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PubMed2001

A pilot study assessing the influences of charge data and group process on diagnostic test ordering by residents.

PURPOSE: Providing charge data to resident physicians has been shown to reduce the amounts spent on diagnostic testing. This pilot study sought to determine the influences of charge data and group decision making on diagnostic test ordering by internal medicine residents. METHOD: In an interactive workshop, 23 internal medicine residents received a hypothetical case. They completed an 18-item questionnaire estimating charges for diagnostic tests and then "ordered" tests. The residents were then randomly divided into groups that either received charge data, received charge data after ordering tests, or received no charge data. The groups ordered tests by consensus. Tests were weighted for appropriateness (+1 to +6) and inappropriateness (-1 to -6). Analyses compared individual and group decisions and effect of availability of charge data. RESULTS: Residents with access to charge data spent less on tests, but also had lower appropriateness scores. The appropriateness of the diagnostic workup was better by groups than by individuals, but cost more. CONCLUSION: Cost-containment interventions targeted towards doctors in training need to address the effect on quality of care and the influence of the group process in clinical decision making. Group diagnostic decisions may be more costly, but more appropriate.

Cost Control↗
PubMed2000

Frequency of dry eye diagnostic test procedures used in various modes of ophthalmic practice.

PURPOSE: There are many suggested dry eye diagnostic test batteries in the literature. However, clinicians use a wide variety of dry eye diagnostic tests in clinical practice due to a number of factors, including time constraints. In addition, there has been no systematic description of the standard of care in diagnosing dry eye in the literature. The purpose of this study is to determine the type and frequency of dry eye diagnostic tests used in various modes of ophthalmic practice across a spectrum of dry eye severity. METHODS: A total of 467 patient charts (patients with a previous dry eye diagnosis) were reviewed retrospectively to determine diagnostic test frequency. In reviewing patient charts, the following tests were identified as performed or not performed: symptom assessment, fluorescein staining, tear break-up time (TBUT), Schirmer test, rose bengal staining, and "tear assessment" (including quantity and quality of the tear meniscus). RESULTS: Dry eye diagnostic tests were used in the following frequencies across all modes of practice: symptom assessment (82.8%), fluorescein staining (55.5%), TBUT (40.7%), tear assessment (22.2%), Schirmer test (8.5%), and rose bengal staining (4.9%). When the clinics are pooled, two test procedures were used with the highest frequency (38.9%). The most commonly performed two-test procedure combination was a symptom assessment combined with fluorescein staining of the cornea (43.7%). CONCLUSIONS: Symptom assessment plays a large role in the diagnosis of dry eye. The current clinical standard of care for dry eye diagnosis includes the performance of at least one test procedure in addition to a symptom assessment.

Contrast Media↗
PubMed1989

A utility-based model for comparing the cost-effectiveness of diagnostic studies.

The effective cost of a diagnostic test is the money spent per unit of diagnostic performance. The latter can be measured as diagnostic utility (DU), the probability-weighted sum of the utilities of the four test outcomes TP, TN, FP, and FN: DU = U(TP)P(TP) + U(TN)P(TN) + U(FP)P(FP) + U(FN)P(FN). DU (which also is called expected utility) incorporates the clinical decision analytic variables sensitivity (Se), specificity (Sp), equivocal fraction (EF), disease probability (P(D)), and outcome utility (U). DU is not an inherent property of a diagnostic test but of test-observer interactions in a clinical setting. The model sets the effective cost (EC) of a diagnostic test = actual direct cost (ADC)/DU. When DU = 1 (perfect test) EC = ADC and the patient benefits from the test dollar for dollar. When DU less than 1, EC exceeds ADC. If DU approaches O, EC becomes infinite; the test has no effectiveness at any cost. DU depends strongly on P(D) if Se and Sp differ significantly; then EC also depends on P(D), and the effective cost of a test performed in the wrong P(D) setting may be several times its actual direct cost. This model of comparing effective costs compares actual direct cost with clinical measures of test performance and utility values that allow expression of patient/doctor fears and preferences. It offers a more clinically realistic setting than models based on costs alone.

Cost-Benefit Analysis↗
PubMed1996

Diagnostic utility of endocrine and neuroimaging screening tests in first-onset adolescent psychosis.

