Using decision theory to derive optimal cut‐off scores of screening instruments: an illustration explicating costs and benefits of mental health screening
- 1 December 2007
- journal article
- research article
- Published by Wiley in International Journal of Methods in Psychiatric Research
- Vol. 16 (4), 219-229
- https://doi.org/10.1002/mpr.230
Abstract
This paper shows how decision theory can be used to determine optimal cut-off scores on mental health screeners. The procedure uses (a) the costs and benefits of correct and erroneous decisions, and (b) the rates of correct and erroneous decisions as a function of the cut-off score. Using this information, for each cut-off point expected costs are calculated. The cut-off point with the lowest expected costs is the optimal cut-off score. An illustration is given in which the General Health Questionnaire is employed as a major depression screener. Optimal cut-off points are determined for four different contexts: patients, health service providers, society, and mental health researchers. As in these four situations different costs are encountered, different optimal cut-off points were found. Copyright © 2008 John Wiley & Sons, Ltd.Keywords
This publication has 21 references indexed in Scilit:
- Economic costs of minor depression: a population‐based studyActa Psychiatrica Scandinavica, 2007
- Cost-utility of brief psychological treatment for depression and anxietyThe British Journal of Psychiatry, 2006
- The economic burden of depression in the US: societal and patient perspectivesExpert Opinion on Pharmacotherapy, 2005
- Screening for depression in primary care: what do we still need to know?Depression and Anxiety, 2004
- Measuring the potency of risk factors for clinical or policy significance.Psychological Methods, 1999
- Assessment of 2 × 2 Associations: Generalization of Signal-Detection MethodologyThe American Statistician, 1988
- Optimal Cutting Scores Using A Linear Loss FunctionApplied Psychological Measurement, 1977
- Primer on Certain Elements of Medical Decision MakingNew England Journal of Medicine, 1975
- Defining a "fair" or "unbiased" selection model: A question of utilities.Journal of Applied Psychology, 1975
- TOWARD AN INTEGRATION OF THEORY AND METHOD FOR CRITERION‐REFERENCED TESTS1,2Journal of Educational Measurement, 1973