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MRCPsych Teaching 2008




Critical Appraisal of Diagnostic Test Studies



   Alex J Mitchell
   Consultant in Liaison Psychiatry
   University of Leicester
Contents
• Importance of understanding diagnostic tests

• Statistics of diagnostic validity

• Examples
Importance of understanding diagnostic tests
What Is a Diagnostic Test in Psychiatry?
•   CT/MRI
•   CSF
•   Blood tests eg TFTs
•   SCAN/SCID/PSE/MINI
•   Neuropsychological Testing
•   MMSE
•   HADS/BDI/CESD?
•   Clinical Judgement
•   Self-report
Why Is a HADS score not a diagnosis?
Why Is a HADS score not a diagnosis?

  1. No core features
  2. No symptom ranking
  3. No functional assessment
  4. Duration unclear
  5. What if Missing items?
  6. Imprecise
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)
MRCPsych08 - How To Analyse Diagnostic Test Studies (June08)

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  • 1. MRCPsych Teaching 2008 Critical Appraisal of Diagnostic Test Studies Alex J Mitchell Consultant in Liaison Psychiatry University of Leicester
  • 2. Contents • Importance of understanding diagnostic tests • Statistics of diagnostic validity • Examples
  • 3. Importance of understanding diagnostic tests
  • 4. What Is a Diagnostic Test in Psychiatry? • CT/MRI • CSF • Blood tests eg TFTs • SCAN/SCID/PSE/MINI • Neuropsychological Testing • MMSE • HADS/BDI/CESD? • Clinical Judgement • Self-report
  • 5. Why Is a HADS score not a diagnosis?
  • 6. Why Is a HADS score not a diagnosis? 1. No core features 2. No symptom ranking 3. No functional assessment 4. Duration unclear 5. What if Missing items? 6. Imprecise