OBJECTIVE: To determine the diagnostic utility of endocrine and neuroimaging screening tests in first-onset adolescent psychosis. METHOD: 111 consecutively admitted adolescents (aged 13 through 19 years) who presented with a first-onset psychosis and who had an unremarkable medical history and normal physical examination were given a battery of endocrine and neuroimaging screening tests. Diagnostic utility of a screening test was defined as an abnormal result (a positive test) that either led to a previously unknown or unsuspected medical diagnosis or played an important role in the clinical care of the patient. RESULTS: 15.4% of the endocrine screening tests and 11.0% of the neuroimaging screening tests were identified as positive. However, no endocrine and no neuroimaging tests met criteria for diagnostic utility. The direct cost of this screening battery was $636.95 per patient. CONCLUSION: Routine endocrine and neuroimaging screening tests in first-onset adolescent psychosis provide no diagnostic utility and are not cost-effective. Selective use of appropriate endocrine and neuroimaging diagnostic tests in populations with symptoms suggestive of organic disorders should replace routine screening procedures.

Adolescent↗
PubMed2004

Diagnoses and presenting symptoms in an infant psychiatry clinic: comparison of two diagnostic systems.

OBJECTIVE: To present data from a general infant psychiatry clinic, including range and frequency of presenting symptoms, relationship between symptoms and diagnoses, and comparison of two diagnostic systems, DSM-IV and Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-3). METHOD: A retrospective chart review was conducted for 177 children, ages birth to 58 months, who were seen between 1982 and 1997. Presenting symptoms were identified. Subjects were given diagnoses using both DSM-IV and DC: 0-3. Presenting symptom variables were reduced using subjective and empirical determinants. Stepwise regression analyses were used to determine whether presenting symptoms and demographic variables predicted diagnoses. RESULTS: Descriptive statistics on the distribution of current presenting symptoms and assigned diagnosis were compared with previous studies. The study demonstrated interrater reliability for diagnoses using both diagnostic systems, evidence of diagnostic validity via the regression analyses, and good concordance where DSM-IV and DC: 0-3 overlap. DSM-IV disruptive behavior disorders may be better conceptualized in DC: 0-3 as regulatory disorders, leading to alternative conceptualization of the disorder and a different course of treatment. CONCLUSIONS: This study clarifies a developmental progression of presenting symptoms and diagnoses and suggests the need for continued diagnostic re-evaluation in early childhood. Greater attention to relationship factors and consideration of trauma factors is encouraged.

Child↗
PubMed1998

Routine diagnostic laparoscopy is unnecessary in staging tumors of the pancreatic head.

BACKGROUND: This study examined the success of computed tomography (CT) and angiography in predicting resectability of tumors of the pancreatic head and retrospectively examined whether diagnostic laparoscopy would have contributed additional staging information. METHODS: The records of 67 patients with tumors of the pancreatic head were reviewed. Thirty-four patients had unresectable tumors, and 33 had tumors that were considered operable according to CT and angiographic findings. RESULTS: Surgical resection was successful in 27 of 33 patients (82%). Surgical resection was abandoned in 6 cases due to inability to develop a plane behind the pancreatic head in 4 cases, peritoneal implants in 1 case, and an occult hepatic metastasis in 1 case. Diagnostic laparoscopy might have detected metastases in the latter two cases. Thus, in retrospect, diagnostic laparoscopy might have altered management in only 2 of 33 surgical cases (7%). CONCLUSIONS: The potentially limited usefulness of diagnostic laparoscopy in this series, in retrospect, raises the question of whether routinely using diagnostic laparoscopy in staging tumors of the pancreatic head is cost effective.

Adult↗
PubMed2003

Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy.

