PHQ-2 / PHQ-9 eCQM Follow-Up Helper for PCPs, Specialists, and Surgeons
A simple, scope-aware way to recognize, document, and route a depression screen. Built so a busy team can use it in under 30 seconds.
988 Suicide & Crisis Lifeline · 24/7, free, confidential
Anyone in the U.S. can call or text 988, or chat at 988lifeline.org. Many patients don’t know this exists - sharing it is part of your safety plan.
Two ways to use this tool. Pick the one that fits your moment - you can switch anytime.
Tap one button to load a generic note. Fastest path - about 10 seconds. ~10 sec
Paste a short non-PHI string, or fill in the tool + score. Optional - you can also leave it blank and just fill in safety / role below.
If either flag is positive, the tool routes to a direct safety assessment regardless of total score.
Role drives the wording and what you’re expected to do.
Click the button. Your result, recommendations, and copy-paste-ready note appear right below.
Tap any card to flip it for the evidence. Short, quotable, source-linked - use them with patients, in M&Ms, in pre-op clinic, or in your next QI huddle.
In an individual participant data meta-analysis (n = 17,357), the PHQ-9 at a cut-off ≥ 10 had sensitivity 85% (95% CI 0.79–0.89) and specificity 85% versus semistructured diagnostic interviews. Specificity rose to 89% in screen-eligible populations.
So what: a positive PHQ-9 is a strong signal worth acting on - but it is still a screen, not a diagnosis.
Major depressive disorder prevalence in U.S. primary care is estimated at 5–13% in adults (6–9% in adults > 55). Lifetime prevalence is ~ 13%. One third to one half of treated adults get that treatment in primary care.
So what: universal screening isn’t fishing - it’s reasonable case-finding for a high-prevalence, under-detected condition.
In a large cohort of distal radius fracture surgeries, pre-op depression was associated with higher odds of SSI (OR 1.25, 95% CI 1.14–1.37), wound complications (OR 1.17), hardware complications (OR 1.18), ED visits for post-op pain (OR 1.28), and 30-day readmission (OR 1.21).
So what: recognizing and routing a positive screen isn’t a soft “wellness” task - it touches the surgical outcome you’re being graded on.
Across surgical specialties, smokers had pooled adjusted OR 3.60 (95% CI 2.62–4.93) for wound necrosis, 2.07 for healing delay/dehiscence, 1.79 for surgical site infection, and 2.07 for hernia (Sorensen meta-analysis). At least 4 weeks of pre-op cessation reduces SSI.
So what: behavioral risk factors are perioperative risk factors. Recognize, communicate, route.
In 3,064 non-cardiac surgical patients, HbA1c 8.0–10.0% had OR 2.4 (95% CI 1.2–4.7) and HbA1c ≥ 10.0% had OR 3.0 (95% CI 1.2–7.3) for 30-day SSI vs HbA1c < 6.5%. Cardiac and arthroplasty literature is similar in direction.
So what: the goal isn’t to become the patient’s endocrinologist - it’s to recognize and route for optimization before elective surgery.
In a total joint arthroplasty cohort (n = 542), patients with even mild depression had ~ 4-fold higher odds of persistent opioid use 3 months after surgery vs non-depressed peers. Depression and anxiety were present in nearly a third of patients.
So what: a positive screen has downstream pain-management and stewardship implications, not just psychiatric ones.
In older adults undergoing major elective surgery, moderate pre-op depressive symptoms were associated with ~ 3-fold and high-burden symptoms with ~ 9-fold increased risk of 1-year decline in instrumental activities of daily living (IADLs), with an exposure-response gradient and increased risk of post-acute care discharge.
So what: screening + routing isn’t cosmetic - it’s tied to whether grandma walks back into her own kitchen next year.
Screening does not make the surgeon the treating psychiatrist. The risk-management issue is failing to recognize and route an abnormal result, especially when safety concerns are present. This is clinical workflow guidance, not legal advice - follow local policy and consult compliance/legal leadership for organization-specific rules.
Tap a card to see the citations and direct links. Same idea as the pearls - less scrolling, more substance.
Use these for measure definition, value sets, encounter timing (14 days prior → 2 days after), and qualifying follow-up plans.
Original PHQ-9 validation paper plus the canonical PHQ screener site for clean copies of PHQ-2, PHQ-9, and translations.
Reference for screening, assessment, mitigation, and discharge expectations when there is suicide risk. Pair with your local policy.
USPSTF recommends screening all adults for depression in clinical practices that can support accurate diagnosis, effective treatment, and follow-up. This is the public-health basis for the eCQM.
The C-SSRS (Columbia Suicide Severity Rating Scale) is the most-cited validated suicide risk assessment, endorsed by the Joint Commission and widely used in primary care, EDs, behavioral health, and surgical clinics. The 6-question Primary Care Screener with Triage Points is what fires inside this tool when the safety lane is triggered.
Call or text 988, or chat at 988lifeline.org. SAMHSA also runs a general behavioral-health line (1-800-662-HELP). Veterans Crisis Line: dial 988, then press 1, or text 838255.
Educational support only. Verify patient-specific decisions against current source guidance and local policy.