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<title xml:lang="en">Adapting the Posterior Probability of Diagnosis (PPOD) Index to Enhance Evidence-Based Screening: An Application to ADHD in Primary Care</title>
<author>
<name sortKey="Lindhiem, Oliver" sort="Lindhiem, Oliver" uniqKey="Lindhiem O" first="Oliver" last="Lindhiem">Oliver Lindhiem</name>
<affiliation>
<nlm:aff id="A1">University of Pittsburgh, School of Medicine, Department of Psychiatry</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Yu, Lan" sort="Yu, Lan" uniqKey="Yu L" first="Lan" last="Yu">Lan Yu</name>
<affiliation>
<nlm:aff id="A1">University of Pittsburgh, School of Medicine, Department of Psychiatry</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Grasso, Damion J" sort="Grasso, Damion J" uniqKey="Grasso D" first="Damion J." last="Grasso">Damion J. Grasso</name>
<affiliation>
<nlm:aff id="A2">University of Connecticut, Department of Psychiatry</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kolko, David J" sort="Kolko, David J" uniqKey="Kolko D" first="David J." last="Kolko">David J. Kolko</name>
<affiliation>
<nlm:aff id="A1">University of Pittsburgh, School of Medicine, Department of Psychiatry</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Youngstrom, Eric A" sort="Youngstrom, Eric A" uniqKey="Youngstrom E" first="Eric A." last="Youngstrom">Eric A. Youngstrom</name>
<affiliation>
<nlm:aff id="A3">University of North Carolina at Chapel Hill, Department of Psychology and Psychiatry</nlm:aff>
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<idno type="pmid">25000935</idno>
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<idno type="RBID">PMC:4285573</idno>
<idno type="doi">10.1177/1073191114540748</idno>
<date when="2014">2014</date>
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<title xml:lang="en" level="a" type="main">Adapting the Posterior Probability of Diagnosis (PPOD) Index to Enhance Evidence-Based Screening: An Application to ADHD in Primary Care</title>
<author>
<name sortKey="Lindhiem, Oliver" sort="Lindhiem, Oliver" uniqKey="Lindhiem O" first="Oliver" last="Lindhiem">Oliver Lindhiem</name>
<affiliation>
<nlm:aff id="A1">University of Pittsburgh, School of Medicine, Department of Psychiatry</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Yu, Lan" sort="Yu, Lan" uniqKey="Yu L" first="Lan" last="Yu">Lan Yu</name>
<affiliation>
<nlm:aff id="A1">University of Pittsburgh, School of Medicine, Department of Psychiatry</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Grasso, Damion J" sort="Grasso, Damion J" uniqKey="Grasso D" first="Damion J." last="Grasso">Damion J. Grasso</name>
<affiliation>
<nlm:aff id="A2">University of Connecticut, Department of Psychiatry</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kolko, David J" sort="Kolko, David J" uniqKey="Kolko D" first="David J." last="Kolko">David J. Kolko</name>
<affiliation>
<nlm:aff id="A1">University of Pittsburgh, School of Medicine, Department of Psychiatry</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Youngstrom, Eric A" sort="Youngstrom, Eric A" uniqKey="Youngstrom E" first="Eric A." last="Youngstrom">Eric A. Youngstrom</name>
<affiliation>
<nlm:aff id="A3">University of North Carolina at Chapel Hill, Department of Psychology and Psychiatry</nlm:aff>
</affiliation>
</author>
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<title level="j">Assessment</title>
<idno type="ISSN">1073-1911</idno>
<idno type="eISSN">1552-3489</idno>
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<date when="2014">2014</date>
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<p id="P1">This study adapts the Posterior Probability of Diagnosis (PPOD) Index for use with screening data. The original PPOD Index, designed for use in the context of comprehensive diagnostic assessments, is overconfident when applied to screening data. To correct for this overconfidence, we describe a simple method for adjusting the PPOD Index to improve its calibration when used for screening. Specifically, we compare the adjusted PPOD Index to the original index and Naïve Bayes probability estimates on two dimensions of accuracy, discrimination and calibration, using a clinical sample of children and adolescents (
<italic>N</italic>
