Brodey B, Purcell SE, Rhea K, et al. (2018). Rapid and accurate behavioral health diagnostic screening: Initial validation study of a web-based self-report tool (the SAGE-SR). Journal of Medical Internet Research. 20(3): e108. doi: 10.2196/jmir.9428
Researchers developed the Screening Assessment for Guiding Evaluation-Self Report (SAGE-SR), a computerized self-report assessment of Diagnostic Statistical Manual-5 (DSM-5) diagnoses to improve the time commitment and clinician burden involved in administering the Structured Clinical Interview for DSM-5 (SCID-5). First, researchers developed 1200 potential items based on 13 DSM-5 diagnostic categories in the SCID, including mood, anxiety, psychotic, and substance use disorders. A panel of 3 psychiatrists, including the lead author of the SCID, and 4 psychologists reviewed items for clarity and correspondence with DSM criteria, reducing the item pool to 664 items. Researchers then conducted cognitive interviews (participants completed SAGE-SR items while providing feedback) with a clinical sample (n=50) and preliminary validation testing of an initial version of the SAGE-SR with healthy (n=85) and clinical (n=44) samples. Clinical interviews resulted in the removal of 4 items and splitting 1 item into 2. During validation testing, a subset of 42 healthy participants returned after 1 week to evaluate test-retest reliability. As expected, the clinical sample took longer, on average, to complete the screener and full measure (9 and 24 minutes, respectively) than the healthy sample (7 and 15 minutes, respectively). The SAGE-SR took less time to complete than the SCID in both samples. All diagnostic categories except mania or hypomania showed at least “good” reliability. The resulting SAGE-SR measure included 661 items, including 65 screener items, scored on a 5-point Likert scale (never to always). Researchers plan to conduct further reliability and validity testing with larger clinical samples.