American Academy of Health Care Providers in the Addictive Disorders, 10 Ellet Street, Boston, MA, 02122, USA,
J Gambl Stud. 2014 Sep;30(3):577-607. doi: 10.1007/s10899-013-9380-y.
Much of the debate over how best to estimate the prevalence of problem gambling in the general population is driven by a number of misconceptions, misinterpretations, and questionable, sometimes erroneous assumptions. Among the latter is the failure to understand that what is being validated is not the test but the interpretation of test scores for a specific purpose. In addition there has been a lack of attention to defining the clinical and/or epidemiologic relevance of case definitions in terms of severity and other clinical attributes, a misunderstanding of how test values are interpreted when criterion thresholds or cut-off points are selected, and a failure to replicate the validation of criterion thresholds for defining cases of problem gambling. It is argued further that the distinction between dichotomy and continuum is a false choice, and any emphasis on overestimation is misdirected. Alternative methods for evaluating tests and estimating prevalence are described and a pragmatic empirical approach to the interpretation of prevalence estimates is recommended.
关于如何最好地估计普通人群中赌博问题的流行程度，大部分争论都是由一些误解、曲解和有问题的、有时甚至是错误的假设所驱动的。其中包括未能理解正在验证的不是测试本身，而是针对特定目的对测试分数的解释。此外，人们一直没有关注根据严重程度和其他临床特征来定义病例定义的临床和/或流行病学相关性，也没有理解在选择标准阈值或截止点时如何解释测试值，而且未能复制用于定义赌博问题病例的标准阈值的验证。进一步认为，二分法和连续法之间的区别是一种错误的选择，任何对高估的强调都是错误的。本文还描述了评估测试和估计流行率的替代方法，并建议采用实用的经验主义方法来解释流行率估计值。
