Zhicheng Luo1, Yuqian Li2, Yitan Hou3, Haiqing Zhang1, Xiaotian Liu1, Xinling Qian1, Jingjing Jiang1, Yan Wang1, Xue Liu1, Xiaokang Dong1, Dou Qiao1, Fang Wang4, Chongjian Wang5. 1. Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China. 2. Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, PR China. 3. Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, PR China. 4. Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, PR China. Electronic address: wfang@sxmu.edu.cn. 5. Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China. Electronic address: tjwcj2005@126.com.
Abstract
OBJECTIVE: The two-item generalized anxiety disorder scale (GAD-2) has been investigated in different populations, but with limited evaluation in the Chinese population. This study aimed to validate the diagnostic accuracy of GAD-2 for identifying GAD through a validation study along with an updated meta-analysis. METHODS: We recruited 694 adults in 2015 from "the Henan Rural Cohort study" where the GAD-7 questionnaire was adopted as the gold standard diagnosis. Receiver operating characteristics (ROC) curve and Cronbach's α were determined. Furthermore, a meta-analysis was conducted to evaluate the effectiveness of the GAD-2. RESULTS: In this study, 37 patients [5.33%; 95% confidence interval (CI): 3.78-7.27%] met the criteria for current GAD. The GAD-2 showed a Cronbach's alpha of 0.806 and an area under the ROC curve (AUC) of 0.954 (95% CI: 0.936-0.968). At a cutoff of 3, GAD-2 had highest Youden's index of 0.845, with a sensitivity of 0.865 and a specificity of 0.980. A total of 13 studies were included in the meta-analysis. The pooled sensitivity, specificity and diagnostic odds ratio (DOR) were 0.80, 0.82 and 17.81, respectively, at the optimal cutoff of 3. CONCLUSION: GAD-2 has acceptable properties for identifying GAD at a cutoff of 3 in the Chinese rural population.
OBJECTIVE: The two-item generalized anxiety disorder scale (GAD-2) has been investigated in different populations, but with limited evaluation in the Chinese population. This study aimed to validate the diagnostic accuracy of GAD-2 for identifying GAD through a validation study along with an updated meta-analysis. METHODS: We recruited 694 adults in 2015 from "the Henan Rural Cohort study" where the GAD-7 questionnaire was adopted as the gold standard diagnosis. Receiver operating characteristics (ROC) curve and Cronbach's α were determined. Furthermore, a meta-analysis was conducted to evaluate the effectiveness of the GAD-2. RESULTS: In this study, 37 patients [5.33%; 95% confidence interval (CI): 3.78-7.27%] met the criteria for current GAD. The GAD-2 showed a Cronbach's alpha of 0.806 and an area under the ROC curve (AUC) of 0.954 (95% CI: 0.936-0.968). At a cutoff of 3, GAD-2 had highest Youden's index of 0.845, with a sensitivity of 0.865 and a specificity of 0.980. A total of 13 studies were included in the meta-analysis. The pooled sensitivity, specificity and diagnostic odds ratio (DOR) were 0.80, 0.82 and 17.81, respectively, at the optimal cutoff of 3. CONCLUSION:GAD-2 has acceptable properties for identifying GAD at a cutoff of 3 in the Chinese rural population.
Authors: Frankie Ho Chun Wong; Dara Kiu Yi Leung; Edwin Lok Yan Wong; Tianyin Liu; Shiyu Lu; On Fung Chan; Gloria Hoi Yan Wong; Terry Yat Sang Lum Journal: JMIR Infodemiology Date: 2022-02-25