================================================
QString Phq8::shortname() const
{
return QStringLiteral("PHQ-8");
}
QString Phq8::longname() const
{
return tr("Patient Health Questionnaire 8-item depression scale");
}
QString Phq8::description() const
{
return tr("Self-scoring of 8 depressive symptoms from DSM-IV.");
}
// ============================================================================
// Instance info
// ============================================================================
bool Phq8::isComplete() const
{
if (anyNull(values(strseq(QPREFIX, FIRST_Q, N_QUESTIONS)))) {
return false;
}
return true;
}
QStringList Phq8::summary() const
{
return QStringList{totalScorePhrase(totalScore(), MAX_QUESTION_SCORE)};
}
QStringList Phq8::detail() const
{
using stringfunc::bold;
using uifunc::yesNo;
const int totalscore = totalScore();
const QString sev = severity(totalscore);
const int ncore = nCoreSymptoms();
const int nother = nOtherSymptoms();
const int ntotal = ncore + nother;
// Kroenke et al. (2009) PMID 18752852, p166 [annotations in square
// brackets]:
// 'Current depression was defined in two ways: 1) a PHQ-8 algorithm
// diagnosis of major depression (this requires either the first or second
// item (depressed mood or anhedonia) [CORE SYMPTOMS] to be present “more
// than half the days” [SCORE >=2] and at least 5 of the 8 symptoms [TOTAL
// SYMPTOMS] to be present “more than half the days” [SCORE >=2])...'
const bool mds = (ncore >= 1) && (ntotal >= 5);
// '... or other depression (2 to 4 [TOTAL] symptoms, including depressed
// mood or anhedonia [AT LEAST ONE CORE], are required to be present “more
// than half the days” [SCORE >=2])..."
const bool ods = (ncore >= 1) && (ntotal >= 2) && (ntotal <= 4);
const QString spacer(QStringLiteral(" "));
QStringList lines = completenessInfo();
lines += fieldSummaries(
QStringLiteral("q"),
QStringLiteral("_s"),
spacer,
QPREFIX, FIRST_Q, N_QUESTIONS
);
lines.append(QString());
lines += summary();
lines.append(QString());
lines.append(xstring(QStringLiteral("mds")) + spacer + bold(yesNo(mds)));
lines.append(xstring(QStringLiteral("ods")) + spacer + bold(yesNo(ods)));
lines.append(xstring(QStringLiteral("depression_severity")) + spacer + bold(sev));
return lines;
}
OpenableWidget* Phq8::editor(const bool read_only)
{
const NameValueOptions options_q1_9{
{xstring(QStringLiteral("a0")), 0},
{xstring(QStringLiteral("a1")), 1},
{xstring(QStringLiteral("a2")), 2},
{xstring(QStringLiteral("a3")), 3},
};
QuPagePtr page((new QuPage{
(new QuText(xstring(QStringLiteral("stem"))))->setBold(true),
new QuMcqGrid(
{
QuestionWithOneField(xstring(QStringLiteral("q1")), fieldRef(QStringLiteral("q1"))),
QuestionWithOneField(xstring(QStringLiteral("q2")), fieldRef(QStringLiteral("q2"))),
QuestionWithOneField(xstring(QStringLiteral("q3")), fieldRef(QStringLiteral("q3"))),
QuestionWithOneField(xstring(QStringLiteral("q4")), fieldRef(QStringLiteral("q4"))),
QuestionWithOneField(xstring(QStringLiteral("q5")), fieldRef(QStringLiteral("q5"))),
QuestionWithOneField(xstring(QStringLiteral("q6")), fieldRef(QStringLiteral("q6"))),
QuestionWithOneField(xstring(QStringLiteral("q7")), fieldRef(QStringLiteral("q7"))),
QuestionWithOneField(xstring(QStringLiteral("q8")), fieldRef(QStringLiteral("q8"))),
},
options_q1_9
),
})->setTitle(xstring(QStringLiteral("title_main"))));
m_questionnaire = new Questionnaire(m_app, {page});
m_questionnaire->setType(QuPage::PageType::Patient);
m_questionnaire->setReadOnly(read_only);
return m_questionnaire;
}
// ============================================================================
// Task-specific calculations
// ============================================================================
int Phq8::totalScore() const
{
return sumInt(values(strseq(QPREFIX, FIRST_Q, N_QUESTIONS)));
}
int Phq8::nCoreSymptoms() const
{
int n = 0;
const QStringList fieldnames = strseq(QPREFIX, 1, 2);
for (const QString& fieldname : fieldnames) {
if (valueInt(fieldname) >= 2) {
n += 1;
}
}
return n;
}
int Phq8::nOtherSymptoms() const
{
int n = 0;
const QStringList fieldnames = strseq(QPREFIX, 3, 8);
for (const QString& fieldname : fieldnames) {
if (valueInt(fieldname) >= 2) {
n += 1;
}
}
return n;
}
QString Phq8::severity(const int score)
{
// Kroenke et al. (2009) PMID 18752852, p166:
// "The frequency distribution of major depression and other depression by
// standard PHQ-8 severity intervals (0–4, 5–9, 10–14, 15–19, and
// 20–24)..."
if (score >= 20) return TextConst::severe();
if (score >= 15) return TextConst::moderatelySevere();
if (score >= 10) return TextConst::moderate();
if (score >= 5) return TextConst::mild();
return TextConst::none();
}