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Diagnostic Systems and Prognostic Validity

William T. Carpenter Jr, MD; John S. Strauss, MD; John J. Bartko, PhD
Arch Gen Psychiatry. 1980;37(2):228-229. doi:10.1001/archpsyc.1980.01780150118013.
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To the Editor.—  we were impressed with the report by Kendell et al in the Archives (36:25-31, 1979), comparing six diagnostic systems according to their prognostic validity. It helped clarify an issue relevant to our 12-point flexible system that we had left unsettled, and it provides an opportunity to comment on two other points.Using two-year and five-year outcome data, we previously reported that several well-known sets of diagnostic criteria using cross-sectional sign and symptom criteria were weak predictors of outcome in patients classed as schizophrenic.1.2 Findings reported by Kendell et al are consistent in most respects. Our 12-point flexible diagnostic system showed a trend (P <.10) toward predictive significance in our study; hence, that Kendell et al found this system to be a significant predictor of symptomatic course in their study suggests the borderline significance in our data may actually reflect some prognostic power. However, it must be


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