Symptomsofdepressionandanxietycan significantly impact a patient's health status and quality of life. The APPROACH-IS study administered the Hospital Anxiety and Depression Scale (HADS) to assess the prevalence ofdepression and anxiety symptoms among adultswith congenital heart disease and theirpotential impacton health status andquality of life. Thefollowingtablefrom Kovaks, et al.

2023 publication includes the associated score ranges indicating elevated symptoms ofdepressionandanxiety.

Table1.

HADSScore	DepressionandAnxietySymptoms
8-10	Mildlyelevated
11-13	Moderatelyelevated
14orgreater	Severelyelevated

Assume the HADS scores in the study sample are normally distributed with a mean of 5.6 and a standard deviation of 4.75. If 19 study participants complete the HADS, what would be the 99%confidenceintervalaroundthisestimateofthemean?

How would the 99% confidence interval around this estimate of the mean change if thesamplesizeweretoincrease?

A. Thewidthofthe 99% confidenceinterval aroundthisestimateofthemean woulddecrease.

B. The margin of error used to calculate the 99% confidence interval around thisestimateofthemeanwoulddecrease.

C. The 99% confidence interval would more precisely estimate the true value of the mean HADS score among adults with congenital heart disease.

D. Alloftheabove.

E. Wewouldneedtoknowtheexactsample sizetoanswerthis question.