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Maximum Likelihood Estimates of the Accuracy of Four Diagnostic Techniques

Department of Clinical Epidemiology and Biostatistics, McMaster University

Harold R. Miller

Department of Psychiatry, McMaster University

This study examined the sensitivities and specificities of four diagnostic techniques used in psychiatry; the clinical interview, the Diagnostic Interview Schedule (DIS), the Psychiatric Diagnostic Interview (PDI), and the Millon Clinical Multiaxial Inventory (MCMI). Subjects consisted of 207 patients drawn from in- and out-patient units, and 32 people from a correctional institution. A maximum likelihood estimation approach was used to estimate the sensitivity and specificity of each instrument. It was found that no one technique was clearly superior to the others. The psychometric properties were highly dependent upon the diagnosis. It was concluded that structured interview schedules are preferred for making diagnoses, but that further development of them is necessary. Self-report scales may be most useful in the description and prediction of individual's behaviors in different situations.

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