RESUMEN
Despite the popularity of the PTSD Checklist (PCL) as a clinical screening test, there has been no comprehensive quality review of studies evaluating its diagnostic accuracy. A systematic quality assessment of 22 diagnostic accuracy studies of the English-language PCL using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) assessment tool was conducted to examine (a) the quality of diagnostic accuracy studies of the PCL, and (b) whether quality has improved since the 2003 STAndards for the Reporting of Diagnostic accuracy studies (STARD) initiative regarding reporting guidelines for diagnostic accuracy studies. Three raters independently applied the QUADAS tool to each study, and a consensus among the 4 authors is reported. Findings indicated that although studies generally met standards in several quality areas, there is still room for improvement. Areas for improvement include establishing representativeness, adequately describing clinical and demographic characteristics of the sample, and presenting better descriptions of important aspects of test and reference standard execution. Only 2 studies met each of the 14 quality criteria. In addition, study quality has not appreciably improved since the publication of the STARD Statement in 2003. Recommendations for the improvement of diagnostic accuracy studies of the PCL are discussed.
Asunto(s)
Escalas de Valoración Psiquiátrica , Trastornos por Estrés Postraumático/diagnóstico , Lista de Verificación , Humanos , Garantía de la Calidad de Atención de Salud/métodosRESUMEN
Assessment of the effort level is an essential step in establishing the internal validity of any neuropsychological evaluation. The use of response bias measures as part of a core battery, however, is less common outside of forensic evaluations. The amount of time needed to administer many of these tests is often cited as a likely explanation for their exclusion from routine neuropsychological evaluations. This study examined all three trials of the Test of Memory Malingering (TOMM) in a large sample (n = 213) of inpatients on an epilepsy monitoring unit with the goal of establishing cut scores for early termination. TOMM Trial 1 demonstrated impressive diagnostic accuracy for determining both adequate and suboptimal levels of effort; various cut scores and classification statistics are presented. The optional Retention trial from the TOMM also increased the hit rate 16% in the detection of poor effort. Clinical implications, limitations, and directions for further research are discussed.