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Comparing screening instruments to predict posttraumatic stress disorder.

Mouthaan J, Sijbrandij M, Reitsma JB, Gersons BP, Olff M - PLoS ONE (2014)

Bottom Line: Areas under the curve and specificities at 80% sensitivity were compared between instruments.Areas under the curve in all instruments were adequate (SPAN: 0.83; TSQ: 0.82; IES-R: 0.83) with no significant differences.The modest specificities and low positive predictive values found for all instruments could lead to relatively many false positive cases, when applied in clinical practice.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, Centre for Anxiety Disorders, Research Group Psychotrauma, Academic Medical Centre, Amsterdam, The Netherlands.

ABSTRACT

Background: Following traumatic exposure, a proportion of trauma victims develops posttraumatic stress disorder (PTSD). Early PTSD risk screening requires sensitive instruments to identify everyone at risk for developing PTSD in need of diagnostic follow-up.

Aims: This study compares the accuracy of the 4-item SPAN, 10-item Trauma Screening Questionnaire (TSQ) and 22-item Impact of Event Scale-Revised (IES-R) in predicting chronic PTSD at a minimum sensitivity of 80%.

Method: Injury patients admitted to a level-I trauma centre (N = 311) completed the instruments at a median of 23 days and were clinically assessed for PTSD at 6 months. Areas under the curve and specificities at 80% sensitivity were compared between instruments.

Results: Areas under the curve in all instruments were adequate (SPAN: 0.83; TSQ: 0.82; IES-R: 0.83) with no significant differences. At 80% sensitivity, specificities were 64% for SPAN, 59% for TSQ and 72% for IES-R.

Conclusion: The SPAN, TSQ and IES-R show similar accuracy in early detection of individuals at risk for PTSD, despite differences in number of items. The modest specificities and low positive predictive values found for all instruments could lead to relatively many false positive cases, when applied in clinical practice.

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Related in: MedlinePlus

ROC curves of the SPAN, TSQ and IES-R for 6 month PTSD.Note: ROC curves represent original sensitivity and specificity values using linear interpolation between the observed data points. ROC, Receiver Operating Characteristic; SPAN, Startle, Physiological Arousal, Anger & Numbness; TSQ, Trauma Screening Questionnaire; IES-R, Impact of Event Scale-Revised; PTSD, posttraumatic stress disorder.
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pone-0097183-g002: ROC curves of the SPAN, TSQ and IES-R for 6 month PTSD.Note: ROC curves represent original sensitivity and specificity values using linear interpolation between the observed data points. ROC, Receiver Operating Characteristic; SPAN, Startle, Physiological Arousal, Anger & Numbness; TSQ, Trauma Screening Questionnaire; IES-R, Impact of Event Scale-Revised; PTSD, posttraumatic stress disorder.

Mentions: AUCs of the SPAN (0.83, 95% CI = 0.66–1.00), TSQ (0.82, 95% CI = 0.66–0.98) and IES-R (0.83, 95% CI = 0.72–0.94) were adequate (see Figure 2). There were no statistical significant differences between the AUCs of the SPAN, TSQ and IES-R (P SPAN-TSQ = 0.84, P SPAN-IES-R = 0.97, P TSQ-IES-R = 0.85). Figure 2 shows the ROC curves of the original data points of sensitivity and specificity values of the SPAN, TSQ and IES-R for 6 month PTSD using linear interpolation between the data points.


Comparing screening instruments to predict posttraumatic stress disorder.

Mouthaan J, Sijbrandij M, Reitsma JB, Gersons BP, Olff M - PLoS ONE (2014)

ROC curves of the SPAN, TSQ and IES-R for 6 month PTSD.Note: ROC curves represent original sensitivity and specificity values using linear interpolation between the observed data points. ROC, Receiver Operating Characteristic; SPAN, Startle, Physiological Arousal, Anger & Numbness; TSQ, Trauma Screening Questionnaire; IES-R, Impact of Event Scale-Revised; PTSD, posttraumatic stress disorder.
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4016271&req=5

pone-0097183-g002: ROC curves of the SPAN, TSQ and IES-R for 6 month PTSD.Note: ROC curves represent original sensitivity and specificity values using linear interpolation between the observed data points. ROC, Receiver Operating Characteristic; SPAN, Startle, Physiological Arousal, Anger & Numbness; TSQ, Trauma Screening Questionnaire; IES-R, Impact of Event Scale-Revised; PTSD, posttraumatic stress disorder.
Mentions: AUCs of the SPAN (0.83, 95% CI = 0.66–1.00), TSQ (0.82, 95% CI = 0.66–0.98) and IES-R (0.83, 95% CI = 0.72–0.94) were adequate (see Figure 2). There were no statistical significant differences between the AUCs of the SPAN, TSQ and IES-R (P SPAN-TSQ = 0.84, P SPAN-IES-R = 0.97, P TSQ-IES-R = 0.85). Figure 2 shows the ROC curves of the original data points of sensitivity and specificity values of the SPAN, TSQ and IES-R for 6 month PTSD using linear interpolation between the data points.

Bottom Line: Areas under the curve and specificities at 80% sensitivity were compared between instruments.Areas under the curve in all instruments were adequate (SPAN: 0.83; TSQ: 0.82; IES-R: 0.83) with no significant differences.The modest specificities and low positive predictive values found for all instruments could lead to relatively many false positive cases, when applied in clinical practice.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, Centre for Anxiety Disorders, Research Group Psychotrauma, Academic Medical Centre, Amsterdam, The Netherlands.

ABSTRACT

Background: Following traumatic exposure, a proportion of trauma victims develops posttraumatic stress disorder (PTSD). Early PTSD risk screening requires sensitive instruments to identify everyone at risk for developing PTSD in need of diagnostic follow-up.

Aims: This study compares the accuracy of the 4-item SPAN, 10-item Trauma Screening Questionnaire (TSQ) and 22-item Impact of Event Scale-Revised (IES-R) in predicting chronic PTSD at a minimum sensitivity of 80%.

Method: Injury patients admitted to a level-I trauma centre (N = 311) completed the instruments at a median of 23 days and were clinically assessed for PTSD at 6 months. Areas under the curve and specificities at 80% sensitivity were compared between instruments.

Results: Areas under the curve in all instruments were adequate (SPAN: 0.83; TSQ: 0.82; IES-R: 0.83) with no significant differences. At 80% sensitivity, specificities were 64% for SPAN, 59% for TSQ and 72% for IES-R.

Conclusion: The SPAN, TSQ and IES-R show similar accuracy in early detection of individuals at risk for PTSD, despite differences in number of items. The modest specificities and low positive predictive values found for all instruments could lead to relatively many false positive cases, when applied in clinical practice.

Show MeSH
Related in: MedlinePlus