= 321) whose caregivers completed the Vanderbilt Assessment Scale to screen for Attention-Deficit/Hyperactivity Disorder (ADHD) and who subsequently completed a comprehensive diagnostic assessment. Results indicated that the adjusted PPOD Index, original PPOD Index, and Naïve Bayes probability estimates are comparable using traditional measures of accuracy (sensitivity, specificity, AUC) but the adjusted PPOD Index showed superior calibration. We discuss the importance of calibration for screening and diagnostic support tools when applied to individual patients.</p>
</div>
</front>
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<front>
<journal-meta>
<journal-id journal-id-type="nlm-journal-id">9431219</journal-id>
<journal-id journal-id-type="pubmed-jr-id">20737</journal-id>
<journal-id journal-id-type="nlm-ta">Assessment</journal-id>
<journal-id journal-id-type="iso-abbrev">Assessment</journal-id>
<journal-title-group>
<journal-title>Assessment</journal-title>
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<issn pub-type="ppub">1073-1911</issn>
<issn pub-type="epub">1552-3489</issn>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">25000935</article-id>
<article-id pub-id-type="pmc">4285573</article-id>
<article-id pub-id-type="doi">10.1177/1073191114540748</article-id>
<article-id pub-id-type="manuscript">NIHMS603502</article-id>
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<subject>Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Adapting the Posterior Probability of Diagnosis (PPOD) Index to Enhance Evidence-Based Screening: An Application to ADHD in Primary Care</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Lindhiem</surname>
<given-names>Oliver</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Yu</surname>
<given-names>Lan</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Grasso</surname>
<given-names>Damion J.</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kolko</surname>
<given-names>David J.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Youngstrom</surname>
<given-names>Eric A.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>1</label>
University of Pittsburgh, School of Medicine, Department of Psychiatry</aff>
<aff id="A2">
<label>2</label>
University of Connecticut, Department of Psychiatry</aff>
<aff id="A3">
<label>3</label>
University of North Carolina at Chapel Hill, Department of Psychology and Psychiatry</aff>
<author-notes>
<corresp id="cor1">Corresponding Author: Oliver Lindhiem, Ph.D., University of Pittsburgh, School of Medicine, Department of Psychiatry, 3811 O'Hara St., Pittsburgh, PA 15213, Office: 537 Bellefield Towers, Phone: 412-246-5909, Fax: 412-246-5341,
<email>lindhiemoj@upmc.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted">
<day>13</day>
<month>6</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub">
<day>06</day>
<month>7</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="ppub">
<month>4</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>01</day>
<month>4</month>
<year>2016</year>
</pub-date>
<volume>22</volume>
<issue>2</issue>
<fpage>198</fpage>
<lpage>207</lpage>
<pmc-comment>elocation-id from pubmed: 10.1177/1073191114540748</pmc-comment>
<abstract>
<p id="P1">This study adapts the Posterior Probability of Diagnosis (PPOD) Index for use with screening data. The original PPOD Index, designed for use in the context of comprehensive diagnostic assessments, is overconfident when applied to screening data. To correct for this overconfidence, we describe a simple method for adjusting the PPOD Index to improve its calibration when used for screening. Specifically, we compare the adjusted PPOD Index to the original index and Naïve Bayes probability estimates on two dimensions of accuracy, discrimination and calibration, using a clinical sample of children and adolescents (
<italic>N</italic>
= 321) whose caregivers completed the Vanderbilt Assessment Scale to screen for Attention-Deficit/Hyperactivity Disorder (ADHD) and who subsequently completed a comprehensive diagnostic assessment. Results indicated that the adjusted PPOD Index, original PPOD Index, and Naïve Bayes probability estimates are comparable using traditional measures of accuracy (sensitivity, specificity, AUC) but the adjusted PPOD Index showed superior calibration. We discuss the importance of calibration for screening and diagnostic support tools when applied to individual patients.</p>
</abstract>
<kwd-group>
<kwd>evidence-based assessment</kwd>
<kwd>screening</kwd>
<kwd>item response theory</kwd>
<kwd>calibration</kwd>
<kwd>ADHD</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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