Should the PANSS be rescaled?

Abstract:

:The design of the Positive and Negative Syndrome Scale (PANSS) with item levels ranging from 1 to 7 leads to the trivial result that the 30-item scale's zero level (no symptoms) is 30. This causes serious problems when ratios are calculated which always implicitly depend on a natural zero point (equals 0). Recent publications concerning efficacy of antipsychotics correctly suggest a subtraction of 30 points to every PANSS before calculating percent change (PC). Nevertheless, the traditional approach using uncorrected scores is still in common practice. This analysis aims to clarify which approach is the most appropriate from a statistical perspective.For analysis, data from a naturalistic study on 400 patients with a schizophrenic spectrum disorder and simulated data sets were used. While calculations concerning absolute score values and their differences are not affected, considerable problems arise in calculations of PC and related response criteria. Even significance levels of estimated treatment effects change, depending on the structure of the data (eg, baseline symptom severity). Using a PANSS version with items ranging from 0 to 6 would avoid such often neglected pitfalls.

journal_name

Schizophr Bull

journal_title

Schizophrenia bulletin

authors

Obermeier M,Mayr A,Schennach-Wolff R,Seemüller F,Möller HJ,Riedel M

doi

10.1093/schbul/sbp124

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

455-60

issue

3

eissn

0586-7614

issn

1745-1701

pii

sbp124

journal_volume

36

pub_type

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