Stratum-specific likelihood ratios of the General Health Questionnaire in the community: help-seeking and physical co-morbidity affect the test characteristics
Stratum-specific likelihood ratios of the General Health Questionnaire in the community: help-seeking and physical co-morbidity affect the test characteristics
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DOI：
10.1017/s0033291702005494
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发表时间：
2002-05-01
影响因子：
6.9
通讯作者：
Goldberg, DP
中科院分区：
文献类型：
--
作者：
Furukawa, TA;Andrews, G;Goldberg, DP
背景在循证医学中，层特异性似然比（SSLR）现在越来越被认为是一种比最佳截止值及其相关灵敏度和特异性更方便且更可推广的解释诊断信息的方法。我们以前检查了SSLR的一般健康问卷（GHQ）在初级保健设置。本论文旨在研究这些SSLR是否可推广到社区设置。综合国际诊断访谈（CIDI）和GHQ管理的澳大利亚全国心理健康和福祉调查的澳大利亚人口的代表性样本。我们首先比较了SSLR的GHQ在澳大利亚城市的估计，我们以前从发达的城市中心在世界卫生组织的心理问题在一般医疗保健研究。如果发现社区的SSLR与初级保健中的SSLR存在显著差异，我们寻求解释变量。世卫组织研究中，澳大利亚城市和城市中心的SSLR在六个分层中的三个分层中存在显著差异。然而，当我们将样本限制在那些有身体问题的健康专业人士时，澳大利亚研究中的SSLR与初级保健环境中观察到的SSLR非常接近。不同的SSLR适用于初级保健和一般人群样本。用于发达国家的一般人口调查。澳大利亚全国调查的结果代表了目前可用的最佳估计。对于发展中国家或农村地区，结果不太确定，调查人员可能希望进行试点研究。
Background. In evidence-based medicine, stratum-specific likelihood ratios (SSLRs) are now being increasingly recognized as a more convenient and generalizable method to interpret diagnostic information than an optimal cut-off and its associated sensitivity and specificity. We previously examined the SSLRs of the General Health Questionnaire (GHQ) in primary care settings. The present paper aims to examine if these SSLRs are generalizable to the community settings.Methods. The Composite International Diagnostic Interview (CIDI) and the GHQ were administered on a representative sample of the Australian population in the Australian National Survey of Mental Health and Well-Being. We first compared the SSLRs of GHQ in urban Australia with the estimates that we had previously obtained from the developed urban centres in the WHO Psychological Problems in General Health Care study. If the SSLRs in the community were found to differ significantly from those in the primary care, we sought for explanatory variables.Results. The SSLRs in urban Australia and in the urban centres in the WHO study were significantly different for three out of the six strata. When we limited the sample to those with physical problems who visited a health professional, however, the SSLRs in the Australian study were strikingly close to those observed for primary care settings.Conclusions. Different sets of SSLRs apply to primary care and general population samples. For general population surveys in developed countries. the results of the Australian National Survey represent the currently available best estimates. For developing countries or rural areas, the results are less definitive and an investigator may wish to conduct a pilot study.