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On Diagnosing Rare Disorders Rarely: Appropriate Use of Screening Instruments
Author(s) -
Clark Andrew,
Harrington Richard
Publication year - 1999
Publication title -
journal of child psychology and psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.652
H-Index - 211
eISSN - 1469-7610
pISSN - 0021-9630
DOI - 10.1111/1469-7610.00442
Subject(s) - psychology , psychiatry
The main aim of this study was to determine whether child mental health professionals who regularly use questionnaires to screen for mental disorders know that these questionnaires have a low predictive value when the base rate of a disorder is low. The study was based on a representative sample of professionals who used questionnaires regularly to screen for mental disorders. They were set a problem in which a clinic sample was screened with a questionnaire that, at a certain cut‐point, had 80% sensitivity and 80% specificity, and in which the true base rate of disorder was 10%. Only 10% (5/48) of respondents answered correctly that just 30% of individuals who scored above this cut‐point would actually have the disorder and more than half of respondents believed that 80% would have the disorder. Both users and designers of questionnaires need to be more aware of and explicit about their drawbacks as screens for mental disorders.

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