Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A) for detecting anxiety disorders in adults

The use of the HADS-A for screening purposes with a cutoff ≥ 8 in an exemplary cohort of 1000 individuals with an AAD prevalence of 17% would result in 675 individuals testing negative, of whom 44 would be false negatives, while 325 would test positive. Of these, 199 would be false positives, potentially straining the available healthcare resources. However, caution is warranted in interpreting the review findings, as the strength of evidence was limited by the risk of bias, concerns regarding applicability and substantial, unexplained heterogeneity. The use of estimates derived from clinical populations in which HADS-A is applied would be a reasonable approach. However, subgrouping by clinical population is currently unfeasible due to the limited number of studies per population category. This represents an area of further exploration in future research. The unexplained heterogeneity makes it challenging to reliably predict the results of future studies. Given these limitations, the universal use of the HADS-A with a cutoff ≥ 8 for screening in different settings and populations is currently questionable.