Performance of screening and diagnostic tests. Application of receiver operating characteristic analysis

Arch Gen Psychiatry. 1987 Jun;44(6):550-5. doi: 10.1001/archpsyc.1987.01800180068011.


Evaluation of psychiatric screening and diagnostic tests has benefited from the application of sensitivity, specificity, the kappa-statistic, and predictive values. These measures derive their meaning from a single criterion threshold. Receiver operating characteristic (ROC) analysis extends assessment of test performance by providing information about all possible pairs of achievable sensitivity and specificity values. The ROC analysis offers a comprehensive means for comparing different tests or different scoring procedures for one test. As a demonstration we used the ROC analysis to evaluate three types of scoring rules for one psychiatric test, the Health Opinion Survey. The demonstration indicated that ROC analysis can profitably take a place among the standard methods for test evaluation in psychiatric research. In addition, ROC analysis can assist clinicians in selecting appropriate test procedures for particular patient populations.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Borderline Personality Disorder / classification
  • Borderline Personality Disorder / diagnosis
  • False Negative Reactions
  • False Positive Reactions
  • Humans
  • Mental Disorders / classification
  • Mental Disorders / diagnosis
  • Personality Inventory
  • Psychiatric Status Rating Scales*
  • Psychological Tests*
  • Psychometrics
  • Statistics as Topic*