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Evaluating the value of adding diagn...

Warren, Susan L.

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Evaluating the value of adding diagnostic symptoms using posterior probability and sensitivity/specificity procedures.

Record Type:	Language materials, printed : Monograph/item
Title/Author:	Evaluating the value of adding diagnostic symptoms using posterior probability and sensitivity/specificity procedures./
Author:	Warren, Susan L.
Description:	313 p.
Notes:	Source: Dissertation Abstracts International, Volume: 71-04, Section: B, page: 2115.
Contained By:	Dissertation Abstracts International71-04B.
Subject:	Biology, Biostatistics. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3397576
ISBN:	9781109695670

Evaluating the value of adding diagnostic symptoms using posterior probability and sensitivity/specificity procedures.
Warren, Susan L.

Evaluating the value of adding diagnostic symptoms using posterior probability and sensitivity/specificity procedures. - 313 p.

Source: Dissertation Abstracts International, Volume: 71-04, Section: B, page: 2115.

Thesis (Ph.D.)--The George Washington University, 2010.

Many scientists have expressed concerns about the validity of psychiatric diagnoses. Because psychiatric illnesses are not directly observable and because latent class analysis has a number of beneficial properties (e.g., does not require symptoms to be continuously distributed or additive in the way they combine, aims for homogeneity within the classes), several authors have advocated the use of latent class analysis for the evaluation of psychiatric diagnostic criteria. The overall goal of the research was to further develop statistical methodology for latent class analysis in order to evaluate the value for improved diagnostic accuracy/precision of adding symptoms to diagnostic criteria. The research examined a Standard Procedure, which tested the null hypothesis that the candidate symptom had equal prevalence in all classes, and new statistics, which were designed to characterize and test value added for diagnosis. One new statistic focused on posterior probabilities and predictive precision/discrimination and the second focused on sensitivity/specificity and diagnostic accuracy. The statistics were investigated using simulations with differing levels of symptom and diagnostic prevalence and sample sizes. The results showed that the tests developed for the new statistics afforded considerably lesser power than the Standard Procedure to reject the hypothesis of equal symptom prevalence across classes, but the interpretation information that was obtained from the new statistics could aid clinical research because the statistics were grounded in interpretable standards of diagnostic accuracy, involving sensitivity, specificity and Area Under the Curve. In addition, the Standard Procedure was found to be sensitive to data sparseness so might not be appropriate to use to examine rare symptoms and diagnoses. The methods were also applied to data collected in a substantive study of child anxiety disorders. Three candidate symptoms were examined for inclusion in the diagnosis of social phobia: (1) inhibited behavior, (2) discomfort with disapproval/praise, and (3) fear of scolding/reprimand. Based upon the research, none were recommended for inclusion in the diagnosis of social phobia.

ISBN: 9781109695670Subjects--Topical Terms:

1018416
Biology, Biostatistics.

Evaluating the value of adding diagnostic symptoms using posterior probability and sensitivity/specificity procedures.
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020 $a 9781109695670
035 $a (UMI)AAI3397576
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040 $a UMI $c UMI
100 1 $a Warren, Susan L. $3 1669078
245 1 0 $a Evaluating the value of adding diagnostic symptoms using posterior probability and sensitivity/specificity procedures.
300 $a 313 p.
500 $a Source: Dissertation Abstracts International, Volume: 71-04, Section: B, page: 2115.
500 $a Advisers: Karen Bandeen-Roche; Samuel J. Simmens.
502 $a Thesis (Ph.D.)--The George Washington University, 2010.
520 $a Many scientists have expressed concerns about the validity of psychiatric diagnoses. Because psychiatric illnesses are not directly observable and because latent class analysis has a number of beneficial properties (e.g., does not require symptoms to be continuously distributed or additive in the way they combine, aims for homogeneity within the classes), several authors have advocated the use of latent class analysis for the evaluation of psychiatric diagnostic criteria. The overall goal of the research was to further develop statistical methodology for latent class analysis in order to evaluate the value for improved diagnostic accuracy/precision of adding symptoms to diagnostic criteria. The research examined a Standard Procedure, which tested the null hypothesis that the candidate symptom had equal prevalence in all classes, and new statistics, which were designed to characterize and test value added for diagnosis. One new statistic focused on posterior probabilities and predictive precision/discrimination and the second focused on sensitivity/specificity and diagnostic accuracy. The statistics were investigated using simulations with differing levels of symptom and diagnostic prevalence and sample sizes. The results showed that the tests developed for the new statistics afforded considerably lesser power than the Standard Procedure to reject the hypothesis of equal symptom prevalence across classes, but the interpretation information that was obtained from the new statistics could aid clinical research because the statistics were grounded in interpretable standards of diagnostic accuracy, involving sensitivity, specificity and Area Under the Curve. In addition, the Standard Procedure was found to be sensitive to data sparseness so might not be appropriate to use to examine rare symptoms and diagnoses. The methods were also applied to data collected in a substantive study of child anxiety disorders. Three candidate symptoms were examined for inclusion in the diagnosis of social phobia: (1) inhibited behavior, (2) discomfort with disapproval/praise, and (3) fear of scolding/reprimand. Based upon the research, none were recommended for inclusion in the diagnosis of social phobia.
590 $a School code: 0075.
650 4 $a Biology, Biostatistics. $3 1018416
690 $a 0308
710 2 $a The George Washington University. $b Biostatistics. $3 1285320
773 0 $t Dissertation Abstracts International $g 71-04B.
790 1 0 $a Bandeen-Roche, Karen, $e advisor
790 1 0 $a Simmens, Samuel J., $e advisor
790 1 0 $a Dayton, C. Mitchell $e committee member
790 1 0 $a Lai, Yinglei $e committee member
790 1 0 $a Lachin, John $e committee member
790 1 0 $a Albert, Paul $e committee member
790 $a 0075
791 $a Ph.D.
792 $a 2010
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3397576