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Comment & Response |

Computerized Adaptive Test–Depression Inventory Not Ready for Prime Time

Bernard J. Carroll, MBBS, PhD, FRCPsych1
[+] Author Affiliations
1Pacific Behavioral Research Foundation, Carmel, California
JAMA Psychiatry. 2013;70(7):763. doi:10.1001/jamapsychiatry.2013.1318.
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To the Editor The Computerized Adaptive Test–Depression Inventory (CAT-DI)1 is a tour de force of computing that lacks clinical grounding. Clinicians do not need another scale to screen for depression using 7 to 22 items.1 Existing scales2,3 do that well with 10 to 12 items and, unlike CAT-DI, provide a symptom crosswalk to DSM-IV criteria. CAT-DI does not deliver clinically useful symptom profiles: exemplar case 2 (Table 3 in the Gibbons et al article1) was not assessed for sleep, appetite, concentration, or psychomotor disturbances. Thus, after administering CAT-DI, clinicians would still need to administer a standardized scale to verify DSM-IV diagnostic criteria. There is no clinical gain; the objective to “decrease patient and clinician burden” is not achieved. The variably disjunctive item selection process guarantees inconsistent symptom assessments across subjects (Table 3 in the Gibbons et al article1) and longitudinally. Standardized scales avoid these problems. No analyses showed that CAT-DI performance matches existing scales.

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July 1, 2013
Robert D. Gibbons, PhD; David J. Weiss, PhD; Paul A. Pilkonis, PhD; Ellen Frank, PhD; Tara Moore, MA, MPH; Jong Bae Kim, PhD; David J. Kupfer, MD
1Center for Health Statistics, University of Chicago, Chicago, Illinois
2Department of Psychology, University of Minnesota, Minneapolis, Minnesota
3Western Psychiatric Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
JAMA Psychiatry. 2013;70(7):763-765. doi:10.1001/jamapsychiatry.2013.1322.
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