Blay S L, Ramos L R, Mari J de J
Departamento de Psiquiatria e Psicologia Médica da Escola Paulista de Medicina, São Paulo, Brazil.
J Am Geriatr Soc. 1988 Aug;36(8):687-92. doi: 10.1111/j.1532-5415.1988.tb07169.x.
A validity study of the Brazilian version of the 15-item Short Psychiatric Evaluation Schedule (SPES), included in the mental health assessment of Older Americans Resources and Services (OARS), designed to detect psychiatric disorders in the elderly, against the "caseness" criterion suggested by Cooper and Schwarz was carried out with a community sample, as part of a survey to study health and living conditions of the elderly in a large urban center of a developing country, São Paulo, Brazil. The screening questionnaire was completed by 292 subjects, and 91 were selected for the psychiatric interview. The validity coefficients were as follows: sensitivity 61%, specificity 89%, positive predictive value 66%, negative predictive value 87% and misclassification rate 18%. A discriminant analysis using a stepwise procedure was then applied to select the best item discriminators of the screening questionnaire. The best set of discrimination comprised six items leading to the following validity coefficients: sensitivity 82%, specificity 77%, positive predictive value 58%, negative predictive value 92% and misclassification rate 21%. The possible factors related to false positive and false negative responses on the screening are discussed.
作为一项针对巴西圣保罗这个发展中国家大型城市中心老年人健康与生活状况的调查的一部分,对巴西版15项简短精神评估量表(SPES)进行了效度研究。该量表包含在美国老年人资源与服务(OARS)心理健康评估中,旨在检测老年人的精神障碍,研究以社区样本为对象,对照库珀和施瓦茨提出的“病例”标准展开。292名受试者完成了筛查问卷,其中91人被选入精神科访谈。效度系数如下:灵敏度61%,特异度89%,阳性预测值66%,阴性预测值87%,错误分类率18%。然后应用逐步判别分析程序来选择筛查问卷中最佳的项目判别指标。最佳判别指标组由六个项目组成,得出的效度系数如下:灵敏度82%,特异度77%,阳性预测值58%,阴性预测值92%,错误分类率21%。文中讨论了筛查中与假阳性和假阴性反应相关的可能因素。