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Comment & Response
July 2013

Computerized Adaptive Test–Depression Inventory Not Ready for Prime Time

Author Affiliations
  • 1Pacific Behavioral Research Foundation, Carmel, California

Copyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Psychiatry. 2013;70(7):763. doi:10.1001/jamapsychiatry.2013.1318

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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