STUDY DESIGN: A blinded, prospective diagnostic test study was conducted. OBJECTIVES: To assess the reliability and accuracy of individual clinical examination items and self-report instruments for the diagnosis of cervical radiculopathy, and to identify and assess the accuracy of an optimum test-item cluster for the diagnosis of cervical radiculopathy. SUMMARY OF BACKGROUND DATA: Although cervical radiculopathy remains largely a clinical diagnosis, the reliability and diagnostic accuracy of clinical examination items, individually or in combination, for cervical radiculopathy is largely unknown. METHODS: Patients with suspected cervical radiculopathy or carpal tunnel syndrome received standardized electrophysiologic examination of the symptomatic upper quarter followed by a standardized clinical examination by physical therapist examiners blinded to diagnosis. Diagnostic properties were assessed using a neural impairment reference criterion standard. RESULTS: The study involved 82 patients. More than two thirds of 34 clinical examination items had reliability coefficients rated at least fair or better, and 13 items had likelihood ratio point estimates above 2 or below 0.50. A single diagnostic test item cluster of four variables was identified and produced a positive likelihood ratio point estimate of 30.3. The 95% confidence intervals for all likelihood ratio point estimates in this study were wide. CONCLUSIONS: Many items of the clinical examination were found to be reliable and to have acceptable diagnostic properties, but the test item cluster identified was more useful for indicating cervical radiculopathy than any single test item. Upper limb tension Test A was the most useful test for ruling out cervical radiculopathy. Further investigation is required both to validate the test item cluster and to improve point estimate precision.

Adult↗
PubMed2007

Diagnostic yield of routine duodenal biopsies in iron deficiency anaemia: a study from Western Anatolia.

OBJECTIVE: The role of routine endoscopic duodenal biopsies obtained during the evaluation of iron deficiency anaemia is being increasingly emphasized, but insufficiently applied. Diagnostic yield of this practice, mainly identification of coeliac disease, differs in different populations and geographic regions. The aim of this study is to assess the usefulness of routine duodenal biopsies during upper endoscopy in patients presenting with iron deficiency anaemia in Western Anatolia. METHODS: Routine duodenal biopsies were evaluated over a 12-month period in 100 consecutive adult patients with iron deficiency anaemia undergoing upper endoscopy. All potential bleeding lesions were identified and gastric as well as duodenal biopsies were taken for histopathologic investigation. RESULTS: A bleeding lesion is identified in 44% of cases. Duodenal biopsy gives an additional 5% diagnostic yield and revealed three patients with coeliac disease and two patients with giardiasis. One of the patients diagnosed with coeliac disease had a second bleeding lesion at the upper endoscopic examination. Appearance of the duodenal mucosa was normal in all patients including those with diagnostic duodenal biopsy. CONCLUSIONS: Routine duodenal sampling during the upper endoscopic examination gives an additional 5% diagnostic benefit and this practice should be included in the diagnostic work-up of patients with iron deficiency anaemia. As one of the patients who was found to have coeliac disease had a second bleeding lesion that may otherwise explain iron deficiency anaemia, finding a source for bleeding at the upper endoscopy should not preclude duodenal biopsy. Moreover, performing duodenal biopsy is still necessary even though the endoscopic appearance of the mucosa is normal. Aside from coeliac disease, Giardia infestation could be identified as a contributory factor for iron deficiency anaemia, in endemic regions.

Adult↗
PubMed2000

The assessment of quality in medical diagnostic tests: a comparison of ROC/Youden and Taguchi methods.

Diagnostic tests are widely used in many areas of modern technological society, but they are of particular importance in medicine, where early and accurate diagnosis can decrease morbidity and mortality rates of disease. How the quality of diagnostic information and decisions should be measured in a meaningful way has become increasingly important in recent years as an abundance of new diagnostic tests have been introduced. A number of seemingly independent indices are studied for evaluating diagnostic performance such as the receiver operating characteristic curves and signal-to-noise ratios. Designing robustness into diagnostic tests can only be achieved by minimizing the variation in the total number of false diagnosis. This article has undertaken a comparison of signal-to-noise ratios developed by Taguchi in quality engineering and system performance in manufacturing industry. A hybrid is also computed and its relevance to physicians as an efficient assessment method is proposed and strongly encouraged.

Decision Support Techniques↗
PubMed2006

Substance dependence and non-dependence in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD): can an identical conceptualization be achieved?

