In Reply: We agree with Dr Carney and colleagues that depression is an important condition that is associated with increased risk of morbidity and mortality in patients with heart disease and that warrants effective response by clinicians. The recent AHA science advisory1 concluded that routine depression screening in heart disease patients would accomplish that, but this recommendation was not based on a careful review of potential benefits and harms that is customary for a statement of this type.2 Carney et al do not find fault with the quality or rigor of our systematic review. Yet they support the AHA recommendation even though our review did not find any clinical trial that assessed whether depression screening improves depression or cardiac outcomes in heart disease patients or any other evidence that depression screening would likely benefit patients with cardiovascular disease.
Thombs BD, de Jonge P, Ziegelstein RC. Depression Screening in Patients With Heart Disease—Reply. JAMA. 2009;301(13):1337-1338. doi:10.1001/jama.2009.409