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Table 7 Diagnostic performance of the 4DSQ and HADS anxiety scales with respect to detecting any anxiety disorder (prevalence 34%)*

From: Detecting depressive and anxiety disorders in distressed patients in primary care; comparative diagnostic accuracy of the Four-Dimensional Symptom Questionnaire (4DSQ) and the Hospital Anxiety and Depression Scale (HADS)

4DSQ anxiety sensitivity specificity PPV NPV
≥1 0.98 0.20 0.38 0.95
≥2 0.94 0.33 0.41 0.91
≥3 0.90 0.45 0.45 0.90
≥4 0.85 0.57 0.50 0.88
≥5 0.75 0.64 0.51 0.83
≥6 0.70 0.72 0.56 0.82
≥7 0.67 0.78 0.60 0.82
≥8 0.65 0.84 0.67 0.82
≥9 0.59 0.88 0.71 0.81
≥10 0.54 0.90 0.73 0.79
≥11 0.40 0.91 0.70 0.75
≥12 0.32 0.93 0.71 0.73
≥13 0.24 0.94 0.67 0.71
≥14 0.20 0.95 0.67 0.70
HADS anxiety     
≥8 0.98 0.27 0.40 0.96
≥9 0.98 0.35 0.43 0.97
≥10 0.91 0.43 0.45 0.90
≥11 0.84 0.51 0.46 0.86
≥12 0.78 0.63 0.51 0.85
≥13 0.65 0.70 0.52 0.80
≥14 0.58 0.78 0.57 0.78
≥15 0.47 0.83 0.58 0.75
≥16 0.32 0.89 0.59 0.72
≥17 0.21 0.93 0.62 0.70
≥18 0.15 0.97 0.71 0.69
  1. * For each scale three cut-off points are highlighted in bold type: the optimal cut-off point with the best balance between sensitivity and specificity, the best lower cut-off point with a sensitivity ≥0.85, and the best higher cut-off point with a specificity ≥0.85
  2. 4DSQ = Four-Dimensional Symptom Questionnaire
  3. HADS = Hospital Anxiety and Depression Scale
  4. PPV = positive predictive value
  5. NPV = negative predictive value