BACKGROUND: This review summarizes the history of the development of diagnostic constructs that apply to repetitive substance use, and compares and contrasts the nature, psychometric performance and utility of the major diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) diagnostic systems. METHODS: The available literature was reviewed with a particular focus on diagnostic concepts that are relevant for clinical and epidemiological practice, and so that research questions could be generated that might inform the development of the next generation of DSM and ICD diagnoses. RESULTS: The substance dependence syndrome is a psychometrically robust and clinically useful construct, which applies to a range of psychoactive substances. The differences between the DSM fourth edition (DSM-IV) and the ICD tenth edition (ICD-10) versions are minimal and could be resolved. DSM-IV substance abuse performs moderately well but, being defined essentially by social criteria, may be culture-dependent. ICD-10 harmful substance use performs poorly as a diagnostic entity. CONCLUSIONS: There are good prospects for resolving many of the differences between the DSM and ICD systems. A new non-dependence diagnosis is required. There would also be advantages in a subthreshold diagnosis of hazardous or risky substance use being incorporated into the two systems. Biomedical research can be drawn upon to define a psychophysiological 'driving force' which could underpin a broad spectrum of substance use disorders.

Alcoholism↗
PubMed2005

Survey of eye practitioners' attitudes towards diagnostic tests and therapies for dry eye disease.

BACKGROUND: There is a wide variation in the use of diagnostic tests for dry eye disease. The purpose of this study was to survey the attitudes of eye practitioners towards both tests and therapies available for dry eye disease. METHOD: An anonymous, web-based questionnaire was used, containing both quantitative and qualitative sections. RESULTS: Thirty-eight respondents, evenly distributed in experience, confirmed the wide variation of diagnostic tests in use. History and staining techniques were significantly preferred to tests of tear flow (P < 0.05). 'Evidence' was the most valued test characteristic, and was regarded as significantly more important than 'comfort' or 'cost' (P < 0.003). However, 'evidence' was not valued significantly higher than 'ease of use' or 'time taken to perform'. Overall, there was poor satisfaction with diagnostic and therapeutic options in dry eye, for both quantitative and qualitative measures. CONCLUSION: This is the first qualitative study of attitudes towards dry eye disease. Attitudes towards the adequacy of diagnostic tests vary considerably. As evidence supporting a diagnostic test's validity is the most highly valued test characteristic, a systematic review of the topic is justified.

Attitude of Health Personnel↗
PubMed2025

Diagnostic performance of the Sanity 2.0 assay to detect resistance to rifampicin, isoniazid, and fluoroquinolones in tuberculosis.

UNLABELLED: Effective tuberculosis (TB) management relies on prompt diagnosis of Mycobacterium tuberculosis complex (MTBC) and associated drug resistance. The Sanity 2.0 assay is a high-resolution melting assay designed for direct respiratory sample testing, enabling simultaneous detection of MTBC and resistance to rifampicin (RIF), isoniazid (INH), and fluoroquinolones (FQ) in a single step. This study evaluated its diagnostic performance in two registered multicenter trials among bacteriologically confirmed TB patients. Diagnostic performance was evaluated for MTBC detection, as well as for the identification of resistance to RIF, INH, and FQ, using phenotypic drug susceptibility testing, whole-genome sequencing, and a composite reference standard. Agreement analyses were conducted between the Sanity 2.0 assay and Xpert MTB/RIF and Xpert MTB/XDR. Among 611 patients, the Sanity 2.0 assay detected MTBC in 563 patients, exhibiting a sensitivity of 92.1% (95% CI: 89.7-94.0). For detecting resistance to RIF, INH, and FQ, sensitivities exceeded 90%, with specificities of 95.8% (95% CI: 88.5-98.6), 100.0% (95% CI: 96.4-100.0), and 97.8% (95% CI: 93.8-99.3) against the composite reference standard, respectively. The agreement with Xpert MTB/RIF for RIF detection was 98.6% (95% CI: 96.9-99.3). For INH and FQ resistance, the agreement with Xpert MTB/XDR was 92.0% (95% CI: 88.5-94.5) and 94.3% (95% CI: 91.2-96.3), respectively. The Sanity 2.0 assay is a rapid and user-friendly platform capable of detecting both MTBC and key drug resistance. It demonstrated good diagnostic performance and could potentially be an effective alternative to guide individualized anti-TB treatment, especially in resource-limited settings. IMPORTANCE: Rapid and accurate detection of both Mycobacterium tuberculosis complex (MTBC) and key drug resistance is critical to improving tuberculosis treatment outcomes and reducing transmission. However, current molecular diagnostic workflows often require sequential testing, which can delay the initiation of effective and individualized therapy. We evaluated the Sanity 2.0 assay, an integrated high-resolution melting test that simultaneously detects MTBC and resistance to rifampicin, isoniazid, and fluoroquinolone resistance directly from respiratory samples in about 2-3 hours. The assay demonstrated excellent performance, with MTBC detection sensitivity of 92.1% and drug resistance sensitivities exceeding 90% and specificities over 95% against a composite reference standard, as well as strong concordance with World Health Organization-endorsed molecular assays. Implementation of the Sanity 2.0 assay could streamline TB diagnostic workflows; enable rapid, single-step resistance profiling; and facilitate timely, individualized treatment-particularly in resource-limited settings where rapid and comprehensive resistance testing remains a critical unmet need.

