title: The concurrent validity of a new eDiagnostic system for mental disorders in primary care.
abstract: An eDiagnostic system was implemented to classify mental disorders, to support general practitioners.
  
  
  
  Assessing the validity of the system, compared to the psychologists' judgment.
  
  
  
  Concurrent validity, using routinely collected data of 675 primary care patients with a suspicion of a mental disorder in the Netherlands. Four psychologists classified the patients according to the DSM-IV. Hundred records were randomly selected to investigate the inter-rater reliability among psychologists. To investigate the concurrent validity of the system the sensitivity, specificity, positive predictive values (PPVs), negative predictive values (NPVs) and Cohen's κ-values (κ-values) were calculated.
  
  
  
  Inter-rater agreement between psychologists were fair to good or excellent. The system could correctly estimate the echelon (sensitivity range: 0.85-0.95, specificity range: 0.88-0.98) and correctly identify most Axis I classifications (sensitivity: 0.46-1.00, specificity: 0.75-0.99), except for Asperger's, sexual and adjustment disorders (sensitivity: 0.10-0.24, specificity: 0.97-0.99). It could determine the absence of a personality disorder (sensitivity: 0.81, specificity: 0.84, PPV: 0.77, NPV: 0.87 and κ-value: 0.65). The sensitivities and specificities for most specific personality disorders were good, but the PPVs for several specific Axis II classifications were low (PPV range: 0.06-0.77). The system was inaccurate in identifying the global assessment of functioning of patients (e.g. κ-values varied from 0.17-0.46).
  
  
  
  Generally, the system can be seen as a valid instrument for most DSM-IV classifications in primary care patients. It could assist healthcare professionals in the assessment and classification of mental disorders. Future research should include comparison to an independently administered structured clinical interview.
authors: Department of General Practice, Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands.
authors: Ies
authors: I
authors: Dijksman
authors: Department of General Practice, Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands.
authors: Geert Jan
authors: GJ
authors: Dinant
authors: Department of General Practice, Maastricht University/CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands m.spigt@maastrichtuniversity.nl.|Department of Community Medicine, General Practice Research Unit, the Arctic University of Norway, Tromsø, Norway.
authors: Mark
authors: M
authors: Spigt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D058006:General Practice / Q000379:methods; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D009426:Netherlands; D009729:Nursing / Q000379:methods; D015588:Observer Variation; D010554:Personality Disorders / Q000175:diagnosis; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000379:methods*; D011584:Psychology / Q000379:methods*; D012017:Referral and Consultation; D015203:Reproducibility of Results; D055815:Young Adult
keywords: Diagnostic and Statistical Manual of Mental Disorders; general practitioners; mental health; primary health care; referral and consultation.; sensitivity and specificity