Identifying thresholds for classifying childhood psychiatric disorder: Issues and prospects
Identifying thresholds for classifying childhood psychiatric disorder: Issues and prospects
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DOI：
10.1097/00004583-199611000-00012
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发表时间：
1996-11-01
影响因子：
13.3
通讯作者：
Sanford, M
中科院分区：
文献类型：
--
作者：
Boyle, MH;Offord, DR;Sanford, M
目的：根据经验评估选择不同阈值对品行障碍和注意力缺陷多动障碍进行分类的影响，以估计患病率、重测测量的可靠性、知情者（家长/老师）的一致性以及评估共病和障碍的相关特征。方法：该研究的数据来自于 6 至 16 岁儿童 (N = 1,229) 的家长和教师进行的问题清单评估，这些儿童以已知概率从一般人口样本中选择，并来自分层随机子样本 (n = 251) 中获得的结构化访谈。结果：根据设定阈值的基本原理，估计值差异很大。患病率从 0.1 升至 39.2；重测可靠性的 kappa 估计值从 0.19 升至 0.82。基于 kappa 的家长-教师协议从 0.0 升至 0.38。疾病和相关特征之间的相对几率有两倍的差异。结论：使用不同的原理来设定对一般人群中的儿童精神疾病进行分类的阈值对于我们对儿童疾病流行病学的了解具有深远的影响。
Objective: To evaluate empirically the implications of choosing different thresholds to classify conduct disorder and attention-deficit hyperactivity disorder for estimating prevalence, test-retest reliability of measurement, and informant (parent/teacher) agreement and for evaluating comorbidity and associated features of disorder. Method: Data for the study came from problem checklist assessments done by parents and teachers of children aged 6 to 16 years (N = 1,229) selected with known probability from a general population sample and from structured interviews obtained in a stratified, random subsample (n = 251). Results: Estimates varied widely depending on the rationale used to set thresholds. Percent prevalence went from 0.1 to 39.2; kappa estimates of test-retest reliability went from .19 to .82. Parent-teacher agreement based on kappa went from .0 to .38. Relative odds between disorder and associated features varied twofold. Conclusion: Use of different rationales to set thresholds for classifying childhood psychiatric disorder in the general population has profound implications for what we learn about the epidemiology of childhood disorder.