Factors associated with being a false positive on the General Health Questionnaire
Factors associated with being a false positive on the General Health Questionnaire
复制标题
DOI：
10.1007/s00127-005-0881-6
复制
发表时间：
2005-05-01
影响因子：
4.4
通讯作者：
Lewis, G
中科院分区：
文献类型：
--
作者：
Bell, T;Watson, M;Lewis, G
背景一般健康问卷(GHQ)在社区和初级保健研究中被广泛使用，作为对常见精神障碍抑郁和焦虑的更长、更耗时和更昂贵的评估的替代方案。与更长、更详细的评估相比，GHQ的敏感性和特异性在70%至80%之间。尽管令人满意，但这引起了人们对可能与较长时间的评估有关的偏见的关注。我们研究了与GHQ假阳性相关的社会人口学因素，以调查与更详细的评估相关的任何确定偏差。方法邀请来自加的夫、布里斯托尔和庞蒂普里德五个全科诊所的7,357名年龄在16岁及以上的患者完成12个项目的GHQ。在这些患者中，1,154名患者得分在3分或更高，这是我们在GHQ上的病例定义，并完成了修订的临床访谈时间表(CIS-R)的计算机化版本以及简短的社会人口统计调查问卷。结果1154例患者中，344例(30%)假阳性(95%可信区间27%~32%)为假阳性，不是CIS-R病例。调整包括GHQ评分在内的其他变量后，假阳性受试者更有可能被雇用[优势比(OR)2.7，95%可信区间1.4~5.3]、自住者(OR 1.6，95%CI 1.0~2.4)和有亲密的朋友或亲戚谈论个人问题(OR 2.2，95%CI 1.4~3.5)。结论在本研究中，GHQ与CIS-R之间存在一定的偏差。与使用CIS-R的研究相比，使用GHQ来研究社会经济状况和常见精神障碍之间的关系的研究可能会导致对关联性的偏见估计。在经济状况较好和社会支持较好的受试者中，GHQ很可能会导致比独联体-R更高的患病率估计。
Background The General Health Questionnaire ( GHQ) has been used extensively in community and primary care research as an alternative to longer, time-consuming and more expensive assessments of the common mental disorders of depression and anxiety. The sensitivity and specificity of the GHQ compared with longer more detailed assessments is between 70 and 80%. Though satisfactory, this raises the concern about the possibility of bias in relation to longer assessments. We studied socio-demographic factors that were associated with being a false positive on the GHQ in order to investigate any ascertainment bias in relation to more detailed assessments. Method A total of 7,357 consecutive patients aged 16 and over, in five general practices in Cardiff, Bristol and Pontypridd, were invited to complete the 12-item GHQ. Of these, 1,154 patients scored 3 or more, our case definition on the GHQ, and completed a computerised version of the Revised Clinical Interview Schedule (CIS-R) together with a short sociodemographic questionnaire. Results Of the 1,154 subjects who were cases on the GHQ, 344 (30%) (95% CI 27%-32%) were false positive and were not cases on the CIS-R. After adjustment for the other variables, including GHQ score, false positive subjects were more likely to be employed [odds ratio ( OR) 2.7, 95% CI 1.4-5.3], owner-occupiers (OR 1.6, 95% CI 1.0-2.4) and to have a close friend or relative to talk to about personal problems (OR 2.2, 95% CI 1.4-3.5). Conclusion Our results suggest that in this study there was an ascertainment bias on the GHQ in relation to the CIS-R. Studies that use the GHQ to study the relationship between socio-economic status and common mental disorder could lead to biased estimates of association compared to studies that use the CIS-R. It is likely that the GHQ will lead to a higher estimate of prevalence than the CIS-R in subjects who are better off financially and who have better social support.