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J Pediatr Psychol. 2014 Mar;39(2):204-21. doi: 10.1093/jpepsy/jst062. Epub 2013 Aug 21.

A primer on receiver operating characteristic analysis and diagnostic efficiency statistics for pediatric psychology: we are ready to ROC.

Author information

1
PhD, Department of Psychology, University of North Carolina at Chapel Hill, Davie Hall CB 3270, Chapel Hill, NC 27599-3270, USA. eay@unc.edu.

Abstract

OBJECTIVE:

To offer a practical demonstration of receiver operating characteristic (ROC) analyses, diagnostic efficiency statistics, and their application to clinical decision making using a popular parent checklist to assess for potential mood disorder.

METHOD:

Secondary analyses of data from 589 families seeking outpatient mental health services, completing the Child Behavior Checklist and semi-structured diagnostic interviews.

RESULTS:

Internalizing Problems raw scores discriminated mood disorders significantly better than did age- and gender-normed T scores, or an Affective Problems score. Internalizing scores <8 had a diagnostic likelihood ratio <0.3, and scores >30 had a diagnostic likelihood ratio of 7.4.

CONCLUSIONS:

This study illustrates a series of steps in defining a clinical problem, operationalizing it, selecting a valid study design, and using ROC analyses to generate statistics that support clinical decisions. The ROC framework offers important advantages for clinical interpretation. Appendices include sample scripts using SPSS and R to check assumptions and conduct ROC analyses.

KEYWORDS:

diagnostic efficiency; evidence-based medicine; receiver operating characteristic analysis; sensitivity and specificity

PMID:
23965298
PMCID:
PMC3936258
DOI:
10.1093/jpepsy/jst062
[Indexed for MEDLINE]
Free PMC Article

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