Humans↗
PubMed2001

Diagnostic errors in an accident and emergency department.

OBJECTIVES: To describe the diagnostic errors occurring in a busy district general hospital accident and emergency (A&E) department over four years. METHOD: All diagnostic errors discovered by or notified to one A&E consultant were noted on a computerised database. RESULTS: 953 diagnostic errors were noted in 934 patients. Altogether 79.7% were missed fractures. The most common reasons for error were misreading radiographs (77.8%) and failure to perform radiography (13.4%). The majority of errors were made by SHOs. Twenty two diagnostic errors resulted in complaints and legal actions and three patients who had a diagnostic error made, later died. CONCLUSIONS: Good clinical skills are essential. Most abnormalities missed on radiograph were not difficult to diagnose. Junior doctors in A&E should receive specific training and be tested on their ability to interpret radiographs correctly before being allowed to work unsupervised.

Diagnostic Errors↗
PubMed1985

Computer-aided selection of diagnostic tests in jaundiced patients.

A model has been developed for ordering diagnostic tests in jaundiced patients. The system proceeds in two steps: (i) diagnostic hypotheses are calculated for each patient from the results of physical examination and routine biological investigations; (ii) given these hypotheses, the most efficient test (out of 22) for reaching the final diagnosis is selected using four criteria: diagnostic value, risk, financial cost, and time in obtaining the result. This model was tested in 62 patients. In 43 of them (69%), the selected test was sufficient for reaching a diagnostic accuracy of 100%. In this group of patients, a mean of 3.7 (range 1-6) tests per patient was ordered by physicians. In the 19 remaining patients, the selected test was not sufficient for the final diagnosis, thus requiring a multiple choice process. It is suggested that such a system could help physicians to improve the care of patients by more efficient ordering of diagnostic tests.

Adolescent↗
PubMed2005

National survey of diagnostic services for genital herpes.

OBJECTIVE: To investigate the provision of diagnostic services for genital herpes simplex virus (HSV) infection in the United Kingdom. METHODS: National survey of laboratories providing diagnostic services for genital herpes. RESULTS: Completed questionnaires were returned from 25/32 (78%) laboratories participating in the Clinical Virology Network, including seven in London, 12 in the rest of England, one in Wales, four in Scotland, and one in Northern Ireland. Virus culture was the diagnostic method of choice in 20/25 (80%) laboratories; 5/25 (20%) routinely used HSV DNA detection by polymerase chain reaction (PCR). HSV PCR for DNA detection in cerebrospinal fluid (CSF) was available in 17/25 (68%) laboratories. Typing of isolates (HSV-1 or HSV-2) was performed routinely in 22/25 (88%) laboratories. Only 2/25 (8%) laboratories offered HSV type specific serology, although an additional 12/25 (48%) referred requests elsewhere. Consistent with this finding, the number of HSV type specific antibody tests referred to the Health Protection Agency increased by nearly fivefold between 1997 and 2003. CONCLUSIONS: Virus culture remains the preferred diagnostic method for genital herpes, despite evidence indicating that its sensitivity is suboptimal compared to PCR. As HSV PCR is widely available for testing of CSF, it is recommended that clinicians and virologists discuss ways to implement PCR testing of genital swabs, thus enabling greater diagnostic accuracy. A call is made for studies to assess the use of HSV type specific serology in genitourinary medicine (GUM) settings, now that rapid and validated assays have become available and guidelines have been issues to provide recommendations on their use.

Diagnostic Services↗
PubMedDate not supplied

Value of fine needle aspiration cytology in the initial diagnosis of Hodgkin's disease. Analysis of 188 cases with an emphasis on diagnostic pitfalls.

