Diagnostic performance of the PTSD checklist and the Vietnam Era Twin Registry PTSD scale.
Diagnostic performance of the PTSD checklist and the Vietnam Era Twin Registry PTSD scale.
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DOI：
10.1017/s2045796014000365
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发表时间：
2015-10
影响因子：
8.1
通讯作者：
Smith N
中科院分区：
文献类型：
--
作者：
Magruder K;Yeager D;Goldberg J;Forsberg C;Litz B;Vaccarino V;Friedman M;Gleason T;Huang G;Smith N
自我报告问卷经常用于临床和流行病学研究，以评估创伤后应激障碍（PTSD）。一些研究已经评估了这些量表相对于临床医生管理的结构化访谈，但是，一直没有正式的评价其性能相对于非临床医生管理的流行病学评估，如复合国际诊断访谈（CIDI）。我们检查了两个自我报告的PTSD量表，PTSD检查表（PCL）和越南时代双胞胎登记（VET-R）PTSD量表的诊断性能，与CIDI相比。数据来源于一项对5141名越战老兵进行的PTSD流行病学随访研究。测量包括PCL，VET-R PTSD量表和CIDI。对于PCL和VET-R PTSD量表，基于CIDI PTSD诊断生成ROC曲线、曲线下面积（AUC）、灵敏度、特异性、正确分类%、似然比、预测值和质量估计。PCL和VET-R PTSD量表的AUC分别为89.0和87.7%。最佳PCL临界点从31-33范围（考虑灵敏度和特异性时）到36-56范围（考虑质量估计时）不等。VET-R PTSD也有类似的变化，范围从31（考虑敏感性和特异性时）到37-42（考虑质量估计时）。PCL和VET-R PTSD量表使用CIDI PTSD诊断作为标准进行类似的测试。根据使用的指标，有一系列可接受的临界点，但大多数指标表明PCL临界点低于既往在退伍军人人群中进行的研究。
Self-report questionnaires are frequently used in clinical and epidemiologic studies to assess post-traumatic stress disorder (PTSD). A number of studies have evaluated these scales relative to clinician administered structured interviews; however, there has been no formal evaluation of their performance relative to non-clinician administered epidemiologic assessments such as the Composite International Diagnostic Interview (CIDI). We examined the diagnostic performance of two self-report PTSD scales, the PTSD checklist (PCL) and the Vietnam Era Twin Registry (VET-R) PTSD scale, compared to the CIDI. Data were derived from a large epidemiologic follow-up study of PTSD in 5141 Vietnam Era Veterans. Measures included the PCL, VET-R PTSD scale and CIDI. For both the PCL and VET-R PTSD scale, ROC curves, areas under the curve (AUC), sensitivity, specificity, % correctly classified, likelihood ratios, predictive values and quality estimates were generated based on the CIDI PTSD diagnosis. For the PCL and VET-R PTSD scale the AUCs were 89.0 and 87.7%, respectively. Optimal PCL cutpoints varied from the 31–33 range (when considering sensitivity and specificity) to the 36–56 range (when considering quality estimates). Similar variations were found for the VET-R PTSD, ranging from 31 (when considering sensitivity and specificity) to the 37–42 range (when considering quality estimates). The PCL and VET-R PTSD scale performed similarly using a CIDI PTSD diagnosis as the criterion. There was a range of acceptable cutpoints, depending on the metric used, but most metrics suggested a lower PCL cutpoint than in previous studies in Veteran populations.