Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan;
J Multidiscip Healthc. 2009 Jan 27;2:39-44. doi: 10.2147/jmdh.s4817.
The purpose of this study was to apply a two-stage screening method for the large-scale intelligence screening of military conscripts.
We collected 99 conscripted soldiers whose educational levels were senior high school level or lower to be the participants. Every participant was required to take the Wisconsin Card Sorting Test (WCST) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) assessments.
Logistic regression analysis showed the conceptual level responses (CLR) index of the WCST was the most significant index for determining intellectual disability (ID; FIQ ≤ 84). We used the receiver operating characteristic curve to determine the optimum cut-off point of CLR. The optimum one cut-off point of CLR was 66; the two cut-off points were 49 and 66. Comparing the two-stage window screening with the two-stage positive screening, the area under the curve and the positive predictive value increased. Moreover, the cost of the two-stage window screening decreased by 59%.
The two-stage window screening is more accurate and economical than the two-stage positive screening. Our results provide an example for the use of two-stage screening and the possibility of the WCST to replace WAIS-R in large-scale screenings for ID in the future.
本研究旨在应用两阶段筛选方法对新兵进行大规模智力筛查。
我们收集了 99 名文化程度为高中及以下的应征入伍士兵作为研究对象。要求每位参与者接受威斯康星卡片分类测验（WCST）和韦氏成人智力量表修订版（WAIS-R）评估。
逻辑回归分析显示，WCST 的概念水平反应（CLR）指数是确定智力障碍（智商≤84）的最显著指标。我们使用受试者工作特征曲线确定 CLR 的最佳截断点。CLR 的最佳截断点为 66；两个截断点为 49 和 66。与两阶段阳性筛选相比，两阶段窗口筛选的曲线下面积和阳性预测值增加。此外，两阶段窗口筛选的成本降低了 59%。
两阶段窗口筛选比两阶段阳性筛选更准确、更经济。我们的结果为两阶段筛选的应用以及 WCST 未来在大规模 ID 筛查中替代 WAIS-R 的可能性提供了一个范例。
