The QPD Panel may have greater utility in primary care settings than other mental health tests because it automates diagnostic procedures that would otherwise be performed by physicians and medical support staff. The use of hand-held computer units and diagnostic algorithms allows the test to screen for multiple disorders and make specific psychiatric diagnoses, while requiring no time from physicians or staff to administer or score. Use of a familiar laboratory report format allows quick and easy interpretation of test findings by nonpsychiatric physicians. Diagnostic performance appears as good as or better than that of other recently developed instruments. Because diagnostic specificity is high for all disorders, false-positives are rare. Finally, the QPD Panel is well accepted by primary care patients. Concerns that patients may object to the test appear unfounded.
Limitations
The criterion validity study has several limitations. We used a mental health sample, so prevalences of psychiatric disorders were higher than would be observed in a primary care sample. Future studies should be undertaken to replicate the findings in primary care samples. Also, the study did not provide validity coefficients for dysthymic disorder or bulimia nervosa because of low prevalence rates in the study sample. The diagnostic modules for these disorders have high face validity, and test development followed the same procedures used for the validated modules. However, validation against a criterion standard must await further research. Finally, we made no attempt to validate the diagnosis of bipolar disorder against a criterion standard. We believe a bipolar diagnosis should be made by a mental health professional with detailed knowledge of the patient’s history. Thus, the QPD Panel is designed to screen for possible bipolar disorder but not make actual diagnoses.
Conclusions
In light of its validity and its practicality in primary care settings, the QPD Panel may make routine mental health screening feasible for many more physicians. Such routine screening would benefit the many patients who currently go undiagnosed and untreated.
Acknowledgments
Our research was supported in part by a grant from the Research and Development fund of Kaiser Permanente, Colorado Region, and by an unrestricted educational grant from SmithKline Beecham. We thank the staffs of the Kaiser Permanente Aurora Centre Point, Westminster, and Executive Center clinics.