@article{ref1,
title="Developing an optimal short-form of the PTSD Checklist for DSM-5 (PCL-5)",
journal="Depression and anxiety",
year="2019",
author="Zuromski, Kelly L. and Ustun, Berk and Hwang, Irving and Keane, Terence M. and Marx, Brian P. and Stein, Murray B. and Ursano, Robert J. and Kessler, Ronald C.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Although several short-forms of the posttraumatic stress disorder (PTSD) Checklist (PCL) exist, all were developed using heuristic methods. This report presents the results of analyses designed to create an optimal short-form PCL for DSM-5 (PCL-5) using both machine learning and conventional scale development methods. <br><br>METHODS: The short-form scales were developed using independent datasets collected by the Army Study to Assess Risk and Resilience among Service members. We began by using a training dataset (n = 8,917) to fit short-form scales with between 1 and 8 items using different statistical methods (exploratory factor analysis, stepwise logistic regression, and a new machine learning method to find an optimal integer-scored short-form scale) to predict dichotomous PTSD diagnoses determined using the full PCL-5. A smaller subset of best short-form scales was then evaluated in an independent validation sample (n = 11,728) to select one optimal short-form scale based on multiple operating characteristics (area under curve [AUC], calibration, sensitivity, specificity, net benefit). <br><br>RESULTS: Inspection of AUCs in the training sample and replication in the validation sample led to a focus on 4-item integer-scored short-form scales selected with stepwise regression. Brier scores in the validation sample showed that a number of these scales had comparable calibration (0.015-0.032) and AUC (0.984-0.994), but that one had consistently highest net benefit across a plausible range of decision thresholds. <br><br>CONCLUSIONS: The recommended 4-item integer-scored short-form PCL-5 generates diagnoses that closely parallel those of the full PCL-5, making it well-suited for screening.<br><br>© 2019 Wiley Periodicals, Inc.<p /> <p>Language: en</p>",
language="en",
issn="1091-4269",
doi="10.1002/da.22942",
url="http://dx.doi.org/10.1002/da.22942"
}