title: Diagnostic performance of the PTSD checklist and the Vietnam Era Twin Registry PTSD scale.
abstract: OBJECTIVE
  Self-report questionnaires are frequently used in clinical and epidemiologic studies to assess post-traumatic stress disorder (PTSD). A number of studies have evaluated these scales relative to clinician administered structured interviews; however, there has been no formal evaluation of their performance relative to non-clinician administered epidemiologic assessments such as the Composite International Diagnostic Interview (CIDI). We examined the diagnostic performance of two self-report PTSD scales, the PTSD checklist (PCL) and the Vietnam Era Twin Registry (VET-R) PTSD scale, compared to the CIDI.
  
  
  METHODS
  Data were derived from a large epidemiologic follow-up study of PTSD in 5141 Vietnam Era Veterans. Measures included the PCL, VET-R PTSD scale and CIDI. For both the PCL and VET-R PTSD scale, ROC curves, areas under the curve (AUC), sensitivity, specificity, % correctly classified, likelihood ratios, predictive values and quality estimates were generated based on the CIDI PTSD diagnosis.
  
  
  RESULTS
  For the PCL and VET-R PTSD scale the AUCs were 89.0 and 87.7%, respectively. Optimal PCL cutpoints varied from the 31-33 range (when considering sensitivity and specificity) to the 36-56 range (when considering quality estimates). Similar variations were found for the VET-R PTSD, ranging from 31 (when considering sensitivity and specificity) to the 37-42 range (when considering quality estimates).
  
  
  CONCLUSIONS
  The PCL and VET-R PTSD scale performed similarly using a CIDI PTSD diagnosis as the criterion. There was a range of acceptable cutpoints, depending on the metric used, but most metrics suggested a lower PCL cutpoint than in previous studies in Veteran populations.
authors.affiliation: Mental Health Service,Ralph H. Johnson VA Medical Center,Charleston,South Carolina,USA.
authors.forename: K
authors.initials: K
authors.lastname: Magruder
authors.affiliation: Mental Health Service,Ralph H. Johnson VA Medical Center,Charleston,South Carolina,USA.
authors.forename: D
authors.initials: D
authors.lastname: Yeager
authors.affiliation: Seattle Epidemiologic Research and Information Center,VA Puget Sound Health Care System,Seattle,Washington,USA.
authors.forename: J
authors.initials: J
authors.lastname: Goldberg
authors.affiliation: Seattle Epidemiologic Research and Information Center,VA Puget Sound Health Care System,Seattle,Washington,USA.
authors.forename: C
authors.initials: C
authors.lastname: Forsberg
authors.affiliation: Massachusetts Epidemiology Research and Information Center,VA Boston Healthcare System,Boston,Massachusetts,USA.
authors.forename: B
authors.initials: B
authors.lastname: Litz
authors.affiliation: Departments of Epidemiology and Medicine,Emory University,Atlanta,Georgia,USA.
authors.forename: V
authors.initials: V
authors.lastname: Vaccarino
authors.affiliation: Department of Veterans Affairs,National Center for Posttraumatic Stress Disorder,White River Junction,Vermont,USA.
authors.forename: M
authors.initials: M
authors.lastname: Friedman
authors.affiliation: Cooperative Studies Program,Clinical Science Research and Development,VA Office of Research and Development,Washington,DC,USA.
authors.forename: T
authors.initials: T
authors.lastname: Gleason
authors.affiliation: Cooperative Studies Program,Clinical Science Research and Development,VA Office of Research and Development,Washington,DC,USA.
authors.forename: G
authors.initials: G
authors.lastname: Huang
authors.affiliation: Seattle Epidemiologic Research and Information Center,VA Puget Sound Health Care System,Seattle,Washington,USA.
authors.forename: N
authors.initials: N
authors.lastname: Smith
keywords: Assessment; CIDI; PCL; PTSD