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At risk or not at risk? A meta-analysis of the prognostic accuracy of psychometric interviews for psychosis prediction

Fusar-Poli, Paolo and Cappucciati, Marco and Rutigliano, Grazia and Schultze-Lutter, Frauke and Bonoldi, Ilaria and Borgwardt, Stefan and Riecher-Rössler, Anita and Addington, Jean and Perkins, Diana and Woods, Scott W. and McGlashan, Thomas H. and Lee, Jimmy and Klosterkötter, Joachim and Yung, Alison R. and McGuire, Philip. (2015) At risk or not at risk? A meta-analysis of the prognostic accuracy of psychometric interviews for psychosis prediction. World psychiatry : official journal of the World Psychiatric Association (WPA), 14 (3). pp. 322-332.

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Official URL: https://edoc.unibas.ch/68325/

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Abstract

An accurate detection of individuals at clinical high risk (CHR) for psychosis is a prerequisite for effective preventive interventions. Several psychometric interviews are available, but their prognostic accuracy is unknown. We conducted a prognostic accuracy meta-analysis of psychometric interviews used to examine referrals to high risk services. The index test was an established CHR psychometric instrument used to identify subjects with and without CHR (CHR+ and CHR-). The reference index was psychosis onset over time in both CHR+ and CHR- subjects. Data were analyzed with MIDAS (STATA13). Area under the curve (AUC), summary receiver operating characteristic curves, quality assessment, likelihood ratios, Fagan's nomogram and probability modified plots were computed. Eleven independent studies were included, with a total of 2,519 help-seeking, predominately adult subjects (CHR+: N=1,359; CHR-: N=1,160) referred to high risk services. The mean follow-up duration was 38 months. The AUC was excellent (0.90; 95% CI: 0.87-0.93), and comparable to other tests in preventive medicine, suggesting clinical utility in subjects referred to high risk services. Meta-regression analyses revealed an effect for exposure to antipsychotics and no effects for type of instrument, age, gender, follow-up time, sample size, quality assessment, proportion of CHR+ subjects in the total sample. Fagan's nomogram indicated a low positive predictive value (5.74%) in the general non-help-seeking population. Albeit the clear need to further improve prediction of psychosis, these findings support the use of psychometric prognostic interviews for CHR as clinical tools for an indicated prevention in subjects seeking help at high risk services worldwide.
Faculties and Departments:03 Faculty of Medicine > Bereich Psychiatrie (Klinik) > Erwachsenenpsychiatrie UPK > Erwachsenenpsychiatrie (Riecher-Rössler)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Psychiatrie (Klinik) > Erwachsenenpsychiatrie UPK > Erwachsenenpsychiatrie (Riecher-Rössler)
UniBasel Contributors:Riecher-Rössler, Anita
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Wiley
ISSN:1723-8617
e-ISSN:2051-5545
Note:Publication type according to Uni Basel Research Database: Journal article -- This is the peer reviewed version of the following article: "At risk or not at risk? A meta-analysis of the prognostic accuracy of psychometric interviews for psychosis prediction", which has been published in final form at [see DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Language:German
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Last Modified:26 Mar 2019 10:56
Deposited On:26 Mar 2019 10:56

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