Screening for depression in primary care has become a national priority in many countries, although its benefits remain hotly contested. O'Connor and colleagues' systematic review attempts to aid the US Preventive Services Task Force in updating its 2002 recommendations and is aimed at US primary care physicians. Previous reviews have often excluded studies of quality improvement/collaborative care and have generally found a minimal benefit of screening alone.1 The scope of this review (which was funded by the Agency for Healthcare Research and Quality) was to examine the influence of screening on broadly defined patient outcomes and to extend the intervention to include complex quality improvement interventions. Traditionally, the examination of screening has been limited to the question of whether screening benefits the detection of depression. In …