Stratum-specific likelihood ratios of two versions of the general health questionnaire.

Abstract:

BACKGROUND:In other branches of epidemiology, stratum specific likelihood ratios (SSLRs) have been found to be preferable to fixed best threshold approaches to screening instruments. This paper presents SSLRs of GHQ-12 and GHQ-28 and compares the SSLR method with the traditional optimal threshold approach. METHODS:Random effects meta-analysis and meta-regression were used to obtain pooled estimates of SSLRs of the two questionnaires for the 15 centres participating in the WHO study of Psychological Problems in General Health Care. We illustrated the use of SSLRs by applying them to random samples of patients from centres with different backgrounds. RESULTS:For developed and urban centres, the estimates of SSLRs were homogeneous for 10 out of 12 strata of the GHQ-12 and GHQ-28. For other centres, the overall results, which were heterogeneous for six out of 12 strata, were deemed the currently available best estimates. When we applied these results to centres with different prevalences of mental disorders and backgrounds, the estimates matched the actually observed closely. These examples showed how the SSLR approach is more informative than the traditional threshold approach. CONCLUSIONS:Those working in developed urban settings can use the corresponding SSLRs with reasonable confidence. Those working in non-urban or developing areas may wish to use the overall results, while acknowledging that they must remain less certain until further research can explicate heterogeneity. These SSLRs have been incorporated into nomograms and spreadsheet programmes so that future researchers can swiftly derive the post-test probability for a patient or a group of patients from a pre-test probability and GHQ score.

journal_name

Psychol Med

journal_title

Psychological medicine

authors

Furukawa TA,Goldberg DP,Rabe-Hesketh S,Ustün TB

doi

10.1017/s0033291701003713

subject

Has Abstract

pub_date

2001-04-01 00:00:00

pages

519-29

issue

3

eissn

0033-2917

issn

1469-8978

journal_volume

31

pub_type

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