Abstract
Prediction of psychosis in patients at clinical high risk (CHR) has become a mainstream focus of clinical and research interest worldwide. When using CHR instruments for clinical purposes, the predicted outcome is but only a probability; and, consequently, any therapeutic action following the assessment is based on probabilistic prognostic reasoning. Yet, probabilistic reasoning makes considerable demands on the clinicians. We provide here a scholarly practical guide summarising the key concepts to support clinicians with probabilistic prognostic reasoning in the CHR state. We review risk or cumulative incidence of psychosis in, person-time rate of psychosis, Kaplan-Meier estimates of psychosis risk, measures of prognostic accuracy, sensitivity and specificity in receiver operator characteristic curves, positive and negative predictive values, Bayes' theorem, likelihood ratios, potentials and limits of real-life applications of prognostic probabilistic reasoning in the CHR state. Understanding basic measures used for prognostic probabilistic reasoning is a prerequisite for successfully implementing the early detection and prevention of psychosis in clinical practice. Future refinement of these measures for CHR patients may actu...Continue Reading
References
Jul 31, 1975·The New England Journal of Medicine·B J McNeilS J Adelstein
Jan 1, 1991·Journal of Clinical Epidemiology·D L Sackett
Apr 1, 1994·Medical Decision Making : an International Journal of the Society for Medical Decision Making·E J Boyko
Feb 2, 1994·JAMA : the Journal of the American Medical Association·R JaeschkeD L Sackett
Jun 13, 2003·Osteoarthritis and Cartilage·G R Dodge, S A Jimenez
May 1, 1955·Psychological Bulletin·P E MEEHL, A ROSEN
Jul 3, 2004·The British Journal of Psychiatry : the Journal of Mental Science·Laura T NiemiJouko K Lönnqvist
Apr 5, 2007·Acta Paediatrica·Anthony K Akobeng
Nov 5, 2008·Archives of General Psychiatry·Jeremy W CoidPeter B Jones
Apr 22, 2010·Psychological Medicine·C E L GreenL R Valmaggia
Apr 2, 2011·International Journal of Ayurveda Research·Manish Kumar GoelJugal Kishore
Mar 7, 2012·Archives of General Psychiatry·Paolo Fusar-PoliPhilip McGuire
Mar 30, 2012·PloS One·James B KirkbridePeter B Jones
Sep 6, 2012·Southern Medical Journal·Preethi SrinivasanMatt T Bianchi
Sep 6, 2012·Southern Medical Journal·Lawrence E Frisch, Kathryn Morrison
Nov 10, 2012·Acta Psychiatrica Scandinavica·P Fusar-Poli, J Van Os
Nov 21, 2012·JAMA Psychiatry·Paolo Fusar-PoliAlison Yung
Jan 23, 2014·Advances in Health Sciences Education : Theory and Practice·Stacey HallKevin McLaughlin
Sep 25, 2014·The British Journal of Psychiatry : the Journal of Mental Science·Matti PenttiläJouko Miettunen
Mar 5, 2015·European Psychiatry : the Journal of the Association of European Psychiatrists·F Schultze-LutterJ Klosterkötter
Mar 10, 2015·European Psychiatry : the Journal of the Association of European Psychiatrists·S J SchmidtS Ruhrmann
Apr 23, 2015·JAMA Psychiatry·Matthew J KemptonPaolo Fusar-Poli
Jun 5, 2015·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Benno G SchimmelmannFrauke Schultze-Lutter
Jun 6, 2015·The British Journal of Psychiatry : the Journal of Mental Science·Lucia R ValmaggiaPhilip K McGuire
Jul 30, 2015·BMJ Open·Penny F WhitingYoav Ben-Shlomo
Aug 13, 2015·JAMA Psychiatry·Paolo Fusar-Poli
Sep 27, 2015·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Paolo Fusar-PoliPhilip McGuire
Citations
Jun 28, 2016·Schizophrenia Research·Johanne Olivia Grønne KühlMerete Nordentoft
Aug 19, 2016·Schizophrenia Bulletin·André SchmidtPaolo Fusar-Poli
Oct 8, 2016·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Maude SchneiderStephan Eliez
Jan 17, 2017·Psychological Medicine·E StuderusA Riecher-Rössler
Aug 14, 2018·Psychological Medicine·Umut KırlıJim van Os
Oct 23, 2018·JAMA Psychiatry·Paolo Fusar-PoliEwout W Steyerberg
Oct 5, 2018·Evidence-based Mental Health·Sinan Guloksuz, Jim van Os
Jul 30, 2019·Schizophrenia Bulletin·Erich StuderusAnita Riecher-Rössler
Oct 19, 2019·Translational Psychiatry·Paolo Fusar-PoliDaniel Stahl
Mar 15, 2019·European Psychiatry : the Journal of the Association of European Psychiatrists·Magdalena Kotlicka-AntczakPaolo Fusar-Poli
Feb 19, 2020·Molecular Psychiatry·Christina Andreou, Stefan Borgwardt
Mar 12, 2020·JAMA Psychiatry·Paolo Fusar-PoliCelso Arango
Jan 6, 2017·Schizophrenia Bulletin·Paolo Fusar-Poli
Sep 25, 2017·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Paolo Fusar-PoliJohn M Kane
Jan 21, 2018·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Joaquim RaduaPaolo Fusar-Poli
Feb 14, 2018·Schizophrenia Bulletin·Tae Young LeeJun Soo Kwon
Jun 28, 2018·Frontiers in Psychiatry·Cathy DaviesPaolo Fusar-Poli
Apr 9, 2020·Frontiers in Psychiatry·Cristiana MontemagniPaola Rocca
May 31, 2019·Frontiers in Psychiatry·Paolo Fusar-PoliPhilip McGuire
Jan 1, 2017·Schizophrenia Bulletin·Paolo Fusar-PoliJosef Parnas
Feb 8, 2018·European Psychiatry : the Journal of the Association of European Psychiatrists·D OliverP Fusar-Poli
May 19, 2017·Schizophrenia Bulletin·Paolo Fusar-PoliPhilip McGuire
May 13, 2017·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Paolo Fusar-Poli
Jul 21, 2017·European Psychiatry : the Journal of the Association of European Psychiatrists·M P HengartnerA Theodoridou
Dec 20, 2016·European Psychiatry : the Journal of the Association of European Psychiatrists·P Fusar-PoliP McGuire
Nov 12, 2019·Frontiers in Psychiatry·Paolo Fusar-PoliPeter J Uhlhaas
Feb 18, 2017·European Psychiatry : the Journal of the Association of European Psychiatrists·P Fusar-PoliP McGuire
Jan 11, 2020·Frontiers in Psychiatry·Paolo Fusar-PoliJoaquim Radua
Dec 15, 2020·Psychological Medicine·Tae Young LeeJun Soo Kwon
Dec 29, 2020·Frontiers in Psychiatry·Tommaso BoldriniMaria Pontillo
Dec 10, 2020·EClinicalMedicine·Paolo Fusar-PoliPhilip McGuire