Small signal, big noise: Performance of the CIDI depression module
Small signal, big noise: Performance of the CIDI depression module
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DOI：
10.1177/070674370505001308
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发表时间：
2005-11-01
影响因子：
4
通讯作者：
Gnam, WH
中科院分区：
文献类型：
--
作者：
Kurdyak, PA;Gnam, WH
目标：随着加拿大社区健康调查：心理健康和福祉（第 1.2 周期）数据的发布，研究人员首次从居住在家庭中的加拿大人的全国代表性样本中获得了有关几种精神疾病的信息。这项调查使用综合国际诊断访谈（CIDI）来识别患有一种或多种精神疾病的人。在本文中，我们的主要目的是评估支持 CIDI 有效性的证据，即 CIDI 生成的抑郁症诊断在多大程度上反映了 44 例抑郁症的真实病例。方法：我们对 CIDI 进行了严格审查，重点关注抑郁症模块。结果：可靠性研究表明，根据参与者间可靠性衡量，CIDI 表现可靠。然而，不同版本 CIDI 的使用以及偶尔将抑郁模块排除在研究之外表明 CIDI 抑郁模块的可靠性仍未得到证实。 CIDI性能最关键的问题是使用临床样本来测试有效性。临床样本的抑郁症患病率高于社区样本。结论：CIDI 在社区环境中生成的结果可能会有较高的假阳性率，导致患病率错误升高。鉴于 CIDI 在国际上的广泛应用，通过适当的验证研究解决有效性方面的突出问题应成为国际优先事项。
Objectives: With the release of data from the Canadian Community Health Survey: Mental Health and Well-Being (Cycle 1.2), researchers have, for the first time, information on several psychiatric disorders from a nationally representative sample of Canadians residing in households. This survey used the Composite International Diagnostic Interview (CIDI) to identify persons with one or more psychiatric disorders. In this paper, our primary purpose was to evaluate the evidence supporting the validity of the CIDI-that is, the extent to which the depression diagnoses generated by the CIDI reflect true cases of 44 depression.Method: We conducted a critical review of the CIDI, focusing on the depression module.Results: Reliability studies indicate that the CIDI performs reliably, as measured by interrater reliability. However, the use of different versions of the CIDI and the occasional exclusion of the Depression module from studies suggest that the reliability of the CIDI Depression module remains unconfirmed. The most critical issue in regard to the CIDI's performance is that clinical samples are used to test validity. A clinical sample has a higher prevalence of depression than a community sample.Conclusion: The results generated by the CIDI in a community setting likely will have a high false-positive rate, resulting in a falsely elevated prevalence rate. Given the widespread application of the CIDI internationally, addressing the outstanding concerns about validity with proper validation studies should become an international priority.