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The fallacy of thresholds used in defining response and remission in depression rating scales

Abstract : Response and remission are determined by the proportion of people who fall below a threshold score on depression rating scales. This calculation implies a possibility of false positives (FP) and false negatives (FN) depending on sensitivity and specificity of the threshold used, but also on response and remission rates. A simulation illustrates the methodological consequences of this phenomenon in a comparative trial where response and remission rates differ between groups: the probability of being misclassified differs between groups, and measures of association (relative risk and odds ratio) are biased. Alternatives are proposed to cope with this misclassification bias.
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01147038
Contributor : Laurent Jonchère <>
Submitted on : Wednesday, April 29, 2015 - 3:02:06 PM
Last modification on : Wednesday, September 16, 2020 - 4:58:45 PM

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Florian Naudet, Bruno Millet, Jean Michel Reymann, Bruno Falissard. The fallacy of thresholds used in defining response and remission in depression rating scales. International Journal of Methods in Psychiatric Research, Wiley, 2014, 23 (4), pp.469--473. ⟨10.1002/mpr.1393⟩. ⟨hal-01147038⟩

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