OBJECTIVE: To evaluate the diagnostic accuracy and pitfalls of fine needle aspiration (FNA) cytology in the initial evaluation of Hodgkin's disease (HD) and to assess the influence of the pathologist's experience by comparing the results during two periods. STUDY DESIGN: A total of 170 cytodiagnoses of HD were reviewed and compared with those on the final histopathologic report. Thirty-three cases of HD with a previous, different cytologic diagnosis were also selected. In all the cases under study, FNA was performed as part of the initial diagnostic approach. From a practical perspective, diagnostic errors were divided into major or minor according to the consequences on patient management. RESULTS: Fifteen cytologic diagnoses of HD were followed by a different histologic diagnosis after lymph node biopsy. In 33 cases of HD an erroneous cytologic diagnosis was given prior to biopsy. The sensitivity of the series was 82.4% (86.1% excluding nonrepresentative cases). The positive predictive value reached 91.2%. Sensitivity varied from 79.3% in the first period (1982-1990) to 84.9% in the second (1991-1999) (83.3% and 88.2%, respectively, excluding nonrepresentative cases). Similarly, the positive predictive value increased from 89% to 92.8%. Diagnostic errors with important consequences for patient management diminished from 14 in the first period to 5 in the second. CONCLUSION: Cytology offers a rapid and accurate approach not only for the diagnosis of recurrent HD but also for its initial recognition. These results increase the capacity of FNA as a first-level diagnostic technique in the screening of lymphadenopathies.

Biopsy, Needle↗
PubMedDate not supplied

Value of cytology as an adjunctive intraoperative diagnostic method. An audit of 2,250 consecutive cases.

OBJECTIVE: To evaluate the role of intraoperative cytology (IC) in the improvement of diagnostic accuracy obtained by frozen section (FS) alone. STUDY DESIGN: Comparison of 2,250 intraoperative cytologies performed along with frozen sections, with the final diagnoses achieved on paraffin sections. RESULTS: In 18 cases the diagnoses were deferred until the paraffin sections at the time of intraoperative consultation. The diagnostic accuracy in distinguishing benign from malignant lesions by combined intraoperative cytology and frozen section was 99.2%. The accuracy rate is significantly higher than that reported in large series based on frozen section preparations alone. Sensitivity and specificity were, respectively, 98.2% and 100%. The diagnostic accuracy of each technique alone was 94.9% for FS (sensitivity 89.9%, specificity 97.9%) and 96% for IC (sensitivity 94.9%, and specificity 96.8%). Although specific diagnoses were more frequently formulated on the bases of frozen section examination, FSs were not diagnostic in 113 case in which cytology allowed a specific diagnosis. CONCLUSION: Our results emphasize the increasingly important diagnostic role of intraoperative cytology as an adjunct to frozen section. The approach does have limitations.

Breast Neoplasms↗
PubMed2002

Diagnostic efficiency of borderline personality disorder criteria in hospitalized adolescents: comparison with hospitalized adults.

OBJECTIVE: The authors examined the diagnostic efficiency of borderline personality disorder criteria in adolescent inpatients. For comparison, diagnostic efficiency of borderline personality disorder criteria was also examined in a group of concurrently recruited adult inpatients. METHOD: Adolescents (N=123) and adults (N=106) were reliably assessed with the Personality Disorder Examination, a semistructured diagnostic interview for DSM-III-R personality disorders. Sixty-five adolescents and 50 adults met diagnostic criteria for borderline personality disorder. Conditional probabilities were calculated to determine which borderline personality disorder criteria were most efficient as inclusion criteria and as exclusion criteria. Adolescents and adults were analyzed separately, and the results were compared. RESULTS: There were no significant differences between groups with regard to the base rates of the borderline personality disorder diagnosis nor for any borderline personality disorder criterion. The best inclusion criterion for the adolescents was abandonment fears, though for the adults all symptoms were approximately equivalent in this regard. The most efficient exclusion criterion was uncontrolled anger for the adolescents and impulsiveness for the adults. CONCLUSIONS: In hospitalized patients, borderline personality disorder and its symptoms appear to be as frequent for adolescents as for adults. Despite these surface similarities between groups with respect to symptom patterns, several differences were found at the level of the diagnostic efficiency for individual borderline personality disorder criteria. These differences may shed light on the nature of borderline psychopathology during adolescence.

Adolescent↗