Peralta 1999.
Study characteristics | |||
Patient sampling | Prospective, consecutive. | ||
Patient characteristics and setting |
N included in study: 660. N in analysis: 660. Age: Range of mean ages across diagnostic groups: 28.4 to 44.9 years. Gender: M 384, F 276. Ethnicity: Not reported. Comorbid disorders: Not reported. Duration of symptoms: Not reported. Concurrent medications used: Not reported. Inclusion criteria: Symptoms at admission: delusions, hallucinations,marked formal thought disorder, gross disorganised behaviour, severe negative symptoms, or catatonic symptoms. Exclusion criteria: Demonstrable brain disorders, drug misuse confounding diagnosis, mental retardation, serious medical disease or lack of reliable external sources of information. Study aim: Examine the diagnostic significance of FRSs for schizophrenia. Previous treatment for schizophrenia: Not reported. Clinical setting: Inpatients. Country: Spain. |
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Index tests |
Description of FRS used: First‐rank symptoms were assessed by the authors through the Manual for the Assessment of Schizophrenia (MAS) interview assessing 12 FRS's, including "made feelings" symptoms. FRS rated with SAPS ( Scale for the Assessment of Positive Symptoms, 1984). Professionals performing test: Two authors, doctors in the psychiatric unit. Resolution of discrepancies: Not reported. How FRS used in study: Diagnosis. |
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Target condition and reference standard(s) |
Reference standard: Three sets of reference criteria were used: DSM‐III‐R narrow concept (i.e. DSM‐III‐R schizophrenia), a DSM‐III‐R broad concept (i.e. schizophrenia, schizophreniform disorder and schizoaffective disorder) and the Feighner* criteria for definite schizophrenia (Feighner et al, 1972). Target condition(s): Schizophrenia, schizophreniform disorder, schizoaffective disorder, mood disorder, delusional disorder, brief reactive psychosis, atypical psychosis. Professionals performing test: Two authors, doctors in the psychiatric unit.. Resolution of discrepancies: Consensus diagnoses were made by two authors after reviewing all the available information. Inter‐rater reliability for DSM‐111‐R and Feighner schizophrenia was 0.88 and 0.76, respectively. |
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Flow and timing |
Study process: Diagnoses were made using the reference standards at the end of the index admission. FRS assessed in clinical interviews conducted within the first five days of admission. Follow‐up: Not reported. Exclusions: Not explicitly reported. All patients included in the analysis. |
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Comparative | |||
Notes | Part of the Pamplona Study on the phenomenology of functional psychotic disorders. *Feighner's definition was used as the 'gold standard' because it does not give particular diagnostic emphasis to FRSs |
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Methodological quality | |||
Item | Authors' judgement | Risk of bias | Applicability concerns |
DOMAIN 1: Patient Selection | |||
Was a consecutive or random sample of patients enrolled? | Yes | ||
Was a case‐control design avoided? | Unclear | ||
Did the study avoid inappropriate exclusions? | Unclear | ||
Unclear | Low | ||
DOMAIN 2: Index Test All tests | |||
Were the index test results interpreted without knowledge of the results of the reference standard? | Unclear | ||
Did the study pre‐specify whether they were using one or multiple FRSs? | Yes | ||
Unclear | Low | ||
DOMAIN 3: Reference Standard | |||
Is the reference standards likely to correctly classify the target condition? | Yes | ||
Were the reference standard results interpreted without knowledge of the results of the index tests? | Unclear | ||
Unclear | Low | ||
DOMAIN 4: Flow and Timing | |||
Was there an appropriate interval between index test and reference standard? | Yes | ||
Were all patients included in the analysis? | Yes | ||
Did all patients receive a reference standard? | Yes | ||
Did all patients receive the same reference standard? | Yes | ||
Did all patients receive an index test? | Yes | ||
Did all patients receive the same index test? | Yes | ||
Low |